2023 ISAKOS Biennial Congress ePoster
Poor Psychological Readiness Leads to Decreased Return to Sport Following Autologous Chondrocyte Implantation but Does Not Affect Return to Work
Jairo Triana, BS, New York, NY UNITED STATES
Naina Rao, BS UNITED STATES
Michael Buldo-Licciardi, BS, New York UNITED STATES
Arianna Lott, MD, New York, New York UNITED STATES
Nicole Danielle Rynecki, MD, New York, NY UNITED STATES
Jordan Eskenazi, BS, Boca Raton, Florida UNITED STATES
Michael J Alaia, MD, New York, New York UNITED STATES
Laith M. Jazrawi, MD, New York, NY UNITED STATES
Eric Jason Strauss, MD
Kirk Anthony Campbell, MD, New York, NY UNITED STATES
NYU Langone Health Department of Orthopedic Surgery, New York, New York, UNITED STATES
FDA Status Not Applicable
Summary
This study showed that patients that did not return to sport following autologous chondrocyte implantation showed significantly lower clinical outcomes scores and higher subjective reports of fear of reinjury/pain catastrophizing.
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Abstract
Objective
Return to preinjury function in work and sport is dependent on both postoperative physical function and psychological readiness. Kinesiophobia has been studied following various orthopedic surgeries, but data remains scant in patients undergoing cartilage restoration procedures. The purpose of our investigation is to evaluate the effect of fear of reinjury on return to sport (RTS), return to work (RTW), and clinical outcomes following autologous chondrocyte implantation.
Methods
A retrospective review of patients who underwent autologous chondrocyte implantation (ACI) with a minimum of 2-year clinical follow-up was conducted. Patient-reported outcomes collected included the Visual Analog Scale (VAS) and Knee Injury and Osteoarthritis Outcome Score (KOOS). Kinesiophobia and pain catastrophizing was assessed using the Tampa Scale of kinesiophobia-11 (TSK-11) and Pain Catastrophizing Scale (PCS), respectively. Patients were surveyed on their RTS and RTW status.
Results
Fifty-seven patients (50.9% female) were included in our analysis. Twenty-two (38.6%) patients did not RTS. Of the 35 patients (61.4%) who returned, nearly half (48.6%) returned at a lower level of play. TSK-11 scores (p=0.003), PCS (p=0.001), and VAS pain scores (p<0.001) were significantly greater in patients that did not RTS compared to those who returned. All KOOS subscores analyzed were significantly lower (p <0.001) in patients that did not RTS compared to those who returned at the same level or higher. Of the 44 (77.2%) patients previously employed, 97.7% returned to work. Increasing TSK-11 scores were associated with lower odds of returning to sport (p=0.003).
Conclusion
Fear of reinjury decreases the likelihood that patients will return to sport after autologous chondrocyte implantation. Patients that do not return to sport report significantly greater levels of fear of reinjury and pain catastrophizing, and lower clinical knee outcomes. Nearly all patients were able to return to work after surgery.