2025 ISAKOS Biennial Congress ePoster
Validation of a Scale to Assess Psychological Readiness for Return to Sport Following Surgical Treatment of Posterior Cruciate Ligament Injuries
Svenja Höger, MD, Munich, BY GERMANY
Maximilian Hinz, MD, Munich GERMANY
Phillip Schulz, Cand. med., Munich GERMANY
Tilman Bondzio, M.Sc., Prien am Chiemsee, Bavaria GERMANY
Sebastian Siebenlist, MD, MHBA, Prof., Munich, Bavaria GERMANY
Julian Mehl, MD, Munich, Bavaria GERMANY
Philipp Wilhelm Winkler, MD, Assoc. Prof., Linz AUSTRIA
Department of Sports Orthopaedics, Technical University of Munich, Munich, Bavaria, GERMANY
FDA Status Not Applicable
Summary
This study validated the PCL-RSI scale for assessing psychological readiness to return to sport after PCL surgery. Among 38 patients, the scale showed good consistency, correlating with better functional outcomes and less pain. Patients who returned to preoperative sport levels scored significantly higher, indicating the scale’s potential as a tool to guide postoperative care.
ePosters will be available shortly before Congress
Abstract
Background
The existing Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale assesses psychological readiness for returning to sport following anterior cruciate ligament (ACL) reconstruction. This study aimed to validate the ACL-RSI scale for assessing psychological readiness to return to sport after surgical treatment of posterior cruciate ligament (PCL) injuries. The hypothesis was that the PCL-RSI scale is a valid tool for measuring emotions, confidence, and risk assessment in athletes following PCL injury surgery.
Methods
Patients who underwent surgical treatment for PCL injuries between January 2010 and December 2020 were included. Clinical and functional outcomes were assessed using the PCL-RSI, Tegner Activity Scale (TAS), International Knee Documentation Committee subjective knee form (IKDC-SKF), Lysholm Score, and a visual analog scale for pain (VAS). Bilateral stress radiographs (Telos™) were performed to measure posterior tibial translation in comparison to the contralateral side. To assess test-retest reliability, 18 of the 38 patients completed the PCL-RSI scale again after 21 days. Floor and ceiling effects, internal consistency, construct validity, and reliability were analyzed. Statistical significance was set at p<0.05.
Results
Thirty-eight patients (mean age 39.0 ± 12.9 years; 27 males) with a follow-up period of 88.4 ± 36.8 months were included. Functional scores were as follows: PCL-RSI: 53.1 ± 24.6; TAS: 4.0 ± 1.5; IKDC-SKF: 63.8 ± 9.5; Lysholm: 78.1 ± 16.3. No floor or ceiling effects were observed. The PCL-RSI score demonstrated good internal consistency (Cronbach’s alpha = 0.926). It correlated positively with IKDC, Lysholm, and TAS, and negatively with VAS (p<0.05). Patients who returned to their preoperative or higher levels of sport scored significantly higher on the PCL-RSI scale (64.9 ± 24.1) compared to those who did not return (43.9 ± 21.3, p<0.05). Posterior tibial translation at follow-up was significantly reduced compared to preoperative measurements (3.8 ± 3.5 mm vs. 8.5 ± 6.7 mm, p<0.05).
Conclusion
This study demonstrates that the PCL-RSI scale is a valid instrument for assessing psychological readiness to return to sport following surgical treatment of PCL injuries. Patients with higher psychological readiness for return to sport showed better functional outcomes and were more likely to achieve their preoperative activity levels after PCL injury surgery. The PCL-RSI scale could be a valuable tool in postoperative care, helping clinicians to identify patients who may benefit from targeted psychological support to enhance their recovery and return to sport.