Background

Patients who have undergone Anterior Cruciate Ligament recontruction (ACLR) not seldom report long term subjective and objective deficits in their knee function. It is known that patients who suffer kinesiophobia can report worse outcomes in knee function.

Hypothesis

Patients with kinesiophobia have inferior self reported and functional outcomes after ACLR.

Methods

48 patients, 38 (79%) men and 10 (21%) women, mean age 30.8 (±7.1), were included in the study 4.7 (±0.9) years after ACLR. All patients were operated by two senior surgeons. Preoperative and postoperative assessements were performed by two sports specialized physical therapists. Patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee score and Tampa Scale of Kinesiophobia (TSK-17). Quadriceps and hamstring muscle isokinetic strength was assessed at 60°/sec and 180°/sec using the HumacNorm dynamometer. Functional performance was tested with the single-leg-hop test for distance and the Y-balance test for anterior reach.

Results

19/48 patients (39.6%) reported a Tampa kinesiophobia score equal or higher than 37 points, above which is the cut off score for kinesiophobia. The KOOS Sports (p=0.06) and Quality of Life subscores (p=0.10) and the Oxford knee score (p=0.33) revealed no significant differences between patients with and without kinesiophobia. Isokinetic peak torque muscle strength deficits at 60°/sec and 180°/sec for knee flexion and extension were between 2% to 6% compared with the contraleteral side, with no significant differences between groups. The single-leg-hop test was 91.8% (±16.8) and 97.5% (±15.6) respectively in the group with and without kinesiophobia (n.s.). The Y-balance test also revealed no significant difference between groups.

Conclusion

At 5 years after ACLR kinesiophobia is present in a substantial amount of patients. It appears that it cannot be detected or evaluated using standard instruments used for assessment after ACLR.