Purpose

This literature review examines the prevalence and severity of depression and anxiety symptoms in adolescents following ACL injury, with a focus on gender-disaggregated data.

Methods

An electronic search was conducted across databases, including Ovid MEDLINE(R), PUBMED, and the Cochrane Library, covering articles from 1964 to February 13, 2024. Primary search terms were “ACL,” “depression,” “anxiety,” and “adolescent,” expanded using medical subject headings (MeSH). Manual searches of references supplemented the database search. Inclusion criteria included studies on depression or anxiety post-ACL injury in adolescents. Exclusion criteria was studies without adolescent participants or focusing exclusively on one sex.

Results

The search identified 62 studies, with five ultimately selected for comprehensive analysis. Four studies reported on depression using various scales, three measured anxiety symptoms. No studies provided gender-disaggregated data. One study found no significant difference in depression scores between adolescent and adult patients. Another study noted that socioeconomic disadvantage correlated with increased depressive and anxiety symptoms post-surgery. An additional study highlighted a significant increase in depression scores from pre- to post-injury among ACL-injured participants compared to uninjured controls.

Conclusion

Our understanding of the psychological consequences of ACL rupture on female adolescent patients is incomplete. Given the high incidence of ACL injuries in this patient group and their potential psychological vulnerability, improving the evidence base in this area could address a previously neglected aspect of care with positive impacts on returning to sport and quality of life. Future studies of high methodological quality are needed to address this gap in the literature.