Composite psychosocial risk based on the fear avoidance model in patients undergoing anterior cruciate ligament reconstruction: Cluster-based analysis.

Journal Article (Journal Article)

OBJECTIVES: To examine associations between preoperative fear-avoidance model (FAM) risk subgroup status and patient expectation of surgical success with postoperative outcomes at 6 and 12 months after anterior cruciate ligament reconstruction (ACLR). DESIGN: Cohort study. SETTING: Academic medical center. PARTICIPANTS: 54 patients (25 females) undergoing unilateral ACLR. MAIN OUTCOME MEASURES: Cluster analysis distinguished FAM risk subgroups based on preoperative fear of movement/reinjury, self-efficacy, and pain catastrophizing. Preoperative expectation for surgical success was assessed with a numeric rating scale. Six and 12-month outcomes included Subjective Patient Outcomes for Return to Sport, Knee Injury and Osteoarthritis Outcome Score (KOOS) sports/recreation and quality of life, and International Knee Documentation Committee (IKDC) Subjective Knee Form. RESULTS: Thirteen (24%) patients were "moderate-to-high FAM risk." Moderate-to-high FAM risk patients had lower odds of return to sport at 12 months (OR = 0.3, p = .05) and lower KOOS sports/recreation at 6 months (st. beta = -0.27, p = .05), KOOS quality of life at 12 months (st. beta = -0.42, p = .007), and IKDC at 6 (st. beta = -0.29, p = .04) and 12 months (st. beta = -0.47, p = .001). Higher expectation was associated with lower 6-month IKDC (st. beta = -0.36, p = .008) and 12-month KOOS quality of life (st. beta = -0.29, p = .05). CONCLUSIONS: Preoperative FAM risk influences patient-reported outcomes and return to sport at 6 and 12 months.

Full Text

Duke Authors

Cited Authors

  • Coronado, RA; Bley, JA; Huston, LJ; Pennings, JS; Master, H; Reinke, EK; Bird, ML; Scaramuzza, EA; Haug, CM; Mathis, SL; Vanston, SW; Cox, CL; Spindler, KP; Archer, KR

Published Date

  • July 2021

Published In

Volume / Issue

  • 50 /

Start / End Page

  • 217 - 225

PubMed ID

  • 34116406

Pubmed Central ID

  • PMC8422996

Electronic International Standard Serial Number (EISSN)

  • 1873-1600

Digital Object Identifier (DOI)

  • 10.1016/j.ptsp.2021.05.012


  • eng

Conference Location

  • England