Association Between Functional Muscle Assessment and Psychological Factors on Return to Sport and Graft Failure After ACL Reconstruction.

Background: Few researchers have examined both psychological and physical factors simultaneously in return to sport (RTS) and reinjury. Purpose: To assess the role of psychological profiles and physical aspects in RTS and reinjury risk and to inform and develop innovative treatment strategies that may be beneficial after anterior cruciate ligament (ACL) reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: During the rehabilitation process, patients (aged 18-45 years) with ACL reconstruction (using patellar tendon or hamstring autografts) were screened. A statistical analysis was conducted using the cluster method and ascending hierarchical cluster analysis (Ward method), which allowed us to highlight a 4-cluster solution ( Results: The study included a total of 162 athletes to determine psychological profiles. The prospective follow-up percentage for patients who responded was 75.9% regarding RTS and reinjury. Profile 1 (intermediate) was characterized by "moderate reinjury anxiety, no depression"; profile 2 (intermediate depressive) by "moderate reinjury anxiety and minor anxious-depressive reaction"; profile 3 (confident) by "no reinjury anxiety, no depression, high confidence"; and profile 4 (negative) by "high anxiety, high depression, low confidence." The percentage of female athletes was higher in profile 4 than in profile 3 ( Conclusion: Profile 3, which was the most confident and least deficient, and recovered the fastest, had the most relapses. Reinjured athletes in profiles 1 and 2 had deficits in strength, particularly in their hamstrings. Individuals in profile 4, who rarely returned to sports, were the most anxious, the most deficient, and had the greatest difficulty returning to sports.