ArticleOrthopaedic journal of sports medicine2026
The Impact of Preoperative Anxiety on the Incidence of Arthrogenic Muscle Inhibition After Anterior Cruciate Ligament Reconstruction.
Article in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02511158 (Prospective Follow-up Study of Patients Undergoing Knee Ligament Surgery), which is not on this map. Not yet cited in PubMed.
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Prospective Follow-up Study of Patients Undergoing Knee Ligament Surgery
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Abstract
Background: A patient's psychological state plays an important role in the functional outcome of anterior cruciate ligament (ACL) reconstruction. The outcome can be impaired by arthrogenic muscle inhibition (AMI), which is a potentially severe complication after ACL reconstruction. It is better to identify patients at risk of AMI to provide appropriate management. Purpose/Hypothesis: The goal of this study was to evaluate the impact of preoperative anxiety on the incidence of AMI at 21 days after ACL reconstruction. It was hypothesized that patients with high preoperative anxiety would more frequently have AMI on day 21 (D21) after ACL reconstruction than less anxious patients. The secondary goal of this study was to evaluate the rate of AMI on D21 after ACL reconstruction in the high and low anxiety groups. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective cohort study was performed on 143 patients who underwent ACL reconstruction between May and June 2024 at a sports surgery center. The Surgical Fear Questionnaire (SFQ), assessing surgery-related anxiety, was completed by patients before surgery. The incidence of AMI (grade ≥1a) on D21 was the main outcome measure. Patients were divided into 2 groups according to their median SFQ score (≥30 = high anxiety; <30 = low anxiety) and paired for age, sex, and Tegner score. Analysis of the receiver operating characteristic curve and logistic regression analysis were performed to identify the optimal SFQ score to predict the presence of AMI on D21. The rate of secondary arthrolysis was also retrospectively recorded at 6 months after surgery in all patients. Results: After pairing, 55 patients were included in the high anxiety group (mean age, 31.0 ± 11.7 years; mean SFQ score, 43.7 ± 10.8) and 45 in the low anxiety group (mean age, 33.5 ± 11.6 years [ Conclusion: This prospective study showed that preoperative anxiety was associated with early AMI after ACL reconstruction. However, preoperative anxiety had no effect on the need for arthrolysis. Clinically, these findings suggest that the preoperative identification of anxious patients using the SFQ may help guide targeted perioperative interventions and rehabilitation strategies to reduce the risk of AMI and improve early functional recovery. Registration: NCT02511158 (ClinicalTrials.gov).
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