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. 2024 Sep 18;19(9):e0307720.
doi: 10.1371/journal.pone.0307720. eCollection 2024.

Sex-differences in psychological readiness for return-to-sport following anterior cruciate ligament reconstruction

Turk Robby  1 , Nadim Hussein  2 , Arakua Welbeck  2 , Mallory Faherty  3 , Carolyn Killelea  2 , Lee Diehl  2 , Jocelyn Wittstein  2 , Jonathan Riboh  4 , Alison Toth  2 , Ned Amendola  2 , Timothy C Sell  5
Affiliations

Sex-differences in psychological readiness for return-to-sport following anterior cruciate ligament reconstruction

Turk Robby et al. PLoS One. .

Abstract

Females are at greatest risk for reinjury after return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction (ACLR). The reasons for these sex differences, however, remain unclear. Psychological factors such as kinesiophobia have been identified as a potential predictor for reinjury following RTS. Studies investigating kinesiophobia have identified sex differences, yet whether this holds in the ACLR population remains unknown. The purpose of this study was to examine whether there are sex differences in kinesiophobia and other psychological factors, such as readiness to RTS and self-reported pain in the ACLR population. A total of 20 participants, eleven males (23.0 ± 8.4 years, 178.9 ± 7.6 cm, 76.8 ± 10.4 kg) and 9 females (19.6 ± 5.3 years, 165.1 ± 4.0 cm, 73.2 ± 25.0 kg) voluntarily participated in this study. The Tampa Scale for Kinesiophobia (TSK-11), Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scale, and self-reported pain using a visual analog scale (VAS) were administered after clearance for RTS (10.5 ± 2.3 months post-ACLR). Statistical significance was set a priori at p<0.05. A significant difference between sexes was observed for the ACL-RSI with males reporting a significantly higher score (92.82±16.16) compared to females (77.0±15.54; p = 0.040). There were no significant differences between sexes for VAS for pain (males = 4.55 ± 6.50; females = 1.22 ± 3.31; p = 0.228) and TSK-11 (males = 18.73 ± 3.17; females = 19.67 ± 4.61; p = 0.596). The results of this study demonstrated males had significantly higher ACL-RSI scores than females, suggesting males may have higher psychological readiness following clearance for RTS. This study did not demonstrate significant differences between sexes for kinesiophobia or pain level. Caution in interpretation of results is warranted due to the small sample size, highlighting the need for further research in this area.

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Conflict of interest statement

Jonathan Riboh receives funding for and/or has the following disclosures: Arthrex consultant, Smith & Newphew Consultant, Ptotect 3D Scientific Board and stock options, Pendria scientific board and stock options Alison Toth- Vericel Corp Advisory board, speakers bureau, Fellowship support from arthres, smith & newphew, MitekDepuy, Breg Other authors have declared that no competing interets exist.

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