Surprisingly, Female Athletes Mentally Ready to Return to Sport After ACL Reconstruction Have *Higher* Risk of Re-injury (Small Sample Study)

Overview

Paper Summary › Explain Like I'm Five › Conflicts of Interest › Identified Limitations › Rating Explanation › Good to know › Topic Hierarchy › File Information ›

Paper Summary

Paperzilla title

In a small study of female athletes, those who felt psychologically ready to return to sport after ACL reconstruction, particularly those with high risk appraisal scores, had a higher risk of a second ACL injury within two years. However, all athletes in the re-injury group had hamstring tendon autografts, potentially impacting the results.

Explain Like I'm Five

Scientists found that girl athletes who felt very ready and strong to play sports again after a knee injury were actually more likely to hurt that same knee again. It's like being too confident made their knee riskier.

Possible Conflicts of Interest

Some authors received grants and salary support from the NIH and other organizations. One author consulted on an NIH research grant and is on the NFL Scientific Advisory Board. These affiliations may represent potential conflicts of interest, although it's unclear how much influence they might have had on the design, interpretation, or reporting of this study.

Identified Limitations

Limited generalizability

The study only includes female athletes. Therefore, the findings may not generalize to male athletes.

Small sample size

The sample size is small, with only 39 participants in total and 9 in the second ACL injury group. This small sample size limits the generalizability of the findings and makes it difficult to draw definitive conclusions.

Confounding variable

All participants who sustained a second ACL injury had HS autografts. The influence of graft type on risk of reinjury should be addressed in future research with a larger sample.

Missing data

The lack of information about the actual timing of RTS is a weakness. The study only reports whether athletes met RTS criteria sooner or later, but the actual time to RTS is not analyzed. Given the association of early RTS with increased reinjury risk, this information is crucial for interpreting the results.

Lack of preoperative data

The study did not collect preoperative psychological measures, limiting understanding of potential changes from before surgery to the time of testing.

Rating Explanation

This study has a valuable research question and prospective design. However, the small sample size, particularly the limited number of second ACL injuries, substantially limits the conclusions. Furthermore, it's important to consider the exclusive focus on female athletes and the potential influence of graft type, which wasn't fully explored.

Good to know

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Topic Hierarchy

Domain: Health Sciences

Field: Medicine

Subfield: Orthopedics and Sports Medicine

File Information

Original Title: Female Athletes With Better Psychological Readiness Are at Higher Risk for Second ACL Injury After Primary ACL Reconstruction

Uploaded: July 19, 2025 at 12:40 PM

Privacy: Public