Individuals’ experiences of the consequences of anterior cruciate ligament reconstruction surgery

Abstract

Anterior cruciate ligament (ACL) injuries have a profound impact on an individual’s life. The aim of this study was to explore participants’ experiences and perspectives of outcomes of their ACL reconstruction (ACLR) from two to 10 years following surgery, in relation to physical activity, sports, occupation and quality of life. Ten participants completed patient-reported outcome measures (PROM), namely the Tegner Activity Scale, the Knee Outcome and Osteoarthritis Score (KOOS) and the Sports Confidence Scale; and they participated in individual face-to-face semi-structured interviews. The interviews were recorded and transcribed verbatim. The general inductive approach was used for data analysis, and PROMs were analysed descriptively. Two themes were identified from the interviews: “Continuum of fear of re-injury versus confidence” and “Ongoing knee-health related problems and need of health professional advice”. Anterior cruciate ligament reconstruction may lead to long-term fear of injury and behavioural manifestations, with fluctuating levels of confidence during sports. Participants had ongoing knee health-related problems and were concerned about the future risk of re-injury or osteoarthritis. Participants reported good knee function, and yet scored low on quality of life scales (KOOS, median 53/100). The Sports Confidence Scale indicated low knee-related confidence levels (median 41.5/80). Health professionals should consider long-term individual-specific maintenance programmes that improve and maintain confidence and selefficacy for those with ACLR.