Objective To synthesise all qualitative studies investigating patients’ (and parents of paediatric patients) perspectives on their anterior cruciate ligament (ACL) injury and the care they received. Design Systematic review and qualitative evidence synthesis, with certainty of evidence evaluated using GRADE-CERQual. Data sources MEDLINE, The Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, SPORTDiscus and PsycINFO. Eligibility criteria Qualitative studies investigating the perspectives of patients with lived experience of ACL injury. Results We included 56 studies of 806 participants (52% female). Five main themes were identified of mostly moderate-certainty evidence, consistent across different geographical locations and time since injury. Theme 1 (34 studies, 500 participants) ‘ACL – wow, this is bad’: knowledge and beliefs around injury are shaped by external messages both preinjury and postinjury. Theme 2 (40 studies, 562 participants) ‘Who am I now?’: coping with disrupted self-identity. Theme 3 (39 studies, 534 participants) ‘It is easier when you feel supported’: access to individual, interpersonal and community level support can facilitate physical and psychological recovery. Theme 4 (51 studies, 740 participants) ‘Nobody tells you about the head game’: bracing for the psychological roller coaster, including fear of reinjury and despair. Theme 5 (38 studies, 572 participants) ‘I’m not just another statistic’: highlighting the importance of patient-centred care. Conclusions An ACL injury can have significant and lasting impacts on physical, emotional, social and athletic identities. Being cognisant of the impact of external messages and social ecological factors on patients’ perspectives, including their beliefs, preferences, expectations and experiences, may enhance patient outcomes.
Kaplan et al. (Thu,) studied this question.