Activity level, kinesiophobia, and sports injury-related anxiety in professional athletes after anterior cruciate ligament reconstruction

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Introduction This study aimed to examine the associations between anterior cruciate ligament reconstruction (ACL-R) status, activity level, kinesiophobia, and sports injury-related anxiety in professional athletes. Methods This cross-sectional observational study included 115 athletes post-ACL-R and 153 age- and sex-matched healthy athletes. All participants completed the Tegner Activity Scale, Sports Injury Anxiety Scale, and Tampa Scale of Kinesiophobia–Short Version. Results Athletes in the ACL-R group demonstrated significantly lower activity levels compared with controls (6.50 ± 2.63 vs. 8.12 ± 2.30, p < 0.001). No significant between-group differences were observed in sports injury-related anxiety (53.94 ± 13.08 vs. 52.77 ± 12.67, p = 0.643) or kinesiophobia (18.13 ± 3.01 vs. 18.05 ± 2.82, p = 0.990). Kinesiophobia and sports injury-related anxiety were significantly positively correlated in both the ACL-R group ( r = 0.285, p = 0.002) and the control group ( r = 0.365, p < 0.001). Tegner activity level was not significantly correlated with psychological variables in either group. In the ACL-R group, age, surgery year, and return-to-sport time were significant predictors of activity level, whereas sex, injury year, and psychological variables were not significant predictors. Conclusion Professional athletes following ACL-R demonstrated lower activity levels than healthy controls, while kinesiophobia and sports injury-related anxiety were comparable between groups. Psychological variables were not independently associated with activity level after adjustment for demographic and injury-related factors.