Kinesiophobia in Young Adults after Anterior Cruciate Ligament Reconstruction in a Tertiary Care Center of Northern India: A Prospective Study

Background: Anterior cruciate ligament reconstruction (ACLR) is known to restore good-to-excellent functional knee stability. Despite this, high percentage of patients fails to achieve preinjury sports level. Kinesiophobia (the fear of movement) has been reported to be one of the major causes of limitation to return to sports. Western studies have shown the timing of surgery influences the level of kinesiophobia postoperatively but studies on the Indian population are lacking. Objective: The study aims to ascertain the prevalence of postoperative kinesiophobia among patients undergoing ACLR and identifying the risk factors associated with kinesiophobia using the Tampa Scale for Kinesiophobia score, K-SES (Knee self efficacy Scale), and Visual analog Scale (VAS). Study Design: This was an observational cohort analysis. Materials and Methods: Patients attending the outpatient department from January 2018 to June 2022 for ACLR were included in the study. Patient characteristics (age, sex, and body mass index), pain intensity level (VAS score), and knee self-efficacy scale were used as potential predictor variables for kinesiophobia, which was independently evaluated by Tampa Scale at 48 h postoperative, 2 weeks postoperative and at 6 weeks post-ACLR. Results: The mean Tampa Scale scores reduced from 61.87 preoperatively to 21.3 at 6 weeks postoperatively. Mean self-efficacy scale scores at 48 h, 14 days, and 6 weeks were found to be 12.6, 25.51 and 34.7, respectively. VAS mean pain intensity scores at 48 h, 14 days, and 6 weeks were 4.57 ± 1.07, 1.74 ± 0.72, and 0.39 ± 0.49, respectively. Greater decline in pain intensity scores between 48 h and 14 days was observed than between 14 days and 6 weeks. Conclusions: The prevalence of kinesiophobia decreases during postoperative rehabilitation, but high kinesiophobia is still present in a large portion of the patients after ACLR. The Tampa Scale of Kinesiophobia scoring has been found to be very accurate in identifying and segregating people who have kinesiophobia, as well as significant in measuring these risk factors associated with recovery after ACL reconstruction, providing a better approach to understanding the effect of treatment and measuring risk factors.