Fear of reinjury may impact return to sport after MPFL reconstruction
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Key takeaways:
- Psychological factors may negatively impact return to sport after medial patellofemoral ligament reconstruction.
- Fear of reinjury was the top reason cited for not returning to sport.
According to published results, fear of reinjury and other psychological factors may negatively impact return to sport rates among athletes who underwent medial patellofemoral ligament reconstruction.
Researchers performed a retrospective literature review of 18 studies that included 1,072 athletes (1,116 knees) who underwent MPFL reconstruction for patellar instability.
The most common sports included in the studies were soccer, cycling, volleyball/handball and basketball.
Overall, researchers found high rates of return to sport after MPFL reconstruction. Return to sport rates ranged from 60% to 100%, while time to return to sport ranged from 3 months to 10.4 months. In addition, 55.6% to 84% of athletes returned to sport without a decrease in level of competition.
Researchers found fear of reinjury was the top reason for not returning to sport or returning to sport at a lower level of competition, as reported by six studies. Researchers noted loss of interest or personal reasons, pain and decreased function were also factors that negatively impacted return to sport. They noted volleyball or handball athletes had the lowest return to sport rates (18.2% to 50%).
“Surgeons can use this information to advise patients on expectations following surgery,” the researchers wrote in the study.
Perspective
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The authors aimed to assess the rates of return to sport and associated factors after medial patellofemoral ligament reconstruction in a systematic review. They reported that 50% of the studies cited fear of reinjury as the main reason for those who did not return to the same level of sport after surgery.
While this is an important and timely topic, it should be noted that one-third of these studies each contributed less than five patients to this analysis, and, therefore, an aggregate assessment may be more helpful in understanding the contributing roles of each factor. In addition, while the authors reported that volleyball/handball had the lowest rate of return to sports, 18 of the 27 sports had three or fewer subjects included, with only four sports having more than 10 subjects, making it difficult to draw generalizable conclusions from these findings.
Future studies should report results in the context of morphologic risk factors in order to optimally stratify risk after isolated MPFL reconstruction, and larger series in this area of study will help better determine the roles of pertinent factors in returning to sports after this procedure.
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