Abstract
Background:
Patient-athletes visiting the orthopaedic clinic are differentially affected by psychological factors including emotional support and depression. Previous studies have reported that compared to pediatric and adolescent athletes who participate in team sports, athletes who participate in individual sports suffer from increased risk of anxiety, depression, eating disorders, concepts related to exercise addiction, and social and attention issues. The purpose of this study is to compare mental and physical health patient-reported outcome domains among individual and team sport youth athletes recovering from Anterior Cruciate Ligament Reconstruction (ACLR).
Hypothesis:
Mental and physical health patient-reported outcome domains may differ between individual and team sport youth athletes recovering from ACLR.
Methods:
Retrospective review at a single institution identified pediatric (<18yo) patients undergoing ACLR between 1/2019-7/2024 who had patient-reported-outcome-measurement-information-system (PROMIS) scores. We collected demographics, sport participation, and PROMIS Anxiety, Depressive Symptoms, Physical Function Mobility, Fatigue, Peer Relationships, and Pain Interference scores at pre-op, 4-6 weeks, 3 months, 6 months, 9 months, and 12 month post-operatively. PROMIS domain T-Scores were categorically cohorted and bivariate analyses were performed across sport groups at each postoperative timepoint.
Results:
In our cohort of ACL reconstruction patients with a mean age 15 ± 2 years, 70 individual sport athletes and 556 team sport athletes were identified. No demographic differences were identified between sport groups (p>0.05). At 4-6 weeks, individual sport athletes demonstrated a higher proportion of moderate to severe Anxiety (24% vs. 12%, p=0.015) and Fatigue (34% vs. 21%, p=0.026) scores than team sport athletes. Individual sport athletes also had a higher proportion of moderate to severely impaired Physical Function Mobility scores (44% vs. 25%, p=0.025) at 3 months post-op. No other significant differences in PROMIS scores domains were identified between individual and team sport athletes at later postoperative timepoints (p>0.05).
Conclusion:
Athletes who participate in individual sports report higher anxiety and fatigue scores at the 4-6 week post-operative visit and lower mobility scores at the 3-month post-operative visits following ACL reconstruction compared to athletes who participate in team sports, though no difference was found at later follow-ups. Therefore, individual sport athletes may require more mental and physical guidance during the first 3 months following ACL reconstruction surgery. This finding suggests that some aspects of team sports may increase coping ability in the first few weeks following ACL reconstruction. However, Peer Relationships PROMIS scores did not differ between team sport and individual sport athletes at these timepoints.
