Abstract
Objectives:
Previous studies suggest that psychological readiness influences patients’ ability to return to sport (RTS) after surgery. The purpose of this study is to describe the postoperative psychological state of patients following osteochondral allograft (OCA) transplantation in the knee and to determine whether patient-perceived kinesiophobia is associated with the rate of RTS.
Methods:
A retrospective review of the electronic medical record at a single institution was conducted for all patients that underwent OCA transplantation from January 2010 to January 2020. Patient-reported outcomes including the Visual Analog Scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Tampa Scale of Kinesiophobia-11 (TSK-11) were collected. Patients were surveyed regarding their postoperative RTS status.
Results:
A total of 38 patients (52.6% female) were included in our analysis. Overall, RTS rate was 63.2% (n=24), with 50% (n=12) of these patients returning at a lower level of play. When comparing patients that RTS to those that did not, patients that RTS had significantly superior KOOS pain (p=0.019) and KOOS QOL (p=0.011). Measures of kinesiophobia (TSK-11) were significantly higher among patients that did not RTS (p=0.014), while satisfaction (p=0.410) and pain intensity (p=0.327) were comparable between groups. Logistic regression models controlling for demographic factors, VAS pain scores, and lesion size showed that for every one-point increase in TSK-11 kinesiophobia score, patients were 1.33 times more likely to return to sport at a lower level (p=0.009). For every one-point increase in TSK-11 scores KOOS QOL decreased by 2.39 points (p<0.001).
Conclusions:
Fear of reinjury decreases the likelihood that patients will return to their pre-operative level of sport after OCA transplantation. Patients that do not RTS report significantly greater fear of reinjury and inferior clinical outcomes, despite similar levels of satisfaction and pain compared to those that RTS.
