The Effect of the Anxiety State before and After Acl Reconstruction on the Treatment Success

Background: A tear in the ACL is usually treated surgically. This procedure is considered a complicated surgery with a long rehabilitation. Only 65% of the patients regain full function of the knee. There is limited data about the psychological effect on the outcome.

Our hypothesis suggests a negative correlation between the patient’s anxiety and the surgical outcomes- higher depression and anxiety rates bring to a decline in the surgical outcome.

Methods: A prospective study of 20 patients over 1 year. The patients scheduled to over go ACL reconstruction are examined physically and mentally by appropriate questionnaires.

The questionnaires are filled before the procedure, and 4 times during the

rehabilitation: 6 weeks after the procedure, 3, 6 and 12 months after the procedure.

The questionnaires that were filled are: State-Trait Anxiety Inventory (STAI), Beck

Depression Inventory (BDI), Short Form 36 (SF36), Lysholm (knee function).

Results: Significant improvements were found in the Lysholm scores, especially between the mean score six weeks after the surgery, 48.9, and a year after the surgery, 78.65 (p=0.001). The Physical Component Summary (PSC) of the SF36 showed significant improvements, especially between the mean score six weeks after the surgery, 34.17, and a year after the surgery 47.43 (p<0.0001). The Mental Component Summary (MSC) of the SF36 score showed significant improvements, especially between the mean score before the surgery, 43.07, and a year after the surgery 51.405 (p=0.021).

A significant correlation between the Lysholm score and the STAI score was found: after six months the correlation coefficient was -0.659 (p=0.001) and after a year the correlation coefficient was 0.559 (p=0.012).

A correlation was found between the Lysholm and the BDI score (R=-0.772, p<0.0001).

Another correlation was found between the PSC of the SF36 score and the BDI score (R=-0.60, p=0.005).

Conclusions: The mental state before and after ACL reconstruction effects the surgical outcome and physical functioning of the knee.