Biopsychosocial profiles following ACL reconstruction: A latent class analysis of barriers to return-to-activity.

Objective: Understanding of how biopsychosocial factors interrelate to affect recovery from ACL injuries is essential for improving patient outcomes. This research aimed to use Latent Class Analysis (LCA) to classify individuals post-ACL reconstruction into subgroups reflecting their particular biopsychosocial challenges to recovery.

Design: Cross-Sectional.

Methods: This multisite investigation included 134 ACLR patients approximately 6 months (5.6 months ± 1.8 SD) following surgery. The ACL Reasons scale, various Patient Reported Outcome (PRO), and performance-based measures were assessed. LCA was used to categorize patients into subgroups based on the ACL Reasons scale. Subgroups were then compared across demographic, PRO, and performance-based measures using one-way analysis of variance and chi-squared tests.

Results: LCA identified two distinct groups of patients who were less active after ACL reconstruction, characterized by varying levels of injury related fear, anxiety and depression. These groups reported lower outcomes and demonstrated reduced performance on hop tests in comparison to those who were as active as before their surgery.

Conclusion: Patients less active post-surgery fall into two categories: one hindered by injury-related fear and symptoms, the other by mostly symptoms alone. Tailored interventions could enhance recovery, with one group possibly benefiting from psychological support and the other from a focus on functional and symptomatic treatment.