Trial reportSports health
Female Athletes With Better Psychological Readiness Are at Higher Risk for Second ACL Injury After Primary ACL Reconstruction.
Trial report in Sports health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Primary anterior cruciate ligament reconstruction in female athlete-specific literature lacks standardization in outcome reporting : a scoping review.Bone & joint open · 2026Pooled it
- Return-to-Sport Outcomes and Psychological Readiness to Return to Sport After Revision Compared to the Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis.Sports medicine - open · 2026Pooled it
- The utility of psychological readiness scales in predicting return to sport: a systematic review.BMC psychology · 2025Pooled it
- ACL injuries in elite alpine skiing reliably allow athletes to return to competition and perform at or above their pre-injury level.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Psychological and Physical Readiness Profiles for Return to Sport in Patients After Anterior Cruciate Ligament Reconstruction: An Analysis of 822 Patients.Orthopaedic journal of sports medicine · 2026Article
- Postoperative Anterior Cruciate Ligament-Return to Sport after Injury Scores Predict Reinjury in Adolescent Athletes.Orthopaedic journal of sports medicine · 2026Article
- From Slump to Comeback: Psychological Determinants of Performance Decline, Burnout, and Recovery in Competitive Athletes-A Systematic Review.Sports (Basel, Switzerland) · 2026Review
- Muscle performance but not biomechanics associate with second knee injury in a matched cohort of athletes who passed functional return-to-sport criteria after ACL reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Beyond the Injury: A Case Report on Psychological Intervention During ACL Rehabilitation in a Professional Futsal Player.International journal of environmental research and public health · 2025Article
- Sports Injuries in Female and Non-Binary Athletes: A Systematic Review.Current reviews in musculoskeletal medicine · 2025Review
- Young Athletes Perceiving Greater Improvement After Return to Sport Bridge Program Sustained More Ipsilateral ACL Graft or Contralateral ACL Injuries During Their First Season Back: An Observational Study.Journal of functional morphology and kinesiology · 2025Article
- Greater psychological response and participation in knee-strenuous activity 8 months after anterior cruciate ligament reconstruction in patients with generalised joint hypermobility who sustained a second anterior cruciate ligament injury: A cross-sectional registry study.Journal of experimental orthopaedics · 2025Article
- Return to preinjury pivoting sports after anterior cruciate ligament reconstruction is different between males and females, as are the patient-reported reasons.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Translation, cross-cultural adaptation, and validation of the Chinese version of the injury-psychological readiness to return to sport scale.BMC sports science, medicine & rehabilitation · 2025Article
- Reason Profiles for not Returning to Preinjury Activity Level Following Anterior Cruciate Ligament Reconstruction- A Latent Class Analysis With Subgroup Comparison of Patient-Reported Outcome Measures.Orthopaedic journal of sports medicine · 2025Article
- Administering the ACL-RSI Before or After ACL Functional Testing: Does It Matter?International journal of sports physical therapy · 2025Article
- Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) subcategories are affected by subjective running ability and medial single-leg hop distance in postreconstruction patients at 6 months.Journal of experimental orthopaedics · 2024Article
- It is time to target psychological readiness (or lack of readiness) in return to sports after Anterior Cruciate Ligament tears.Journal of experimental orthopaedics · 2023Article
- Differences in psychological readiness for return to sport after anterior cruciate ligament injury is evident in thigh musculature motor unit characteristics.BMJ open sport & exercise medicine · 2023Article
- The Influence of Psychosocial Factors on Patients Undergoing Anterior Cruciate Ligament Reconstruction.Sports healthReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundApproximately 1 in 4 athletes returning to sports will sustain a second anterior cruciate ligament (ACL) injury. Psychological factors related to kinesiophobia, confidence, and psychological readiness are associated with second ACL injury; however, the evidence is conflicting. HYPOTHESIS: Athletes who sustain a second ACL injury (ie, graft rupture or contralateral ACL rupture) within 2 years of ACL reconstruction (ACLR) would have greater kinesiophobia, less confidence, and lower psychological readiness prior to return to sport (RTS) compared with athletes who do not sustain a second ACL injury. STUDY
designSecondary analysis of a prospective randomized trial. LEVEL OF EVIDENCE: Level 3.
methodsA total of 39 female Level I/II athletes completed the following measures after postoperative rehabilitation and a 10-session RTS and second ACL injury prevention program: ACL Return to Sport after Injury (ACL-RSI) scale, the 11-item Tampa Scale of Kinesiophobia (TSK-11), and question 3 on the Knee injury and Osteoarthritis Outcome Score (KOOS) quality of life (QoL) subscale. Athletes were dichotomized based on whether they sustained a second ACL injury within 2 years of ACLR or not. Independent
resultsNine athletes sustained a second ACL injury (4 graft ruptures and 5 contralateral ACL ruptures). The group that sustained a second ACL injury had higher scores on the ACL-RSI (
conclusionAthletes who sustained a second ACL within 2 years of ACLR had a more positive psychological outlook, higher scores on the specific questions related to the risk appraisal construct of the ACL-RSI, and met RTS criteria sooner than athletes who did not sustain a second ACL injury. CLINICAL RELEVANCE: Counseling athletes about delaying RTS to reduce the risk of second ACL injury may be especially important in athletes who display high psychological readiness and meet RTS criteria sooner.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.