The Impact of Preoperative Anxiety on the Incidence of Arthrogenic Muscle Inhibition After Anterior Cruciate Ligament Reconstruction

Background: A patient's psychological state plays an important role in the functional outcome of anterior cruciate ligament (ACL) reconstruction. The outcome can be impaired by arthrogenic muscle inhibition (AMI), which is a potentially severe complication after ACL reconstruction. It is better to identify patients at risk of AMI to provide appropriate management. Purpose/Hypothesis: The goal of this study was to evaluate the impact of preoperative anxiety on the incidence of AMI at 21 days after ACL reconstruction. It was hypothesized that patients with high preoperative anxiety would more frequently have AMI on day 21 (D21) after ACL reconstruction than less anxious patients. The secondary goal of this study was to evaluate the rate of AMI on D21 after ACL reconstruction in the high and low anxiety groups. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective cohort study was performed on 143 patients who underwent ACL reconstruction between May and June 2024 at a sports surgery center. The Surgical Fear Questionnaire (SFQ), assessing surgery-related anxiety, was completed by patients before surgery. The incidence of AMI (grade ≥1a) on D21 was the main outcome measure. Patients were divided into 2 groups according to their median SFQ score (≥30 = high anxiety;