急性跟腱断裂后担心再次受伤与伤后恢复较差和运动量较少有关

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2024-10-31 DOI:10.1002/jeo2.70077

Elin Larsson, Agnes LeGreves, Annelie Brorsson, Pernilla Eliasson, Christer Johansson, Michael R. Carmont, Katarina Nilsson Helander

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摘要

目的本研究旨在探讨对跟腱再次损伤的恐惧如何影响患者恢复到以前的运动水平以及跟腱总断裂评分（ATRS）的自我报告结果。方法收集了 2015 年至 2020 年期间在莫恩达尔萨赫格伦斯卡大学医院接受急性跟腱断裂治疗的大批患者的数据。分析了 ATRS 以及有关再次受伤的恐惧、治疗方式、治疗满意度和恢复情况的其他问题。分析的目的是确定再次受伤的恐惧对患者报告的康复情况和体育活动的影响。结果在总共 856 名符合条件的患者中，有 550 人（64%）回答了自我报告问卷并参与了随访。其中，425 人（77%）为男性，125 人（23%）为女性。ATRS、康复百分比、对治疗的满意度、5分制康复程度以及受伤后与受伤前的体力活动水平与再次受伤的恐惧有显著关系（p <0.001）。在接受非手术治疗的患者中，59% 的患者表示害怕再次受伤，而在接受手术治疗的患者中，48% 的患者表示害怕再次受伤（p = 0.024）。表示害怕再次受伤的患者的 ATRS 中位数得分比不表示害怕再次受伤的患者低 15 分（p < 0.001）。结论半数以上跟腱断裂患者害怕肌腱再次受伤。害怕再次受伤的患者的 ATRS 得分明显较低。这表明，在治疗跟腱断裂后，解决心理问题非常重要。证据等级 II 级。

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Fear of reinjury after acute Achilles tendon rupture is related to poorer recovery and lower physical activity postinjury

Purpose

The aim of this study was to investigate how fear of reinjury to the Achilles tendon affects return to previous levels of physical activity and self-reported Achilles tendon Total Rupture Score (ATRS) outcomes.

Methods

Data were collected from a large cohort of patients treated for an acute Achilles tendon rupture at Sahlgrenska University Hospital Mölndal between 2015 and 2020. The ATRS and additional questions concerning fear of reinjury, treatment modality, satisfaction of treatment and recovery were analyzed 1–6 years postinjury. Analysis was performed to determine the impact of fear of reinjury on patient-reported recovery and physical activity.

Results

Of a total of 856 eligible patients, 550 (64%) answered the self-reported questionnaire and participated in the follow-up. Of the participants, 425 (77%) were men and 125 (23%) were women. ATRS, recovery in percentage, satisfaction of treatment, recovery on a 5-point scale and physical activity level post- versus preinjury were significantly related to fear of reinjury (p < 0.001). Of the nonsurgically treated patients, 59% reported fear of reinjury compared to 48% of the surgically treated patients (p = 0.024) Patients that reported fear of reinjury had a 15-point lower median ATRS score than those who did not (p < 0.001).

Conclusion

More than half of patients who have suffered an Achilles tendon rupture are afraid of reinjuring their tendon. Patients who reported fear of reinjury exhibited a significantly lower ATRS score. This indicates the importance of addressing psychological aspects in the treatment after this injury.