Self-Directed Psychological Support After ACL Reconstruction

Key Takeaways

• Return to sport at 12 months was similar in participants receiving BANG plus usual care and usual care alone.
• Functional and psychological outcomes were not significantly different between groups.

A 24-week internet-delivered psychological support program added after ACL reconstruction did not improve 12-month return to sport in a randomized controlled trial. Investigators compared BAck iN the Game (BANG) plus usual care with usual care alone after reconstruction. At 12 months, return to sport was 36% in both groups.

The trial randomized 161 participants, with 80 assigned to BANG plus usual care and 81 to usual care alone. Participants were 15 to 30 years old and had played contact or noncontact pivoting sports at least twice weekly before injury. All intended to return to pivoting sports after anterior cruciate ligament reconstruction.

BANG was a 24-week internet-delivered psychological support program based on cognitive behavioral therapy principles, and sports participation was reported every fortnight after reconstruction.

The primary endpoint was return to sport at 12 months, with a risk ratio of 1.01 for the between-group comparison. The 95% confidence interval was 0.59 to 1.73, and the P value was .971. Investigators also assessed functional and psychological outcomes at 3, 6, and 12 months after ACL reconstruction, and knee function was measured at 12 months.

Across follow-up, 12 participants sustained new ACL injuries, with 6 events recorded in each group.