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Self-efficacy of knee function as a pre-operative predictor of outcome 1 year after anterior cruciate ligament reconstruction

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The knee self-efficacy scale (K-SES) has been shown to have good reliability, validity and responsiveness during rehabilitation for patients’ perceived self-efficacy of knee function. Determinants of self-efficacy of knee function 1 year after ACL reconstruction have been found to be the patients’ internal locus of control and knee symptoms in sports and recreation. The predictive ability of perceived self-efficacy of knee function measured by the K-SES has not been studied in terms of patient outcome after an ACL reconstruction. The purpose of this study was to explore the potential for pre-operative self-efficacy of knee function measured by the K-SES to predict patient outcome in terms of physical activity, knee symptoms and muscle function 1 year after an ACL reconstruction. Thirty-eight patients were evaluated for outcome in terms of physical activity with the Tegner activity scale and the physical activity scale (PAS), knee symptoms with the Lysholm knee scoring scale and the knee injury and osteoarthritis outcome score (KOOS) and knee function with ability tests for muscle function 1 year after ACL reconstruction. Multiple regression and logistic multiple regression analysis were used to evaluate the K-SES as a possible predictor of outcome. The patients’ present perceived self-efficacy of knee function (K-SESPresent) pre-operatively was a significant predictor (P = 0.016) of the patients returning to their intensity and frequency of physical activity (PAS) 1 year after ACL reconstruction, when adjusted for age, gender and pre-injury physical activity level (TegnerPre-injury) (odds ratio = 2.1). The patients’ perceived future self-efficacy of knee function (K-SESFuture) pre-operatively was a significant predictor (P = 0.045) of their self-rated knee function in sports/recreational activities (KOOSSports/recreation) at the 1-year follow-up, when adjusted for age, gender and TegnerPre-injury (R 2 =0.25). The pre-operative K-SESFuture was also a significant predictor (P = 0.023) of the patients’ knee-related quality of life (KOOSQol), at the 1-year follow-up, when adjusted for age, gender and TegnerPre-injury (R 2 =0.23). The pre-operative K-SESFuture was furthermore a significant predictor of an acceptable outcome 1 year after surgery, on the Lysholm knee scoring scale (P = 0.003, odds ratio = 1.7), as well as on KOOSSports/recreation (P = 0.002, odds ratio = 1.6) and knee-related quality of life (KOOSQol) (P = 0.037, odds ratio = 1.4), when adjusted for age, gender and TegnerPre-injury. The pre-operative K-SESFuture was also a significant predictor (P = 0.04) of an acceptable outcome 1 year after surgery, on the one-leg hop for distance (odds ratio = 2.2), when adjusted for age, gender and TegnerPre-injury. In conclusion, this study indicates that patients’ perceived self-efficacy of knee function pre-operatively is of predictive value for their return to acceptable levels of physical activity, symptoms and muscle function 1 year after ACL reconstruction.

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Acknowledgments

This study was supported by a grant from the Swedish National Centre for Research in Sports and the Local Research and Development Council of Göteborg and southern Bohuslän.

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Authors and Affiliations

  1. Department of Orthopaedics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden

    Pia Thomeé, Roland Thomeé, B. I. Eriksson & Jon Karlsson

  2. Department of Medicine, Multidisciplinary Pain Centre, Sahlgrenska University Hospital, Göteborg, Sweden

    Mats Börjesson

  3. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden

    Peter Währborg

  4. Sportrehab – Physical Therapy and Sports Medicine Clinic, Göteborg, Sweden

    Pia Thomeé & Roland Thomeé

  5. Lundberg Laboratory for Orthopaedic Research, Sahlgrenska University Hospital, Gröna Stråket 12, 413 45, Göteborg, Sweden

    Pia Thomeé

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  1. Pia Thomeé
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Correspondence to Pia Thomeé.

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Thomeé, P., Währborg, P., Börjesson, M. et al. Self-efficacy of knee function as a pre-operative predictor of outcome 1 year after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthr 16, 118–127 (2008). https://doi.org/10.1007/s00167-007-0433-6

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