Psychological Readiness and Kinesiophobia Are Not Associated With Effusion-Synovitis in Early Recovery After Anterior Cruciate Ligament Reconstruction.

CONTEXT: Effusion-synovitis commonly develops following anterior cruciate ligament reconstruction (ACLR) and may influence physical and psychological recovery. We examined the association between effusion-synovitis severity and psychological readiness to return to sport and kinesiophobia at 4 to 6 months post-ACLR. DESIGN: Cross-sectional. METHODS: We assessed 52 participants (age = 18.4 [4.0] y; 27 females; time since surgery = 5.0 [0.9] mo) between 4 and 6 months post-ACLR. We graded effusion-synovitis using the Outcome Measures in Rheumatology ordinal scale (0 = absent to 3 = severe) from suprapatellar ultrasound images and dichotomized into absent/mild (grades 0-1, n = 24) and moderate/severe (grades 2-3, n = 28) groups. We assessed psychological readiness and kinesiophobia using the ACL Return to Sport after Injury Scale and the Tampa Scale of Kinesiophobia-11, respectively. We compared outcomes between groups using analysis of covariance models adjusted for time since surgery and sex. Sensitivity analyses treated effusion-synovitis as an ordinal variable (Spearman correlations) and as a binary variable (no effusion vs any effusion). RESULTS: Effusion-synovitis grade distribution: grade 0, n = 6 (11.5%); grade 1, n = 18 (34.6%); grade 2, n = 18 (34.6%); and grade 3, n = 10 (19.2%). We observed no significant between-group in kinesiophobia (absent/mild: 21.3 [5.4], moderate/severe: 22.0 [5.7]; F1,48 = 0.01, P = .927; 95% CI, 0.000-0.041) or psychological readiness (absent/mild: 62.2 [20.2], moderate/severe: 56.0 [27.2]; F1,48 = 0.00, P = .990; 95% CI, 0.000-0.000). Sensitivity analyses yielded consistent null findings. CONCLUSIONS: Effusion-synovitis severity did not associate with kinesiophobia or psychological readiness at 4 to 6 months post-ACLR, with small effect sizes.