51 You get what you expect - expectations of recovery following a traumatic knee injury are associated with 1-year outcomes

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Introduction Following traumatic knee injury, patients often have overly optimistic expectations of recovery. We explored: i) factors associated with expectations of complete recovery; and ii) whether expectations were associated with recovery outcomes.Materials and Methods We included 147 participants with anterior cruciate ligament (ACL) and/or meniscal injury from a nationwide cohort study. Baseline (<6 months post-injury) questionnaires included patient and injury characteristics, activity level (Tegner), pain, mental health, and expectations of recovery (expecting complete recovery or not at 1-year post-injury). At 1-year post-injury, participants completed the Patient Acceptable Symptom State (PASS) and global rating of change (GRoC). Logistic and linear regressions were applied.Results Ninety-one participants (62%) expected complete recovery at 1 year (66% women; mean±SD age 36±15 years) and 56 (38%) did not (79% women; 35±15 years). Expecting complete recovery was more likely among participants who had surgery (OR = 2.69, 95% CI 1.34–5.40), were privately insured (OR = 2.16, 95% CI 1.04–4.45), and had higher pre-injury Tegner scores (OR = 1.17, 95% CI 1.01–1.36). Participants with expectations of complete recovery at baseline were more likely to report complete recovery at 1-year: meeting PASS threshold (OR = 2.50, 95% CI 1.25–5.00) and completely recovered on GRoC (OR = 4.10, 95% CI 1.58–10.63).Conclusion Patient expectations of complete recovery after traumatic knee injury were associated with having undergone surgery, having private insurance and higher pre-injury activity levels. Baseline expectations of complete recovery are associated with achieving complete recovery at 1-year, making them a key target for early rehabilitation.

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