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JRPMS Vol 2, No 4, December 2018, p.124-130

doi: 10.22540/JRPMS-02-124


Review Article

Fear of re-injury following ACL reconstruction: an overview

Stavros D. Papadopoulos1, Maksim Tishukov1, Konstantinos Stamou1, Trifon Totlis1,2, Konstantinos Natsis1,3

  1. Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Heath Sciences, Aristotle University of Thessaloniki, Greece
  2. Thessaloniki Minimally Invasive Surgery (TheMIS) Orthopaedic Center, St. Luke’s Hospital, Thessaloniki, Greece
  3. Interbalkan Medical Center, Thessaloniki, Greece

Keywords: ACL reconstruction, Kinesiophobia, Sports injuries, Rehabilitation, Return to sports


Patients undergo ACL reconstruction not only to avoid subsequent meniscal or chondral injuries and early osteoarthritis, but especially to return to the pre-injury level of activity. Yet, this level of activity is achieved in only 40 to 70% of the cases. This inability to return to the pre-injury level of activity, even when functional tests allow medical clearance to continue sports, is mainly attributed to fear of re-injury or kinesiophobia. This fear affects the athlete’s physical abilities, function and return to sports. Thus, it should be considered as a real risk factor undermining the patients’ knee movement and should be one of the core targets for the rehabilitation programme. Healthcare professionals have to assess the athletes that present with fear of re-injury and implement into their rehabilitation programme the appropriate adjunctive interventions, such as the “graded exposure”.