Males have higher psychological readiness to return to sports than females after anterior cruciate ligament reconstruction: a systematic review and meta-analysis

• Published in: BMJ Open Sport & Exercise Medicine 2024, Vol.10 (4), p.e001996
• Main Authors: Obradovic, Anja, Manojlovic, Marko, Rajcic, Aleksandra, Jankovic, Stefan, Andric, Nikola, Ralic, Vuk, Zlicic, Tamara, Aleksic, Branko, Ninkovic, Srdjan, Veraksa, Aleksander, Drid, Patrik
• Format: Article
• Language: English
• Subjects: Athletes; Females; Gender; Gender differences; Joint and ligament injuries; Knee; Knee injuries; Knee surgery; Meta-analysis; Registration; Sport and exercise psychology; Sports injuries; Surgery; Systematic Review
• ISSN: 2055-7647; 2055-7647
• DOI: 10.1136/bmjsem-2024-001996

ObjectivesTo examine sex differences in psychological readiness to return to sport following anterior cruciate ligament (ACL) reconstruction as well as to determine whether males and females separately fulfilled cut-off values (≥65) of psychological readiness necessary to return to sport.Information sourcesWeb of Science, Scopus and PubMed were comprehensively searched from inception to January 2024 to identify relevant studies.Eligibility criteriaObservational investigations that compared males and females with a history of ACL reconstruction concerning psychological readiness to return to sport.Risk of biasStudies were rated using the Methodological Index for Non-Randomised Studies.Included studiesOnly 11 reports fulfilled the eligibility criteria and were included in the quantitative analysis. A total of 2618 participants were subjected to the primary ACL reconstruction, out of 1631 males and 987 females. Psychological readiness to return to sport was evaluated approximately 9±2.9 months following surgery.Synthesis of resultsThe main findings demonstrated that males had slightly higher psychological readiness to return to the sport than females (standardised mean difference 0.33; 95% CI 0.14 to 0.52; p=0.0007; I2=77%) after ACL surgery. In addition, the mean psychological readiness to return to the sport of males was 70.1±8.8 points and of females 65.1±8.8 points, indicating that both sexes exceeded recommendations necessary to return to sport.ConclusionMales had slightly higher psychological readiness to return to sport than females approximately 9±2.9 months after ACL reconstruction and both sexes exceeded the highlighted recommendations necessary to return to sport.PROSPERO registration numberCRD42024497769: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024497769.