Sport Injury-Related Growth and Quality of Life Trajectories in Young Athletes After Anterior Cruciate Ligament Reconstruction: A Mixed Methods Study.

CONTEXT: The purpose of this study was to describe young athletes' trajectories of perceived quality of life (QOL) following anterior cruciate ligament injury and reconstruction, and to explore how athletes conceptualize QOL during recovery.

DESIGN

A mixed methods study integrating quantitative QOL trajectories with qualitative description of athletes' individual experiences.

METHODS

Semistructured interviews were conducted with 13 Australian athletes (mean age: 21, 7 males and 6 females) 1-year after anterior cruciate ligament reconstruction. During interviews, participants rated their perceived QOL at 3 timepoints (preinjury, preoperative, and 1-y postoperative) using a visual analog scale (0-100). Participants were asked to discuss their injury, surgical, and recovery experiences, including perceptions and conceptualizations of QOL across time. Descriptive analyses were used to characterize QOL trajectories. Interview transcripts were coded and analyzed independently by 2 reviewers using inductive thematic analysis to identify themes related to the changes in QOL.

RESULTS

Athletes' mean self-reported QOL exhibited a V-shaped trajectory: preinjury (80 [11]), preoperative (39 [22]), to 1-year postoperative (78 [12]). Qualitative analysis identified an overarching theme of sport injury-related growth, which provided insight into how athletes perceived and made sense of improvements in QOL. Sport injury-related growth was characterized by 4 distinct mechanisms: satisfaction with surgery (optimism regarding surgical outcomes), gratitude (identifying benefits of the injury experience), cognitive reframing (shifting focus to life domains unaffected by injury), and resilience (recognizing personal strength).

CONCLUSION

Young athletes generally regained acceptable levels of perceived QOL at 1-year postoperative following anterior cruciate ligament reconstruction. The presence of sport injury-related growth mechanisms may help explain these favorable trajectories and should be considered when interpreting postoperative outcomes.