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Войти в исследования Orthopaedics & traumatology, surgery & research : OTSR · 2026
Association between preoperative anxiety and postoperative pain and stiffness after anterior cruciate ligament reconstruction: a retrospective, single-center study.
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Gay Alice, Noailles Thibaut, Sanchez Matthieu, Morin Vincent, Boue Lisa, Bourret Stéphane, Hardy Alexandre
Аннотация
INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction is a common, minimally invasive outpatient procedure, but it is often associated with preoperative anxiety that can adversely affect postoperative outcomes. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a validated tool for assessing both anxiety and information needs. We evaluated the association between preoperative anxiety, as measured by the APAIS, and the occurrence of postoperative pain and flexion contracture following ACL reconstruction.
MATERIALS AND METHODS: This single-center retrospective observational study included patients who underwent ACL reconstruction in 2024. Preoperative anxiety was assessed using the French version of the APAIS. This score was calculated during the pre-anesthesia consultation. Patients with an APAIS score >11 were classified as "anxious." Immediately after surgery, analgesic consumption (levels 1-3 or use of locoregional anesthesia) and the duration of postoperative monitoring were recorded. Postoperative complications, including flexion contracture and the need for revision surgery, were evaluated at 3 weeks.
RESULTS: In total, 201 patients were included (52.7% men, 47.3% women; mean age, 25.4 years). Preoperative anxiety was identified in 18.4% of patients. Compared to non-anxious patients, anxious patients demonstrated a 2.5-fold increase in the use of level 2 analgesics in the immediate postoperative period and a 7-fold increase in the likelihood of requiring locoregional anesthesia in the recovery room. No associations were observed between preoperative anxiety and the occurrence of flexion contracture at 3 weeks.
CONCLUSION: In patients undergoing ACL reconstruction, preoperative anxiety was significantly associated with increased analgesic requirements in the immediate postoperative period. Systematic screening and management of anxiety may help improve short- and medium-term postoperative outcomes.
LEVEL OF EVIDENCE: IV; retrospective study.
MATERIALS AND METHODS: This single-center retrospective observational study included patients who underwent ACL reconstruction in 2024. Preoperative anxiety was assessed using the French version of the APAIS. This score was calculated during the pre-anesthesia consultation. Patients with an APAIS score >11 were classified as "anxious." Immediately after surgery, analgesic consumption (levels 1-3 or use of locoregional anesthesia) and the duration of postoperative monitoring were recorded. Postoperative complications, including flexion contracture and the need for revision surgery, were evaluated at 3 weeks.
RESULTS: In total, 201 patients were included (52.7% men, 47.3% women; mean age, 25.4 years). Preoperative anxiety was identified in 18.4% of patients. Compared to non-anxious patients, anxious patients demonstrated a 2.5-fold increase in the use of level 2 analgesics in the immediate postoperative period and a 7-fold increase in the likelihood of requiring locoregional anesthesia in the recovery room. No associations were observed between preoperative anxiety and the occurrence of flexion contracture at 3 weeks.
CONCLUSION: In patients undergoing ACL reconstruction, preoperative anxiety was significantly associated with increased analgesic requirements in the immediate postoperative period. Systematic screening and management of anxiety may help improve short- and medium-term postoperative outcomes.
LEVEL OF EVIDENCE: IV; retrospective study.