Abstract
CONTEXT: How specific coping strategies are associated with short-term outcomes among athletes after knee surgery is unknown. OBJECTIVE: To determine whether (1) specific coping strategies were associated with return to sport, satisfaction, self-reported knee function, or kinesiophobia after sport-related knee surgery and (2) these associations varied by age, sex, or surgical procedure. STUDY DESIGN: Case series. METHODS: Athletes (N = 184; men: n = 104, women: n = 80; aged <20 years: n = 38; aged 20-25 years: n = 35; aged 26-31 years: n = 36; aged 32-40 years: n = 36; aged >40 years: n = 39) who underwent outpatient knee surgery at a single center were enrolled. Use of specific coping strategies (self-distraction, venting, acceptance, positive reframing, emotional support, and instrumental support) was assessed preoperatively with the Brief-Coping Orientation to Problems Experienced inventory. Relationships among coping strategies and postoperative satisfaction, return to sport, International Knee Documentation Committee-Subjective and Tampa Scale for Kinesiophobia scores at a median 10.7 months follow-up were determined with consideration for age, sex, and surgical procedure. RESULTS: Return to the prior level of sport was 72%, and satisfaction was 86%. Most coping strategies had age-specific utilization rates; positive reframing was used least frequently in individuals aged <20 years. Satisfaction increased with greater positive reframing among those aged <20 years and decreased with greater self-distraction among men. Return to sport was higher with greater positive reframing in people aged <32 years. No coping strategies predicted International Knee Documentation Committee-Subjective scores. Greater positive reframing correlated with less kinesiophobia in individuals aged <20 years and greater instrumental support with less kinesiophobia in those aged >40 years. No other coping strategies were associated with outcomes. The surgical procedure was not related to an association between coping strategies and outcomes. CONCLUSIONS: Coping strategies had age-specific associations with outcomes after knee surgery in athletes. Positive reframing was infrequently used in younger athletes. Greater use of positive reframing in this group may improve return to sport and satisfaction and reduce fear of reinjury.