Biopsychosocial profiles following ACL reconstruction: A latent class analysis of barriers to return-to-activity.

The study was cross-sectional, so it shows who reported similar barriers at one time point, not how profiles change after surgery or cause failed return. Patients were tested 3 to 12 months after ACLR, and the as-active group was about 1.75 months further from surgery than the limited groups, which may affect comparisons. Latent class analysis can misassign people to groups, and group labels may not fit every patient. The activity screen used a single item to decide who completed the reasons scale, which may not capture the complexity of return to activity. The sport played at injury was not consistently recorded, so sport-specific recovery factors were not analyzed. Patients with incomplete measures were excluded, and the study was not a treatment trial.

The authors reported no direct financial affiliation with a commercial organization, except disclosures. One author's institutions have received past, current, and ongoing funding from NIH, the Department of Defense, the Department of Veterans Affairs, and the Arthritis Foundation. That author also has industry-sponsored research funding related to injury prevention and sport performance, ongoing Arthrex funding to evaluate ACL surgical treatment optimization, and author royalties from Human Kinetics and Wolters Kluwer.

Do not read these groups as proof that fear, anxiety, and depression cause poor return to activity, or that a specific psychological treatment will work. This was a cross-sectional profiling study, not a treatment trial, and the profiles may not be stable over time.