Correlation Between Psychological Readiness, Knee Function, and Isokinetic Performance After Anterior Cruciate Ligament Reconstruction (ACLR) Using Peroneus Longus Tendon Graft (PL-ACL-2025)

NCT07201597 | Recruiting

• 1 other identifier: PL-ACL-2025
• Study Type: observational
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

This clinical trial aims to investigate the correlation between psychological readiness, knee function, and isokinetic performance after anterior cruciate ligament reconstruction (ACLR) using the Peroneus Longus tendon graft (PLT). ACL injuries are common among athletes, and the standard treatment is ACL reconstruction surgery (ACLR). However, the success of the surgery does not solely depend on physical recovery but also on the psychological readiness of athletes to return to their sport. This study focuses on athletes who have undergone ACLR using the Peroneus Longus tendon (PLT). The primary objective is to compare psychological readiness, self-reported knee function (IKDC score), isokinetic performance (quadriceps and hamstring strength), and muscle strength ratios between athletes who meet return-to-sport (RTS) criteria and those who do not. Psychological readiness will be assessed using the ACL-Return to Sport after Injury (ACL-RSI) scale, while knee function will be evaluated using the IKDC subjective score. Isokinetic testing will assess quadriceps and hamstring strength at various angular velocities. This study aims to provide a more comprehensive understanding of the factors influencing an athlete's ability to return to sport after ACLR, combining both physical and psychological aspects. The results will help optimize rehabilitation strategies by offering a multidimensional approach, considering both physical and psychological factors, to improve recovery protocols for ACL-injured athletes.

Conditions

Anterior Cruciate Ligament (ACL) Injury; Athletic Injuries; Knee Injuries

Keywords

ACL Injury; ACL Reconstruction; Peroneus Longus Tendon; Return to Sport; Psychological Readiness; Knee Function; Isokinetic Strength Testing; Hamstring-to-Quadriceps Ratio; Post-Surgery Rehabilitation; Sports Medicine; Physical Therapy Rehabilitation; Knee Stability; peroneus longus graft

Outcome Measures

Primary Outcomes (2)

• Psychological Readiness to Return to Sport

  Psychological readiness to return to sport measured by the validated Arabic version of the ACL-Return to Sport after Injury (ACL-RSI). Total score 0-100; higher scores indicate greater psychological readiness.

  Up to 9 months post-operative

• Isokinetic Strength Performance (Quadriceps Strength at Various Velocities)

  This measure evaluates quadriceps strength at 60°/s, 120°/s, and 240°/s using the HUMAC NORM Isokinetic Dynamometer. It assesses peak torque and average power production in both the injured and uninjured limbs.

  Up to 9 months post-operative

Secondary Outcomes (6)

• Knee Function

  Up to 9 months post-operative

• Isokinetic Performance (Quadriceps and Hamstring Strength at Different Velocities)

  Up to 9 months post-operative

• Dynamic Postural Control

  Up to 9 months post-operative

• Core Muscle Endurance

  Up to 9 months post-operative

• Limb Symmetry Index (LSI)

  Up to 9 months post-operative

Study Arms (2)

Athletes Meeting Return-to-Sport (RTS) Criteria

This group includes athletes who have undergone anterior cruciate ligament reconstruction (ACLR) using a Peroneus Longus tendon graft and meet the return-to-sport (RTS) criteria. These athletes demonstrate psychological readiness, self-reported knee function, and sufficient strength recovery (isokinetic strength at 60°/s, 120°/s, and 240°/s), with an H/Q ratio ≥ 90% and IKDC score ≥ 90. These athletes are eligible to return to their pre-injury sport levels based on the established RTS criteria. They will be assessed for psychological readiness using the ACL-RSI scale, knee function with the IKDC score, and isokinetic strength testing at various velocities.

Athletes Not Meeting Return-to-Sport (RTS) Criteria

This group includes athletes who have undergone ACLR using a Peroneus Longus tendon graft but do not meet the RTS criteria. These athletes may experience insufficient psychological readiness, self-reported knee function, or muscle strength recovery. Specifically, they may have an H/Q ratio below 90%, an IKDC score lower than 90, or fail to achieve adequate isokinetic strength at the required angular velocities (60°/s, 120°/s, 240°/s). These athletes will be assessed using the ACL-RSI scale, IKDC score, and isokinetic strength testing, and the study will explore the factors contributing to their inability to meet RTS criteria.

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

The study population consists of male recreational athletes who have undergone anterior cruciate ligament reconstruction using the Peroneus Longus tendon. These athletes must meet specific criteria to return to sport and will be evaluated for both physical and psychological readiness. Participants will be assessed at least 6 months post-surgery, with both case (RTS) and control (non-RTS) groups based on their ability to return to sport.

You may qualify if:

• Male recreational athletes aged 18-35 years.
• Participation in sports that involve deceleration, jumping, cutting, or turning (e.g., basketball, soccer, volleyball).
• Primary unilateral ACL injury treated with ACL reconstruction using a Peroneus Longus autograft.
• Single evaluation 6-12 months after ACL reconstruction.
• Completed a standardized postoperative rehabilitation program for ≥6 months, with near-complete rehabilitation and some level of sport participation.
• Sufficient knee confidence, no effusion/edema, full knee range of motion, and able to perform all functional tests safely.
• Able to provide written informed consent.

You may not qualify if:

• Revision ACL reconstruction.
• Prior ACL reconstruction on the ipsilateral or contralateral knee.
• Multi-ligament knee injury.
• Concomitant meniscal repair or bilateral ACL reconstruction.
• Knee pain \> 3/10 at evaluation that prevents or impairs testing.
• Incomplete knee extension or knee flexion \< 110°.
• Lower-limb fracture or surgery within the past 6 months.

Sponsors & Collaborators

• Cairo University: lead
• Al Hayah University In Cairo: collaborator

Study Sites (1)

AHUC

Cairo, Cairo Governorate, 11865, Egypt

RECRUITING

MeSH Terms

Conditions

Wounds and Injuries; Athletic Injuries; Knee Injuries; Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Leg Injuries

Central Study Contacts

Mostafa Hamdy

CONTACT

+201287412996; hamdymostafa655@gmail.com

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Demonstrator of Physical Therapy

Study Record Dates

• First Submitted: September 20, 2025
• First Posted: October 1, 2025
• Study Start: October 8, 2025
• Primary Completion: November 1, 2025
• Study Completion: November 1, 2025
• Last Updated: October 1, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)