Effect of Intraoperative Live Video Viewing on Kinesiophobia After ACL Reconstruction

NCT07540715 | Completed

• 1 other identifier: NEU-ORTHO-ACL-2022
• Study Type: interventional
• Target: 65
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this randomized controlled trial is to investigate whether intraoperative live arthroscopic video viewing improves postoperative psychological and functional outcomes in patients undergoing primary anterior cruciate ligament (ACL) reconstruction under spinal anesthesia Participants are randomly assigned to either a video-viewing group, where they watch their surgery in real-time, or a control group receiving standard care without visual feedback The primary objective is to determine whether this patient-specific visual biofeedback reduces postoperative kinesiophobia at 24 weeks. Secondary objectives aim to evaluate the intervention's effects on state anxiety, illness perception, postoperative pain, and patient-reported functional recovery, including IKDC, Lysholm, and SF-36 scores .

Conditions

Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Kinesiophobia; Anxiety

Keywords

Anterior Cruciate Ligament Reconstruction; Kinesiophobia; Intraoperative Video; Visual Biofeedback; Anxiety; Functional Recovery

Outcome Measures

Primary Outcomes (1)

• Tampa Scale of Kinesiophobia (TSK-11) Score

  Kinesiophobia (fear of movement or reinjury) is assessed using the 11-item Tampa Scale of Kinesiophobia. The total score ranges from 11 to 44, with higher scores indicating a greater degree of kinesiophobia and fear of movement.

  Preoperative (baseline), 4 weeks postoperatively, and 24 weeks postoperatively

Secondary Outcomes (6)

• State-Trait Anxiety Inventory (STAI) Score

  Preoperative (baseline), 4 weeks postoperatively, and 24 weeks postoperatively

• Brief Illness Perception Questionnaire (B-IPQ) Score

  Preoperative (baseline), 4 weeks postoperatively, and 24 weeks postoperatively

• Visual Analog Scale (VAS) for Pain

  4 weeks and 24 weeks postoperatively

• International Knee Documentation Committee (IKDC) Subjective Knee Form Score

  4 weeks and 24 weeks postoperatively

• Lysholm Knee Score

  4 weeks and 24 weeks postoperatively

Study Arms (2)

Video Viewing Group

EXPERIMENTAL

Participants view the arthroscopic procedure live on the operating room monitor while under spinal anesthesia * The monitor is positioned within the patient's direct visual field * During the procedure, the operating surgeon provides standardized step-by-step verbal explanations describing the normal intra-articular structures, the torn ACL, the major steps of reconstruction, and the final appearance of the graft * All other perioperative management, standard surgical care, and postoperative rehabilitation are identical to the control group

Behavioral: Intraoperative Live Video Viewing

Control Group

ACTIVE COMPARATOR

Participants undergo the same standardized arthroscopic anterior cruciate ligament reconstruction procedure under the same anesthetic and perioperative conditions as the experimental group, but are not allowed to view the arthroscopic monitor . They receive routine perioperative communication and standard surgical care, but no structured intraoperative explanation of arthroscopic findings or reconstruction steps is provided

Procedure: Standard ACL Reconstruction

Interventions

Standard ACL Reconstruction PROCEDURE

Routine primary arthroscopic anterior cruciate ligament reconstruction without targeted visual or structured cognitive interventions.

Also known as: Standard Surgical Care

Control Group

Intraoperative Live Video Viewing BEHAVIORAL

A patient-centered cognitive intervention providing real-time visual feedback of the reconstructed knee anatomy to mitigate psychological barriers such as kinesiophobia and

Also known as: Visual Biofeedback

Video Viewing Group

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Aged 18 years and older.
• Diagnosis of isolated anterior cruciate ligament (ACL) rupture.
• Scheduled to undergo primary arthroscopic ACL reconstruction under spinal anesthesia.

You may not qualify if:

• Concomitant knee injuries requiring additional surgical procedures that substantially alter early postoperative weight-bearing and rehabilitation (e.g., meniscal repair or microfracture)
• Multiligament injury or posterior cruciate ligament (PCL) injury.
• Advanced chondral damage, rheumatologic disease, bleeding diathesis, or active local/systemic infection
• Psychiatric disorders requiring active treatment
• Inability to remain conscious, cooperative, and communicative throughout the procedure (e.g., developing deep sedation with a Ramsay score \>2 or requiring conversion to general anesthesia)

Sponsors & Collaborators

• Konya City Hospital: lead

Study Sites (1)

Konya City Hospital

Konya, 42020, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries; Kinesiophobia; Anxiety Disorders

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries; Phobic Disorders; Mental Disorders

Study Officials

• Oğuzhan Pekince, MD

  Konya City Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Due to the nature of the intervention, participants, care providers, and the operating surgeon could not be blinded. However, all postoperative psychological and functional assessments were conducted by independent specialists (a psychiatrist and a physical medicine and rehabilitation specialist) who were completely blinded to group allocation. The statistician was also blinded during the primary analysis.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Model Details: Participants are randomly assigned in a 1:1 ratio to either the intervention group (intraoperative video viewing) or the control group (standard care) to proceed in parallel for the 24-week duration of the study.

Study Record Dates

• First Submitted: April 14, 2026
• First Posted: April 20, 2026
• Study Start: January 1, 2023
• Primary Completion: April 20, 2025
• Study Completion: April 10, 2026
• Last Updated: April 20, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)