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After an anterior cruciate ligament (ACL) injury, people need secondary prevention strategies to identify osteoarthritis at its earliest stages so that interventions can be implemented to halt or slow the progression toward its long-term burden. The Osteoarthritis Action Alliance formed an interdisciplinary Secondary Prevention Task Group to develop a consensus on recommendations to provide clinicians with secondary prevention strategies that are intended to reduce the risk of osteoarthritis after a person has an ACL injury. The group achieved consensus on 15 out of 16 recommendations that address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. We hope this statement raises awareness among clinicians and researchers on the importance of taking steps to mitigate the risk of osteoarthritis after an ACL injury.

Context While 84% of patients expect to return to activity within 1 year of ACL reconstruction (ACLR), as few as 24% of patients will return to their preinjury level of activity. By considering a patient's perceptions of their reengagement in activity after ACLR, clinicians and researchers may be better equipped to implement interventions that are patient-centered. Objective To describe the validation of the ACL Reasons survey, a tool to aid clinicians and researchers in understanding patient perceptions of barriers to physical activity (PA) engagement following ACLR. Design Cross-sectional study design. Patients or Other Participants The ACL Reasons survey was administered via Qualtrics to 78 patients 6–24 months post-primary, unilateral ACLR. Patients were categorized as active, more challenging, or less active based on their responses to the ACL Reasons. Main Outcome Measure(s) ACL Reasons survey development occurred via an iterative process of drafting and revising based upon feedback from a team of external expert reviewers. Tegner Activity level, Marx Activity score, the Knee Injury and Osteoarthritis Outcomes Score (KOOS), ACL-RSI score, and Tampa Scale of Kinesiophobia (TSK-11) score were compared between groups using ANOVA and Kruskal Wallis tests. Results Groups significantly differed based on Tegner activity level (p Conclusions These results support the validity of the ACL Reasons survey as a tool to identify barriers to PA engagement following ACLR. This tool may help facilitate communication between patients with ACLR and their healthcare provider to enhance patient-centered care.

Clinical Question: Are fear-avoidance beliefs associated with self-reported knee function in patients with a knee injury? Clinical Bottom Line: There is currently consistent, good-quality, patient-oriented evidence that demonstrates an association between fear-avoidance beliefs and self-reported knee function in patients with a knee injury. Future research should longitudinally examine the association of fear-avoidance beliefs and self-reported knee function in patients with a knee injury.