Anterior Cruciate Ligament Injuries, Depression, Mental Health Issue
Conditions
Brief summary
The goal of this parallel arm prospective randomized control trial study is to compare outcomes in Anterior Cruciate Ligament Reconstruction (ACLR) Surgery patients after exposure to a virtual psychological intervention (VPI) versus standard care. The main question the investigators are asking is if virtual administration of psychological CBT modules will be an accessible and convenient vehicle to improve ACLR outcomes. Participants will be placed either into a treatment group receiving virtual modules of cognitive behavioral therapy in addition to standard of care ACLR surgery or the control group receiving only the standard of care ACLR surgery. The investigators hypothesize that ACLR patients in the VPI cohort will have improved return to sport and post operative outcomes compared to controls.
Detailed description
This study is a parallel arm prospective randomized-controlled trial. The expected duration of the study is two years. Participants will be placed either into a treatment group receiving virtual modules of cognitive behavioral therapy in addition to standard of care ACLR surgery or the control group receiving only the standard of care ACLR surgery. Trial eligibility criteria are as follows: patients over the age of 12 undergoing first time ACLR with a HFH Sports Orthopedic surgeon. Eligible participants will be randomized using computerized random number generation into two groups: Group A and Group B. Both groups will receive the same standard post-operative rehabilitation protocol. An asynchronous course of pre- and post-operative CBT modules (VPI) will be delivered to patients in Group A as an adjuvant treatment to standard-of-care rehabilitation. Each session is designed to provide patients with different CBT strategies to augment their recovery. Sessions will be delivered virtually by trained health professionals. Participants in Group B will receive standard-of-care rehabilitation only. Demographic information and additional protected health information will be handled securely in a securedatabase. Pre-operative PROMIS and PHQ-2 scores will be obtained for both groups via electronic medical record abstraction. Primary endpoints are as follows: Return to sport, defined as return to pre-injury involvement in the patient's respective sport at 3, 6, 12, and 24 months. Secondary outcomes are as follows: Patient-Reported Outcome Measurement Information System (PROMIS) scores, a validated patient reported outcome instrument, Patient Health Questionnaire-2 (PHQ-2) scores, a validated depression screening questionnaire, ACL-Return to Sport after Injury (ACL-RSI) scores, a validated scale to measure the psychological impact of returning to sport following ACLR3, Post-operative opioid usage and Utilization of additional counseling options (i.e., referral to behavioral health services)
Interventions
BEHAVIORALVirtual Psychological Intervention: Cognitive Behavioral Therapy
An asynchronous course of pre- and post-operative CBT modules (VPI) will be delivered to patients in Group A as an adjuvant treatment to standard-of-care rehabilitation.
Sponsors
Henry Ford Health System
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Caregiver)
Intervention model description
This study is a parallel arm prospective randomized-controlled trial.
Eligibility
Sex/Gender
ALL
Age
13 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients over the age of 12 with ACL injuries undergoing ACLR with a Henry Ford Sports Orthopedic Surgeon * First time ACLR on the injured knee
Exclusion criteria
* Patients undergoing revision ACL surgery * Concomitant posterior cruciate ligament injury of the involved knee * Systemic or local infection pre-operatively * Systemic administration of any type of corticosteroid or immunosuppressive agents within 30 days of surgery * History of rheumatoid arthritis, inflammatory arthritis, or autoimmune diseases * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients who Return to Sport at time set-points | 3,6,12 and 24 months | Comparing number of patients who Return to sport, defined as return to pre-injury involvement in the patient's respective sport at 3, 6, 12, and 24 months in each trial group. |
| Patient-Reported Outcome Measurement Information System (PROMIS) scores for Physical Function and Pain Interference | 3,6,12, and 24 months | Comparing in each trial group, A validated patient reported outcome instrument where 50 is the average reference score of the patient population and the standard deviation is 10. For PROMIS measures, higher scores equals more of the concept being measured (e.g., more Pain Interference, more Physical Function). Thus a score of 60 is one standard deviation above the average referenced population. This could be a desirable or undesirable outcome, depending upon the concept being measured. |
| Patient Health Questionnaire-2 (PHQ-2) scores | 3,6,12, and 24 months | Avalidated depression screening questionnaire with 3 points or more meaning a positive screen |
| ACL-Return to Sport after Injury (ACL-RSI) scores | 3,6,12 and 24 months | A validated scale to measure the psychological impact of returning to sport following ACLR. There are three domains: risk appraisal, confidence, and emotions. A total score between 0 and 100 is calculated by adding and averaging the scores for each item. Greater psychological preparation is indicated by higher scores. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-operative opioid usage | 0-24 months post-operatively | the amount of usage of opioid medication post-operatively |
| Number of patients with Utilization of additional counseling options (i.e., referral to behavioral health services) | 0-24 months post-operatively | Utilization of additional counseling options (i.e., referral to behavioral health services) |
Countries
United States
Contacts
CONTACTMaxim Jani, BS
PRINCIPAL_INVESTIGATORThomas Sean Lynch, MD
Henry Ford Health System
Outcome results
None listed