Article Text

Psychological, social and contextual factors across recovery stages following a sport-related knee injury: a scoping review
  1. Linda K Truong1,2,3,
  2. Amber D Mosewich4,
  3. Christopher J Holt2,
  4. Christina Y Le2,3,
  5. Maxi Miciak2,5,
  6. Jackie L Whittaker1,2
  1. 1 Faculty of Medicine, Department of Physical Therapy, #223, 212 Friedman Building 2177 Westbrook Mall, V6T 1Z3, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
  3. 3 Glen Sather Sports Medicine Clinic, Edmonton, Alberta, Canada
  4. 4 Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
  5. 5 Alberta Innovates, Edmonton, Alberta, Canada
  1. Correspondence to Linda K Truong, Faculty of Medicine, Department of Physical Therapy, #223, 212 Friedman Building 2177 Westbrook Mall, V6T 1Z3, The University of British Columbia, Vancouver, Canada; lltruong{at}


Objective To explore the role of psychological, social and contextual factors across the recovery stages (ie, acute, rehabilitation or return to sport (RTS)) following a traumatic time-loss sport-related knee injury.

Material and methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and Arksey and O’Malley framework. Six databases were searched using predetermined search terms. Included studies consisted of original data written in English that identified or described a psychological, social or contextual factor related to recovery after a traumatic time-loss sport-related knee injury. Two authors independently conducted title–abstract and full-text reviews. Study quality was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was undertaken.

Results Of 7289 records, 77 studies representing 5540 participants (37% women, 84% anterior cruciate ligament tears, aged 14–60 years) were included. Psychological factors were investigated across all studies, while social and contextual factors were assessed in 39% and 21% of included studies, respectively. A cross-cutting concept of individualisation was present across four psychological (barriers to progress, active coping, independence and recovery expectations), two social (social support and engagement in care) and two contextual (environmental influences and sport culture) themes. Athletes report multiple barriers to recovery and valued their autonomy, having an active role in their recovery and diverse social support.

Conclusion Diverse psychological, social and contextual factors are present and influence all stages of recovery following a traumatic sport-related knee injury. A better understanding of these factors at the time of injury and throughout rehabilitation could assist with optimising injury management, promoting RTS, and long-term health-related quality-of-life.

  • knee injuries
  • recovery
  • rehabilitation
  • review
  • sporting injuries

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  • Twitter @LKTphysio, @choltpt, @yegphysio,, @jwhittak_physio

  • Collaborators Linda C Li; Maria Tan.

  • Contributors LKT and JLW were responsible for the conception of the study and along with Maria Tan developed the search strategy. LKT executed the search strategy. All authors independently reviewed records, assessed the methodological quality of included studies and extracted data. LKT was responsible for the first draft of the manuscript. All authors contributed to the interpretation of the findings, critical revision of the manuscript and reviewed the document prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.