Cui MX, Lian YJ, Zhu YK, Zhao HJ, Nie XG, Liu J. Impact of preoperative kinesiophobia on early rehabilitation compliance and functional recovery after arthroscopic meniscal repair. World J Psychiatry 2026; 16(7): 117282 [DOI: 10.5498/wjp.117282]
Corresponding Author of This Article
Ming-Xing Cui, Department of Orthopedic Surgery, The First Affiliated Hospital of Henan Medical University, No. 88 Health Road, Weihui City, Xinxiang 453100, Henan Province, China. cuimingxing1226@163.com
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Psychology
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research-article
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Cui MX, Lian YJ, Zhu YK, Zhao HJ, Nie XG, Liu J. Impact of preoperative kinesiophobia on early rehabilitation compliance and functional recovery after arthroscopic meniscal repair. World J Psychiatry 2026; 16(7): 117282 [DOI: 10.5498/wjp.117282]
World J Psychiatry. Jul 19, 2026; 16(7): 117282 Published online Jul 19, 2026. doi: 10.5498/wjp.117282
Impact of preoperative kinesiophobia on early rehabilitation compliance and functional recovery after arthroscopic meniscal repair
Ming-Xing Cui, Yi-Jun Lian, Yong-Kang Zhu, Hai-Jian Zhao, Xing-Guo Nie, Ju Liu
Ming-Xing Cui, Yi-Jun Lian, Yong-Kang Zhu, Hai-Jian Zhao, Xing-Guo Nie, Ju Liu, Department of Orthopedic Surgery, The First Affiliated Hospital of Henan Medical University, Xinxiang 453100, Henan Province, China
Author contributions: Cui MX and Lian YJ designed the study and drafted the manuscript; Zhu YK and Zhao HJ performed data collection and statistical analysis; Nie XG conducted kinesiophobia assessments and rehabilitation follow-ups; Liu J supervised the study and critically revised the manuscript. All authors approved the final version and are accountable for the integrity of the work.
AI contribution statement: We confirm that in the preparation of this manuscript, we used AI-assisted tools solely for language polishing and reference formatting. No AI tool was used for data analysis, result interpretation, or generation of core scientific conclusions. All authors have reviewed and take full responsibility for the content of the manuscript.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of the First Affiliated Hospital of Henan Medical University (Approval No. EC-2025-717).
Informed consent statement: This study was retrospective in nature. The requirement for written informed consent was waived by the Ethics Committee of The First Affiliated Hospital of Henan Medical University because anonymized clinical data were used.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
Corresponding author: Ming-Xing Cui, Department of Orthopedic Surgery, The First Affiliated Hospital of Henan Medical University, No. 88 Health Road, Weihui City, Xinxiang 453100, Henan Province, China. cuimingxing1226@163.com
Received: December 26, 2025 Revised: January 25, 2026 Accepted: March 6, 2026 Published online: July 19, 2026 Processing time: 184 Days and 5.3 Hours
Abstract
BACKGROUND
Meniscal injury is a common orthopedic condition significantly affecting knee function and quality of life. While arthroscopic meniscal repair has become the preferred treatment, postoperative rehabilitation adherence remains crucial for optimal functional recovery. Kinesiophobia, defined as excessive fear of movement due to concerns about pain or re-injury, has been shown to negatively impact rehabilitation outcomes in various orthopedic conditions. However, its specific impact on rehabilitation compliance and functional recovery after arthroscopic meniscal repair remains inadequately investigated.
AIM
To investigate the impact of preoperative kinesiophobia on early rehabilitation adherence and functional recovery following arthroscopic meniscal repair.
METHODS
A retrospective analysis was conducted on clinical data from 269 patients who underwent arthroscopic meniscal repair between January 2021 and June 2024. Based on preoperative Tampa Scale for Kinesiophobia (TSK) scores, patients were divided into a kinesiophobia group (120 cases, TSK ≥ 37) and a non-kinesiophobia group (149 cases, TSK < 37). The Modified Exercise Adherence Rating Scale (MEARS) was used to assess rehabilitation adherence at 1 month, 3 months, and 6 months postoperatively. Lysholm score, range of motion, and Visual Analogue Scale were used to evaluate knee function recovery and pain status. Pearson correlation analysis was employed to explore the correlation between TSK scores and rehabilitation adherence and functional recovery indicators. Multiple linear regression analysis was used to investigate factors influencing rehabilitation adherence at 3 months postoperatively.
RESULTS
The TSK total score of the kinesiophobia group was (42.8 ± 4.2) points, higher than the non-kinesiophobia group’s (30.5 ± 3.8) points. At 1 month, 3 months, and 6 months postoperatively, the MEARS scores of the kinesiophobia group were lower than those of the non-kinesiophobia group. The excellent adherence rate at 3 months postoperatively was 26.7% in the kinesiophobia group and 54.4% in the non-kinesiophobia group. At 6 months postoperatively, the Lysholm score of the kinesiophobia group was (84.7 ± 9.8) points, lower than the non-kinesiophobia group’s (91.2 ± 7.6) points. Range of motion in the kinesiophobia group was (128.4° ± 10.5°), less than the non-kinesiophobia group’s (135.8° ± 9.3°). Preoperative TSK total score was negatively correlated with MEARS score at 3 months postoperatively and negatively correlated with Lysholm score. Multiple linear regression analysis showed that preoperative TSK score (β = -0.512, P < 0.001), education level (β = 0.186, P = 0.002), and disease duration (β = -0.152, P = 0.012) were independent factors influencing rehabilitation adherence at 3 months postoperatively. Binary logistic regression analysis showed that preoperative TSK score (odds ratio = 1.082, 95% confidence interval: 1.032-1.134, P = 0.001) was an independent risk factor for postoperative complications.
CONCLUSION
Preoperative kinesiophobia is an important factor affecting early rehabilitation adherence, functional recovery, and pain control following arthroscopic meniscal repair. It is recommended to routinely conduct kinesiophobia screening preoperatively and implement early psychological interventions for high-risk patients to improve rehabilitation adherence and promote knee function recovery.
Core Tip: Preoperative kinesiophobia significantly impairs early rehabilitation adherence and delays functional recovery after arthroscopic meniscal repair. Higher Tampa Scale for Kinesiophobia scores predict poorer Modified Exercise Adherence Rating Scale performance, slower improvement in Lysholm scores, limited knee range of motion, and higher postoperative pain levels. Kinesiophobia is also an independent risk factor for postoperative complications. Routine preoperative screening and early psychological intervention may effectively improve adherence and enhance postoperative outcomes.
