{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T17:02:52Z","timestamp":1789405372687,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare long\u2010term joint awareness between reconstructed and contralateral healthy knees following isolated anterior cruciate ligament reconstruction (ACLR) and to investigate the relationships among objective knee stability, psychological readiness and joint awareness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent isolated hamstring tendon autograft ACLR between January 2019 and March 2021 and had a minimum follow\u2010up of 5 years were retrospectively reviewed. Patients with concomitant meniscal, chondral, multiligament, lateral extra\u2010articular procedures or nonhamstring grafts were excluded. Joint awareness was assessed using the forgotten joint score\u201012 (FJS\u201012) for both reconstructed and contralateral healthy knees, and the primary within\u2010patient interlimb comparison was based on FJS\u201012. Secondary outcomes included ACL\u2010return to sport after injury (ACL\u2010RSI), International Knee Documentation Committee (IKDC), Lysholm, visual analogue scale (VAS), Tegner Activity Scale, patient satisfaction and objective stability assessed using Lachman and pivot\u2010shift tests. Multivariable regression and mediation analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010nine patients were included in the final analysis. At a mean follow\u2010up of 68.5\u2009\u00b1\u20093.3 months, reconstructed knees demonstrated significantly lower FJS\u201012 scores than contralateral healthy knees (81.2\u2009\u00b1\u20096.4 vs. 90.1\u2009\u00b1\u20095.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patients with residual instability showed significantly lower ACL\u2010RSI, FJS\u201012, IKDC and Lysholm scores (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). ACL\u2010RSI was strongly correlated with reconstructed\u2010knee FJS\u201012 (rho\u2009=\u20090.786,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and independently predicted both reconstructed\u2010knee FJS\u201012 (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.833,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and interlimb FJS\u201012 differences (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.668,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Mediation analysis identified a statistically significant indirect association between pivot\u2010shift status and FJS\u201012 through ACL\u2010RSI (95% bootstrap CI: \u221211.06 to \u22125.29).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although isolated ACLR provided excellent long\u2010term functional outcomes and restored objective stability in most patients, reconstructed knees remained perceptually inferior to contralateral healthy knees. Psychological readiness was strongly associated with long\u2010term joint awareness. The observed associations suggest that psychological readiness may contribute to the relationship between residual rotational instability and impaired ability to achieve a \u2018forgotten knee\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70604","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:05:42Z","timestamp":1789401942000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychological readiness is associated with long\u2010term joint awareness after isolated anterior cruciate ligament reconstruction: A within\u2010patient comparison with the contralateral healthy knee"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5202-7844","authenticated-orcid":false,"given":"Mehmet Baran","family":"Uslu","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology VM Medicalpark Ankara Hospital Ankara Turkey"},{"name":"Department of Orthopedics and Traumatology Ankara Y\u00fcksek Ihtisas University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3147-9355","authenticated-orcid":false,"given":"Y\u0131lmaz","family":"Ergi\u015fi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Karab\u00fck Training and Research Hospital Karabuk Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2876-0637","authenticated-orcid":false,"given":"Berkcan","family":"G\u00f6kalp","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Karab\u00fck Training and Research Hospital Karabuk Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6152-6480","authenticated-orcid":false,"given":"Osman","family":"\u00c7\u00f6mez","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Bandirma Training and Research Hospital Bal\u0131kesir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3119-5432","authenticated-orcid":false,"given":"Ozan","family":"Altun","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology \u00c7ank\u0131r\u0131 State Hospital \u00c7ank\u0131r\u0131 Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2039-7426","authenticated-orcid":false,"given":"Uygar","family":"Da\u015far","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Karab\u00fck Training and Research Hospital Karabuk Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1136\/bjsm.2010.076364","article-title":"Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta\u2010analysis of the state of play","volume":"45","author":"Ardern CL","year":"2011","journal-title":"Br J Sports Med"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00167-011-1860-y","article-title":"Pivot shift as an outcome measure for ACL reconstruction: a systematic review","volume":"20","author":"Ayeni OR","year":"2012","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.knee.2017.05.007","article-title":"Validating the forgotten joint score\u201012 in 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anterior cruciate ligament reconstruction","volume":"49","author":"Faleide AGH","year":"2021","journal-title":"Am J Sports Med"},{"issue":"2","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","DOI":"10.1093\/ptj\/pzab273","article-title":"Fear of reinjury following surgical and nonsurgical management of anterior cruciate ligament injury: an exploratory analysis of the NACOX multicenter longitudinal cohort study","volume":"102","author":"Filbay S","year":"2022","journal-title":"Phys Ther"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1080\/17453674.2019.1689327","article-title":"The forgotten joint score\u201012 in Swedish patients undergoing knee arthroplasty: a validation study with the knee injury and osteoarthritis outcome score (KOOS) as comparator","volume":"91","author":"Heijbel S","year":"2020","journal-title":"Acta Orthop"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671211003590","article-title":"Incidence and risk factors for residual high\u2010grade pivot shift after acl reconstruction with or without a lateral extra\u2010articular tenodesis","volume":"9","author":"Jacquet C","year":"2021","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jor.2020.03.029","article-title":"The forgotten joint score\u201012 in anterior cruciate ligament injuries","volume":"21","author":"Lee JY","year":"2020","journal-title":"J Orthop"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1177\/03635465211025003","article-title":"Neither residual anterior knee laxity up to 6 mm nor a pivot glide predict patient\u2010reported outcome scores or subsequent knee surgery between 2 and 6 years after acl reconstruction","volume":"49","author":"Magnussen RA","year":"2021","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.26603\/001c.18794","article-title":"The Influence of mode\u2010of\u2010injury on psychological readiness for return\u2010to\u2010sport following anterior cruciate ligament reconstruction: a matched\u2010controlled study","volume":"16","author":"Presley J","year":"2021","journal-title":"Int J Sports Phys Ther"},{"key":"e_1_2_12_14_1","article-title":"Patient\u2010reported outcome measures used on patients with anterior cruciate ligament injury","volume":"16","author":"Prodromidis AD","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s40798-024-00712-w","article-title":"Anterior cruciate ligament return to sport after injury scale (ACL\u2010RSI) scores over time after anterior cruciate ligament reconstruction: a systematic review with meta\u2010analysis","volume":"10","author":"Sell TC","year":"2024","journal-title":"Sports Med 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