{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T20:21:56Z","timestamp":1784751716519,"version":"3.55.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prior literature suggests that patients suffering from fear of reinjury (FORI) following Achilles rupture may fail to return to sport and report worse Achilles Tendon Total Rupture Scores (ATRS); however, this prior study included patients who underwent both surgical and non-surgical management. This study therefore aims to determine whether self-reported fear (srFORI) is associated with worse outcomes as measured by validated Patient-Reported Outcomes Measurement Information System (PROMIS) measures of physical function (PF) and pain interference (PI) and ATRS following operative Achilles repair specifically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This investigation was a retrospective review of all patients who underwent Achilles repair at a single institution (2018-2023). Tendinopathies, open injuries, concomitant fractures, tendon transfers, and gastrocnemius recessions were excluded. A total of 119 patients completed questionnaires containing PROMIS and ATRS, and additional surveys querying srFORI measured at the time of survey participation. Primary outcome was PROMIS. Secondary outcome was ATRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean follow-up duration was 30.3\u2009\u00b1\u20098.3\u2009months. No significant differences existed in baseline characteristics (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05). Twenty-nine of 119 patients (24.4%) self-reported FORI. SrFORI was associated with significantly worse PF relative to those without srFORI (53.0\u2009\u00b1\u20096.1 vs 59.0\u2009\u00b1\u20098.1, mean difference (MD) \u22126.08, 97.5% CI \u22129.79, \u22122.36,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). SrFORI was similarly associated with significantly worse ATRS (72.6\u2009\u00b1\u200917.8 vs 88.7\u2009\u00b1\u200912.3, MD \u221216.18, 97.5% CI: \u221222.89, \u22129.47,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). There were no significant differences in PI (44.9\u2009\u00b1\u20097.0 vs 43.9\u2009\u00b1\u20096.1, MD 1.03, 97.5% CI: \u22122.04, 4.11,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.48). Adjusted regression revealed that srFORI was associated with significantly worse PF (MD 6.2 points lower,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and ATRS (MD 16.5 points lower,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Both differences in PF and ATRS reached MCID. With the numbers available, no significant difference in overall complications could be detected between groups (7.8%, 7\/90, vs 10.3%, 3\/29,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.70).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Nearly 25% of patients self-reported FORI following minimally invasive Achilles tendon repair, which may be associated with clinically and statistically significant deficits in functional outcomes as measured by PROMIS and ATRS following repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114261462481","type":"journal-article","created":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T14:09:14Z","timestamp":1784470154000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Fear of Reinjury Is Associated With Worse Physical Function Measured by PROMIS Following Minimally Invasive Achilles Rupture Repair"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-7334","authenticated-orcid":false,"suffix":"Jr","given":"Steven M.","family":"Hadley","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Chicago, IL, USA"},{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4371-1673","authenticated-orcid":false,"given":"John J.","family":"Peabody","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6702-8871","authenticated-orcid":false,"given":"Rachel","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4030-3858","authenticated-orcid":false,"given":"Eric H.","family":"Durudogan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2060-2137","authenticated-orcid":false,"given":"Sarah 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