{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:53:57Z","timestamp":1781672037293,"version":"3.54.5"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: We evaluate the relationship between preoperative anxiety, as measured by the Surgical Fear Questionnaire (SFQ), and postoperative pain intensity during the first three days following arthroscopic ankle ligament reconstruction. A secondary objective was to determine whether preoperative anxiety levels are associated with failure to reach the Patient Acceptable Symptom State (PASS) threshold for pain by postoperative day 3. Methods: A prospective cohort of 68 patients undergoing anatomic arthroscopic ankle lateral ligament reconstruction between January 2023 and March 2025 was assessed. Patients were categorized into high- and low-anxiety groups based on a tertile distribution of SFQ scores, with a threshold of 45. Pain intensity was measured using the Visual Analog Scale (VAS) on days 0, 1, 2, and 3 postoperatively. The proportion of patients with unacceptable pain (VAS &gt; 3) according to the patient\u2019s acceptable symptom state was compared between groups. A receiver operating characteristic (ROC) curve identified the optimal SFQ threshold for discriminating PASS achievement on day 3. Odds ratios were calculated using logistic regression. Results: A total of 68 patients were included (34 in each group). The mean age was 32.9 \u00b1 10.5 years in the high-anxiety group and 33.1 \u00b1 9.9 years in the low-anxiety group (p = 0.747). The mean SFQ score was 58.9 \u00b1 11.9 in the high-anxiety group and 28.0 \u00b1 10.8 in the low-anxiety group (p &lt; 0.001). There were no significant differences between groups in demographic characteristics. Patients in the high-anxiety group reported significantly higher VAS scores at all postoperative time points. The proportion failing to achieve PASS on day 3 was also significantly greater in the high-anxiety group (67.6% vs. 35.3%, p = 0.015). An SFQ threshold of 46 discriminated PASS status with an AUC of 0.70. Patients with SFQ \u2265 46 had more than triple the odds of not achieving PASS (OR = 3.39; 95% CI: 1.26\u20139.59, p = 0.017). Conclusions: Preoperative anxiety is significantly associated with early postoperative pain and pain acceptability following arthroscopic ankle ligament reconstruction. Identifying and managing high-anxiety patients preoperatively may improve pain outcomes and patient satisfaction.<\/jats:p>","DOI":"10.3390\/jcm15124656","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:27:21Z","timestamp":1781666841000},"page":"4656","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Anxiety Is Associated with Early Postoperative Pain After Arthroscopic Ankle Ligament Reconstruction: A Prospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2050-1999","authenticated-orcid":false,"given":"Ryan","family":"Bou Raad","sequence":"first","affiliation":[{"name":"Centre Hospitalier Jeanne de Navarre, 02400 Ch\u00e2teau-Thierry, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2611-3938","authenticated-orcid":false,"given":"Mohamad","family":"Moussa","sequence":"additional","affiliation":[{"name":"Groupe Hospitalier Selestat-Obernai, 67600 Selestat, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregoire","family":"Rougereau","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, Clinique du Sport, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenie","family":"Valentin","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, Clinique du Sport, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Grimaud","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, Clinique du Sport, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Khiami","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, Clinique du Sport, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Lefevre","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, Clinique du Sport, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1604-8194","authenticated-orcid":false,"given":"Alexandre","family":"Hardy","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, Clinique du Sport, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.3113\/FAI.2008.1063","article-title":"Postoperative Pain Following Foot and Ankle Surgery: A Prospective Study","volume":"29","author":"Chou","year":"2008","journal-title":"Foot Ankle Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1007\/s00167-020-06130-1","article-title":"All-inside Endoscopic Anatomic Reconstruction Leads to Satisfactory Functional Outcomes in Patients with Chronic Ankle Instability","volume":"29","author":"Guillo","year":"2021","journal-title":"Knee Surg. 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