Psychological Considerations for Surgical Outcomes in the Pediatric and Adolescent Athlete

The need to have orthopedic surgery can be stressful for any patient. In young athletes, injuries requiring surgery are fairly common, and the perioperative period can be a particularly difficult time for pediatric and adolescent patients. Surgery can not only negatively impact a young athlete’s lifestyle, identity, and psychological health, but a patient’s psychological response to injury and recovery from surgery can also affect their postoperative outcomes. Negative psychological factors, such as preoperative anxiety, low self-efficacy, kinesiophobia, or unrealistic expectations of recovery, can adversely affect recovery following surgery. This can lead to increased postoperative pain, decreased rates of return to sport, exacerbated mood and mental health disorders, and worse functional outcomes. Conversely, certain factors can improve postsurgical outcomes. Higher levels of self-confidence, motivation, and self-efficacy, optimistic yet realistic expectations, and assuaging parental fears have all been shown to positively impact recovery. The utilization of psychological resources and strategies such as positive reframing, relaxation-guided imagery, modeling videos, and other individualized therapeutic approaches can further enhance an athlete’s postoperative recovery. It is important that the healthcare team is aware of the psychological considerations associated with surgery to best optimize the recovery period and surgical outcomes in young athletes following orthopedic surgery.