3 June 2024

Lt. Col Andy Sheean – Making an IMPACT on ACL Reconstruction

Investigating the Psychology of Recovery

Lt. Col. Andrew Sheean, MD, FAAOS, is an innovative orthopedic sports medicine surgeon and Director of the Clinical Research Center at Brooke Army Medical Center in San Antonio, TX. Dr. Sheean, an esteemed Principal Investigator for The Geneva Foundation (Geneva), is at the forefront of pioneering initiatives bridging military, academic, and clinical research teams to advance patient outcomes following anterior cruciate ligament reconstruction (ACLR). He is leading Geneva’s Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) Project 46 titled, “How Does Resilience Affect Clinical Outcomes Associated with ACL Reconstruction?”  This study is an effort to examine how a patient’s underlying psychological traits, such as their intrinsic resiliency, may impact their recovery following an ACLR surgery. This novel biomedical research is predicated on the understanding that improved patient outcomes following surgery extend beyond the biological aspects of healing and include psychological factors. Therefore, this groundbreaking research initiative may unveil modifiable psychological risk factors such as general mental health, resiliency, and pain catastrophizing that affect health outcomes following ACLR.

Financial Support

Since its inception in 2023, the project led by Dr. Sheean has garnered substantial financial support, with nearly $500,000 being contributed by key organizations such as the Arthroscopy Association of North America (AANA), Military Advanced Surgical Training (MAST), and MIRROR via Geneva. This significant financial backing underscores the importance and potential impact of the project. It has also led to the formation of the IMPACT ACL Group, a collective of surgeons from eight sites across the nation, including Brooke Army Medical Center, United States Air Force Academy, The Cleveland Clinic, University of Chicago, University of Utah, University of Pittsburgh, University of Missouri, and Endeavor Health in Chicago, IL. Each site’s contribution adds to the profound potential of the project, informing future interventional trials designed to modulate patient-specific psychological factors that will directly influence their rates of recovery.

IMPACT Study

The multisite biomedical research initiative, Investigation into Mental Processes and Clinical Therapy for ACL Reconstruction Recovery (IMPACT) Study: Does Patient Psychology Affect Patients’ Response to Anterior Cruciate Ligament (ACL) Injuries and ACLR, is not just a research project but a potential game-changer for the military community. It aims to identify the psychological risk factors that predict worse outcomes of ACLR, understands the factors involved in a successful transition to return to duty military members and restore patients to pre-injury levels of health. For our military community, with an estimated 4,300 ACLRs performed by military surgeons annually, this is a vital initiative that could significantly enhance military medical readiness and improve the quality of life for our warfighters. Moreover, these potentially impactful research findings promise patient outcomes for both military and civilians.

The IMPACT group has recently published two papers demonstrating the need for this large-scale effort, noting promising findings related to resilience, yet a paucity exists in the literature. “The Psychology of ACL Injury, Treatment, and Recovery: Current Concepts and Future Directions” in Sports Health (PMID: 38374636.) and “Patient Resilience Does Not Conclusively Affect Clinical Outcomes Associated with Arthroscopic Surgery but Substantial Limitations of the Literature Exist” in Arthrosc Sports Med Rehabil (PMID: 38379604).

 

Disclaimer: The views expressed do not reflect the official policy of the Department of Defense, or the U.S. Government.