The Hidden Injury: Behavioral Health's Role in Pediatric Orthopaedic Outcomes-A Systematic Review

Area of Science:

• Orthopedics
• Sports Medicine
• Psychology

Background:

• The psychological impact of injuries in young athletes is often underestimated.
• Untreated psychological distress can negatively affect recovery and return-to-sport outcomes.
• Limited research exists on integrated care pathways for pediatric athletes undergoing orthopedic surgery.

Purpose of the Study:

• To systematically review the literature on psychological factors influencing recovery in pediatric athletes with orthopedic injuries.
• To explore the role of integrated care in optimizing outcomes for these athletes.

Main Methods:

• Systematic review of PubMed, Cochrane, and Ovid MEDLINE databases.
• Search terms included pediatric/adolescent, orthopedic/musculoskeletal/surgery, psychological factors, and recovery/rehabilitation.
• Inclusion criteria focused on English articles assessing psychological factors in orthopedic conditions; exclusions included concussions and TBI.

Main Results:

• 197 articles were analyzed, commonly focusing on ACL injuries, general sports injuries, and adolescent idiopathic scoliosis.
• Many studies highlighted emotional distress associated with injury and the negative consequences of unmanaged psychological aspects.
• Populations studied varied, including pediatric, adolescent, and adult groups.

Conclusions:

• Behavioral health specialists (sports psychologists, psychiatrists) can enhance outcomes for high-risk athletes.
• Identifying at-risk athletes and providing timely psychological interventions is essential.
• Future integration of care involves multidisciplinary clinics, standardized screenings, and increased awareness of psychological distress.