Does Grit Impact ACL Outcomes?

Sep 17, 2023

Does Grit Impact ACL Outcomes?

Grit is the disposition to strive for long-term goals despite setbacks and challenges. Given the lengthy, arduous process of rehabilitation after anterior cruciate ligament reconstruction (ACLR), an athlete's grit may predict postoperative outcomes across time.

The primary aim of the study was to evaluate the relationships between baseline (preoperative) grit and postoperative knee outcomes across the year after ACLR among adolescents. 

Study Details

The authors conducted a longitudinal prospective cohort study of participants who sustained an ACL tear and underwent ACLR at a single institution with a single orthopedic surgeon between 2019 and 2021.  Inclusion criteria consisted of participants between 12 and 19 years of age at the time of ACLR


The authors included 137 participants (mean age 15.8 ± 2.74 years, 70% female) from a prospective registry of athletes undergoing ACLR by 1 surgeon at a single institution. There were no statistically significant changes in grit over time and no differences in grit between age and sex.

Higher baseline grit was significantly associated with greater postoperative HSS Pedi-FABS scores (β = 3.72 ± 1.46; P = .01; 95% CI, 0.85-6.59) and NeuroQoL scores across time (β = 3.37 ± 0.93; P < .001; 95% CI, 1.55-5.20).

There were no significant associations between baseline grit and Pedi-IKDC, Lysholm, and PROMIS pain interference or mobility scores.

Study Conclusion

The study findings suggests that grittier athletes may achieve greater physical function over the course of ACLR rehabilitation compared with less gritty athletes, possibly related to the nature of attaining activity-related goals as opposed to symptom improvement.

New Podcast Discussing this Study

In this Overtime episode, The Sports Docs discuss Dr. Jay Albright's recent AJSM publication titled "Association of Grit With Postoperative Knee Outcomes and Physical Function After ACL Reconstruction in Adolescent Athletes."