Extended Abstract
1.    Introduction
Tears of the anterior cruciate ligament (ACL) are among the most common knee injuries sustained by athletes during sports participation and are frequently associated with substantial physical impairments (1). For most individuals with ACL injuries, surgical reconstruction is required to restore knee function and enable a return to athletic activity (2). Many athletes who undergo ACL reconstruction (ACL-R) strive to resume their pre-injury performance levels. To support this objective, a range of questionnaires have been developed to assess psychological factors influencing return to sport (8, 9). For example, the Athletes’ Emotional Responses to Injury Questionnaire evaluates emotional reactions to injury. Reliable and valid instruments are necessary to accurately assess psychological readiness, ensuring a comprehensive evaluation of an athlete’s preparedness to return to sport (10). Tools with strong psychometric properties serve multiple purposes, including facilitating patient-centered care, capturing patient perceptions of health status, assessing intervention effectiveness, and guiding clinical decision-making through patient-reported outcomes (11). Accordingly, this scoping review aims to identify and summarize the assessment tools used to evaluate psychological factors related to return to sport after ACL reconstruction, and to examine the measurement properties and performance characteristics of these instruments. 
2.    Methods
A comprehensive review of assessment tools for psychological factors related to return to sport after anterior cruciate ligament (ACL) reconstruction was conducted. The search covered multiple databases, including PubMed, MEDLINE, Web of Science, ScienceDirect, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, Scopus, Magiran, IRANDOC, IranMedex, MedLib, and SID. The search strategy combined the following keywords: ACL reconstruction, psychometric properties, psychological readiness, fear of knee injury, return to sport, confidence, and ACL. The search period spanned from 2003 to February 2024. Titles and abstracts were initially screened, and full texts of potentially relevant articles were reviewed. Articles meeting the inclusion criteria were retained, while those that did not meet the criteria were excluded. Ultimately, six full-text articles were selected according to the study objectives. The inclusion criteria required descriptive studies focusing on tests assessing psychological factors related to return to sport after ACL reconstruction. Eligible studies also had to be published in either Persian or English. Screening was performed in two stages: a research assistant independently reviewed abstracts, and a full-text screening was conducted by one researcher. Moreover, the studies had to specifically target individuals with ACL reconstruction to be included. The exclusion criteria applied to studies that did not include individuals with ACL reconstruction in their samples, studies that lacked a clear methodology for the psychological tests, and studies that used psychological instruments not classified as psychological tests. After applying these criteria, a senior researcher reviewed the final list of included studies to ensure alignment with the research objectives. Descriptive summary data were extracted by the research assistant and subsequently verified by the senior researcher.
3.    Results
A total of 563 titles were retrieved from the electronic databases, and an additional 12 titles were identified through manual searches of reference lists from relevant articles. After removing duplicates, 153 unique abstracts remained for screening. Of these, 141 articles were excluded based on the eligibility criteria, leaving 12 articles for full-text review. Following this evaluation, 6 studies that specifically examined psychological factors related to return to sport after anterior cruciate ligament (ACL) reconstruction were included. Each of these studies employed different assessment instruments (Fig. 1). 
 

Fig. 1. Flowchart for screening articles

4.    Discussion
The objective of this study was to explore assessment tools for psychological factors associated with return to sport following anterior cruciate ligament (ACL) reconstruction. A review of the existing literature showed that several methodologies have been applied to investigate these factors. In total, six studies were identified that evaluated instruments designed to measure psychological readiness after ACL reconstruction, each using distinct tests. Among these, the ACL-Return to Sport after Injury (ACL-RSI) scale provides the most comprehensive evaluation of psychological readiness in athletes recovering from ACL reconstruction. Although other instruments share certain features with the short version of the ACL-RSI, none assess psychological readiness with the same depth and specificity. Psychological assessment of injured athletes, particularly those with ACL injuries, is crucial for determining safe return-to-sport decisions. Validated instruments such as the ACL-RSI, I-PRRS, TSK, IKDC, and KOOS offer reliable evaluations of psychological readiness, fear of reinjury, and functional performance. These tools enable clinicians, coaches, and practitioners to make evidence-based decisions about the timing of return to sport. Using these instruments in combination provides a multidimensional perspective that not only reduces the risk of reinjury but also supports improvements in both qualities of life and athletic performance. 

Ethical Considerations
Compliance with ethical guidelines
There were no ethical considerations to be addressed in this research.
Funding
This research did not receive any financial support from government, private, or non-profit organizations.
Authors' contributions
All authors contributed equally to preparing the article.
Conflicts of interest
The authors declare that there are no conflicts of interest associated with this article.