Alcohol Misuse, Posttraumatic Stress Symptoms, and Recovery After Musculoskeletal Injury: Implications for Effective Orthopaedic Care

J Am Acad Orthop Surg. 2026 Mar 10. doi: 10.5435/JAAOS-D-25-00641. Online ahead of print.

ABSTRACT

Musculoskeletal injuries severe enough to warrant hospitalization commonly co-occur with alcohol misuse and posttraumatic stress disorder (PTSD) symptoms, complicating recovery (return of comfort and capability). Nearly half of trauma patients have detectable alcohol at injury, and over one in five exhibit symptoms of PTSD during recovery. These co-occurring conditions are associated with greater levels of pain intensity and incapability, limited participation in exercises, and adverse events and hospital readmissions. Routine screening and brief interventions such as Screening, Brief Intervention, and Referral to Treatment for alcohol misuse and standardized self-report screening tools such as the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) have established clinical utility; however, implementation within orthopaedic practice remains inconsistent because of resource limitations, clinician uncertainty, and fragmented care coordination. Integrated, technology-enhanced interventions incorporate psychoeducation, coping-skills training, motivational interviewing, and personalized feedback to concurrently address alcohol misuse, PTSD symptoms, and pain. Digital health platforms-including telehealth and mobile applications-may help overcome barriers to implementing integrated interventions in orthopaedic trauma settings, thereby supporting widespread use and long-term sustainability. Adopting multidisciplinary care pathways tailored to individual risk profiles may facilitate implementation of these interventions, enhancing clinical efficiency, patient adherence, and orthopaedic recovery outcomes.

PMID:41802211 | DOI:10.5435/JAAOS-D-25-00641