Dataset Information

Limited Evidence Suggests a Protective Association Between Oral Contraceptive Pill Use and Anterior Cruciate Ligament Injuries in Females: A Systematic Review.

ABSTRACT:

Context

Female athletes aged 14 to 18 years are at particular risk for anterior cruciate ligament (ACL) injuries. Hormonal factors are thought to predispose them to this injury. Oral contraceptive pills (OCPs) might reduce ACL injury risk, although the literature appears controversial.

Objective

To evaluate the association between OCP use and ACL injuries in women. The secondary objective was to determine the rates of ACL injuries in the pre- and postovulatory phases of the menstrual cycle in OCP and non-OCP (NOCP) users.

Data sources

Searches were performed across 4 reference databases (PubMed, CINAHL, Embase, Cochrane), abstracts from 6 specialty societies, ClinicalTrials.gov , and reference lists of relevant papers.

Study selection

We included studies investigating the association between OCP use and ACL injuries in females of any age or the distribution of ACL injuries across the menstrual cycle in OCP and NOCP users.

Study design

Systematic review.

Level of evidence

Level 3.

Data extraction

Data regarding study design, population characteristics, OCP details, outcome definitions, analytic methods, and results were extracted from the included studies. The methodological quality of each study was assessed using the Newcastle-Ottawa scale.

Results

The search yielded 1305 citations, of which 7 retrospective observational studies met the inclusion criteria. Two large case-control studies with higher methodological quality suggested that OCP use may reduce the risk of sustaining an ACL injury. Five comparative studies examining injury distribution across the menstrual cycle in OCP and NOCP users had conflicting findings, were heterogeneous, and were limited by low methodological quality.

Conclusion

The evidence suggests OCP use may reduce the risk of ACL injury; however, no conclusions can be drawn regarding differences in risk of ACL injuries between OCP and NOCP users across the menstrual cycle. Studies were limited by small sample sizes, heterogeneity, and methodological concerns.

SUBMITTER: Samuelson K

PROVIDER: S-EPMC5665118 | biostudies-literature | 2017 Nov/Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Limited Evidence Suggests a Protective Association Between Oral Contraceptive Pill Use and Anterior Cruciate Ligament Injuries in Females: A Systematic Review.

Samuelson Kathleen K Balk Ethan M EM Sevetson Erika L EL Fleming Braden C BC

Sports health 20171010 6

<h4>Context</h4>Female athletes aged 14 to 18 years are at particular risk for anterior cruciate ligament (ACL) injuries. Hormonal factors are thought to predispose them to this injury. Oral contraceptive pills (OCPs) might reduce ACL injury risk, although the literature appears controversial.<h4>Objective</h4>To evaluate the association between OCP use and ACL injuries in women. The secondary objective was to determine the rates of ACL injuries in the pre- and postovulatory phases of the menstr ...[more]

PMID: 29016234

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Project description:PurposeTo assess failure rate, outcomes, and patient satisfaction in patients who underwent anterior cruciate ligament (ACL) repair with suture augmentation for clinical instability and proximal avulsion of the ACL.MethodsWe retrospectively reviewed consecutive suture-augmented ACL repairs performed by a single surgeon between January 2014 and June 2016 for proximal ACL avulsion. Patients were included if they were at least 24 months postoperative from repair surgery. Patients were excluded from the study if they underwent primary ACL reconstruction instead of repair or if they had a concomitant multiligamentous knee injury. Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), Veterans RAND-12 (VR-12), Marx Activity, and Single Assessment Numeric Evaluation data were collected.ResultsOf 172 patients who underwent ACL surgery between January 2014 and June 2016, 28 (16%) with Sherman type I or II ACL tears or high-grade partial avulsion with clinical instability underwent ACL repair with suture augmentation. One patient was not available for follow-up. The 27 patients were age 27.4 ± 8.6 years, 18 males (66.7%), and 2.8 ± 0.7 years follow-up (range, 2.0-3.8 years). Of these 27 patients, 4 recurrent ACL injuries (14.8%) required revision to reconstruction. The remaining 23 patients had successful ACL repair with no clinical instability and no subjective complaints at final follow-up. Final scores were KOOS 83.7 ± 12.8, Marx 8.6 ± 4.0, VAS 1.1 ± 1.8, physical VR-12 53.6 ± 5.2, mental VR-12 53.1 ± 8.1, and Single Assessment Numeric Evaluation 83.0 ± 12.9. In the 11 patients with baseline data, significant improvements were observed in composite KOOS (50.4 ± 11.5 to 85.7 ± 8.4; P < .001; VAS: 3.9 ± 2.6 to 0.8 ± 0.8; P = .002; and physical VR-12: 39.9 ± 6.5 to 55.5 ± 3.3; P < .001). All 11 patients (100%) met or exceeded the KOOS composite minimum clinically important difference (mean 34.0 increase).ConclusionsIn patients with proximal ACL avulsion, arthroscopic primary ACL repair with suture augmentation demonstrated high functional outcome and improved patient-reported outcomes at 2-year follow-up. The rate of graft failure was 15%.Level of evidenceLevel IV, therapeutic case series.

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Dataset Information

Limited Evidence Suggests a Protective Association Between Oral Contraceptive Pill Use and Anterior Cruciate Ligament Injuries in Females: A Systematic Review.

Context

Objective

Data sources

Study selection

Study design

Level of evidence

Data extraction

Results

Conclusion

Publications

Limited Evidence Suggests a Protective Association Between Oral Contraceptive Pill Use and Anterior Cruciate Ligament Injuries in Females: A Systematic Review.

Similar Datasets

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