Use of Hormonal Contraceptives Is Associated With Decreased Incidence of Anterior Cruciate Ligament Injuries Requiring Reconstruction in Female Patients.

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Sydney A Fry, Ankit Hirpara, Kaitlyn E Whitney, Carson L Keeter, Evangelia P Constantine, Kyle G Williams, Jason L Dragoo
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引用次数: 0

Abstract

Purpose: To investigate associations between hormonal contraceptive use and female patients who had sustained an anterior cruciate ligament (ACL) injury requiring reconstruction.

Methods: Deidentified data collected from female patients aged 15 to 35 years between 2011 and 2024 were obtained from the Colorado Health Data Compass database. The study patients were separated into female patients who sustained an ACL injury that was treated by arthroscopic ACL reconstruction and female patients without a history of ACL injury. Among these groups, non-contraceptive users, total hormonal systemic contraceptive users (including oral contraceptive pills [OCPs], implants, rings, injections, and patches), and OCP users (including formulations of norethindrone [NE] only, drospirenone plus ethinyl estradiol (EE), NE plus EE, and norgestimate plus EE) were included in the analysis.

Results: The 2,120,628 female patients in the systemic hormonal contraceptive use group had a lower incidence of ACL injury (0.079%; 95% confidence interval [CI], 0.075%-0.083%) than the 12,766,138 female patients in the non-contraceptive use group (0.12%; 95% CI, 0.118%-0.121%). In addition, the 745,062 female patients in the OCP use group had a lower ACL injury incidence (0.088%; 95% CI, 0.081%-0.095%), suggesting an association between contraceptive use and ACL injury. When data were stratified by 5-year age intervals, the 15- to 19-year-old group showed no difference in the ACL injury incidence between the OCP use group (0.101%; 95% CI, 0.081%-0.125%) and the non-contraceptive use group (0.118%; 95% CI, 0.114%-0.122%), whereas all other age groups showed a lower ACL injury incidence in the OCP use group. All age groups in the systemic hormonal contraceptive use group had a lower ACL injury incidence than the non-contraceptive use group. Additionally, different contraceptive formulations showed a similar injury incidence, with a lower proportion of ACL injuries in NE-only users (0.03%) compared with norgestimate-EE users (0.093%), NE-EE users (0.099%), and drospirenone-EE users (0.096%).

Conclusions: Systemic hormonal contraceptive use is associated with a lower incidence of ACL injury requiring ACL reconstruction compared with no contraceptive use in female patients aged 15 to 35 years, with a stronger association with progestin-only OCPs. Female patients aged 15 to 19 years showed no difference in the association with the ACL injury incidence between OCP use and no contraceptive use.

Level of evidence: Level III, prognostic retrospective comparative study.

使用激素避孕药与女性前交叉韧带损伤需要重建的发生率降低有关。
目的:探讨激素避孕药的使用与女性前交叉韧带损伤需要重建之间的关系。方法:本研究从科罗拉多州健康数据指南针数据库中获取2011年至2024年间15至35岁的女性患者的去识别数据。研究人员将前交叉韧带损伤的女性与无前交叉韧带损伤史的女性分开,前者接受关节镜下前交叉韧带重建治疗。在这些组中,非避孕药使用者、全激素系统避孕药(包括口服避孕药(OCP)、植入物、环、注射剂和贴片)使用者、OCP使用者(包括仅使用去甲thindrone (NE)、drosprenone (DS) +乙炔雌二醇(EE)、(NE + EE)、norgestimate (NG + EE)制剂)使用者被纳入分析。结果:使用全身性激素避孕药组2,120,628名女性ACL损伤发生率较低(0.079%;CI: 0.075 ~ 0.083),与未使用避孕药具组的12,766,138名女性相比(0.12%;CI: 0.118 ~ 0.121)。使用OCP组的745,062名女性ACL损伤发生率也较低(0.088%;CI: 0.081 ~ 0.095),提示避孕药的使用与前交叉韧带损伤之间存在关联。当按5年年龄间隔分层时,15 - 19岁年龄组使用OCP组的ACL损伤发生率(0.101%,CI: 0.081, 0.125)与未使用避孕药组(0.118%,CI: 0.114, 0.122)之间没有差异,而所有其他年龄组使用OCP组的ACL损伤发生率均较低。与未使用避孕药组相比,使用全身性激素避孕药组的所有年龄组ACL损伤发生率均较低。此外,不同的避孕配方显示出相似的伤害发生率,与NG+EE(0.093%)、NE+EE(0.099%)和DS+EE(0.096%)相比,NE+EE使用者中ACL损伤的比例(0.03%)较低。结论:在15 - 35岁的女性中,与不使用避孕药相比,使用全身性激素避孕药与需要ACL重建的ACL损伤发生率较低相关,且与仅使用孕激素的ocp有更强的相关性。15至19岁的女性在使用OCP和不使用避孕措施与ACL损伤发生率的关联方面没有差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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