TDNet Discover

Background: The risk of developing an anterior cruciate ligament (ACL) tear is higher for females than males. Studies have reached contradictory conclusions regarding the role of hormonal fluctuation patterns and the use of hormonal contraception on ACL injury risk for females. Purpose: To conduct a systematic review of available systematic reviews in literature to delineate the prophylactic effect of contraceptive use on injuries to the ACL for female athletes. Methods: Searches for clinically relevant systematic reviews were conducted using Google Scholar, PubMed, and EBSCOhost. Studies meeting inclusion criteria were independently reviewed by the 3 researchers for quality and overall strength of evidence using the CASP (Critical Appraisal Skills Programme) critical appraisal tool. Data extraction was achieved using a data extraction tool for intervention reviews from The Cochrane Collection and collectively reviewed for consistency. Results: Four reviews totaling 3,166,007 participants were included. All 4 of the studies evaluated received a good quality of evidence score. Although there was not a unanimous conclusion, evaluation of the systematic reviews included in this research found ample evidence that there is a protective component of OCP use against ACL injury, likely due to the suppression of ovulation, which reduces the amount of ligament laxity. Conclusion: It is vital to note that all the reviews also included studies with conflicting evidence, thus highlighting the lack of consensus on the role of oral contraceptives. While these medications have non-reproductive effects and most likely reduce the risk of ACL tears, there must be further investigation with homogenous studies to determine the v true relationship between OCPs and ligamentous injury.