Transcript pa0705023.ppt

Does a Relationship Exist Between the Prevalence of Anterior Cruciate Ligament Injuries
in Females and the Use of Estrogen and Progesterone Containing Contraception?
Rebecca Runge, PA-S and Patricia Bunton, MS, PA-C
Department of Physician Assistant
College of Health Professions, Wichita State University
Introduction
More females have been participating in
competitive athletics in the past twenty years
than previously and sustaining more injuries.
Anterior cruciate ligament (ACL) injuries have
a higher incidence in females than in males.
One study cites that women have a four to
eight times higher chance of sustaining a
grade three sprain of the ACL than men. One
factor that researchers have been exploring
involves the female hormones estrogen and
progesterone. Hormonal influence has yet to
be unanimously accepted among the medical
community as a precipitating factor.
The
purpose of this study is to determine if a
relationship exists between the use of
hormonal contraceptives and the prevalence
of ACL injuries in females. Results from this
study may influence women athletes’ decision
whether
or
not
to
use
hormonal
contraceptives
while
participating
in
competitive sports.
• 26 athletes responded
response rate.
for
a
10.4%
• 8 respondents (30.8%) had no history of
ACL injury and had been using prescription
contraceptives for greater than 12 months.
Oral contraceptives were the type most
commonly used.
• 16 respondents (61.5%) had no history of
ACL injury and no contraceptive use within
the last 12 months.
• 1 respondent (3.8%) had sustained an ACL
injury but was not using contraceptives at
the time of the injury.
• 1 respondent (3.8%) had sustained an ACL
injury and was using a hormonal
contraceptive.
Table 1: Survey Results
Methodology
Womens’ basketball and volleyball coaches
from 11 universities and colleges in Kansas
were contacted by email to determine their
willingness to distribute surveys to female
athletes at their location. Two hundred & fifty
surveys and cover letters, which described the
purpose of the study, were sent to the
coaches in September 2005 for distribution by
the coaches. A self-addressed stamped
envelope was included to encourage
participation in the study. Because of a poor
initial response, a second email was sent out
in late September.
Discussion
Results
Hormonal
contraceptive
use
No Hormonal
contraceptive
use
No ACL
injury
16
ACL injury
8
1
1
No conclusions can be drawn from this
study due to the small number of
respondents. Methods for increasing the
response rate need to be considered if
replication of this research were to be done,
such as mailing the surveys directly to the
athletes, or use of telephone or online
surveys. Better methodology may increase
the ability to determine if there is an
association between whether or not a
female
athlete
uses
hormonal
contraceptives and the risk of sustaining an
ACL injury.
Conclusion
Although no conclusion can be made from
this pilot study, the ongoing debate over this
issue indicates the need for further research
to determine the role, if any, that
endogenous hormones play in either
increasing or decreasing the risk of ACL
injury. As female athletics increases in
popularity, so does the need for research in
prevention of injury while encouraging high
levels of competition.