April 30, 2026
2 min read
Key takeaways:
- Hormonal contraceptive use before ACL surgery may increase risk for pulmonary embolism.
- ED utilization also increased among patients on hormonal contraception.
NEW ORLEANS — Results presented here showed women on hormonal contraception before ACL surgery were more likely to experience complications and ED visits within 90 days after surgery.
“Patients who are on these types of medications prior to surgery should be counseled on the risk for complications that can be increased after surgery for an ACL injury,” Nicholas Bonazza, MD, associate professor in the department of orthopedic surgery at the University of Arizona, told Healio about results presented at the American Academy of Orthopaedic Surgeons Annual Meeting Specialty Day.
Data derived from Bonazza N, et al. Short-term postoperative risks associated with contraceptive use prior to ACL reconstruction in female patients. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting Specialty Day; March 6; New Orleans.
Using the TriNetX database, Bonazza and colleagues retrospectively reviewed data from patients aged 18 years and older who underwent ACL reconstruction or repair between 2007 and 2024. Researchers stratified patients based on whether they were taking hormonal contraceptives within 30 days before surgery or not and propensity matched both groups based on age, sex, race, ethnicity, BMI, diabetes and hypertension.
Nicholas Bonazza
“We then assessed complications that were sustained within 90 days after surgery, primarily focusing on infection, blood clots in the extremity or in the lungs and other common complications known to occur after any surgery, such as urinary tract infection, heart attack and stroke,” Bonazza said. “And then utilization of the emergency room or hospital readmission that could affect both the cost of an episode and indicate severity of the complication.”
In his presentation, Bonazza said patients taking hormonal contraceptives before ACL surgery were 2.1 times more likely to experience pulmonary embolism and 1.7 times more likely to experience deep vein thrombosis. He also said those patients were 1.8 times more likely to have a urinary tract infection. Utilization of the ED also increased among patients taking hormonal contraceptives before ACL surgery, and there was a small but statistically significant increase in knee stiffness and ACL injury, according to Bonazza.
“This study points out that there is a relationship between hormonal contraception and complications, such as a blood clot, after surgery,” Bonazza told Healio. “Further studies will be needed to assess what some of the factors are that may affect that risk, both in terms of counseling patients ahead of time and what we can do to prevent it around the time of surgery.”
For more information:
Nicholas Bonazza, MD, wishes to be contacted through Christine Stencel at cstencel@thereisgroup.com.
Sources/Disclosures
Source:
Bonazza N, et al. Short-term postoperative risks associated with contraceptive use prior to ACL reconstruction in female patients. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting Specialty Day; March 6; New Orleans.
Disclosures:
Bonazza reports no relevant financial disclosures.
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