Epidemiology of Meniscal Allograft Transplantation at Children's Hospitals in the United States.

backgroundMeniscal allograft transplantation (MAT) was developed with the goal of delaying the progression of degenerative disease in the setting of substantial meniscal deficiency. This may be especially important in children and adolescents; however, there is a paucity of literature on MAT in this population. PURPOSE: To evaluate the epidemiology of MAT at pediatric hospitals in the United States, with specific attention to regional and characteristic trends. STUDY

designCase-control study; Level of evidence, 3.

methodsThe Pediatric Health Information System, a national database consisting of 49 children's hospitals, was queried for all patients younger than 25 years who underwent MAT between 2011 and 2018. Characteristic information and surgical history were collected for each patient. The database was also queried for all patients who underwent other meniscal surgeries (including debridement, meniscectomy, and meniscal repair) during the same period (controls). Characteristic and geographic data from the control group were compared with those of the patients who underwent MAT. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors.

resultsA total of 27,168 meniscal surgeries were performed in 47 hospitals, with MAT performed 67 times in 17 hospitals. Twelve (18%) patients underwent a subsequent procedure after transplantation. In multivariate analysis, each year of increasing age resulted in 1.1 times higher odds of having undergone MAT (95% CI, 1.03-1.1;

conclusionIn the United States, pediatric and adolescent patients who underwent MAT were older and more likely to be female and have private insurance than those undergoing meniscal repair or meniscectomy. MAT was only performed in 17 of 47 children's hospitals that perform meniscal surgery. These trends highlight the need for further research, especially regarding differences along the lines of sex and insurance status.