Osteochondral autograft (OAU) transfer and osteochondral allograft (OAL) transfer are options for treating sizable articular cartilage lesions in the knee, but there is little evidence to support one technique over another. The goal of this study is to compare the rate of reoperation among children and adolescents undergoing OAU or OAL of the knee. In this retrospective cohort study, the Pediatric Health Information System, a national database consisting of 49 children's hospitals, was queried for all patients undergoing OAU and OAL between 2012 and 2018. A total of 732 subjects with a mean age of 15.4±2.4 years were included. Of these, 393 (53.7%) initially underwent OAL and 339 (46.3%) underwent OAU. The overall reoperation rate was 144 of 732 (19.7%) at a median of 6.6 months (range, 0.6–53.5 months) after the index operation. This rate was similar for OAL and OAU. For 18 subjects (2.5%), OAU, OAL, or autologous chondrocyte implantation (ACI) was performed at the time of revision surgery. When analyzing only open procedures, we found that the reoperation rate was 25.5% for open OAU compared with 16.5% for open OAL (P=.03). When adjusting for covariates in multivariate regression, we found that those who underwent open OAU had 1.7 times higher odds of requiring a future reoperation than those who underwent open OAL (95% CI, 1.1–2.8; P=.04). Although the rate of reoperation after OAU or OAL among children and adolescents is relatively high, few require revision OAU, OAL, or ACI. Patients undergoing open OAU have higher odds of ultimately requiring reoperation than those undergoing open OAL. [Orthopedics. 20XX;XX(X):xx–xx.]

骨软骨自体移植 (OAU) 移植和骨软骨同种异体移植 (OAL) 移植是治疗膝关节较大关节软骨损伤的选择，但几乎没有证据支持一种技术优于另一种技术。本研究的目的是比较接受膝关节 OAU 或 OAL 的儿童和青少年的再次手术率。在这项回顾性队列研究中，儿科健康信息系统是一个由 49 家儿童医院组成的国家数据库，查询了 2012 年至 2018 年期间接受 OAU 和 OAL 的所有患者。共有 732 名平均年龄为 15.4±2.4 岁的受试者接受了包括。其中，393 名 (53.7%) 最初接受了 OAL，339 名 (46.3%) 接受了 OAU。总体再手术率为 732 例中的 144 例 (19.7%)，指数手术后的中位数为 6.6 个月（范围，0.6-53.5 个月）。OAL 和 OAU 的这一比率相似。对于 18 名受试者 (2.5%)，在翻修手术时进行了 OAU、OAL 或自体软骨细胞植入 (ACI)。当仅分析开放式程序时，我们发现开放式 OAU 的再手术率为 25.5%，而开放式 OAL 为 16.5%（P =.03）。在调整多变量回归中的协变量时，我们发现接受开放式 OAU 的患者未来需要再次手术的几率是接受开放式 OAL 的患者的 1.7 倍（95% CI，1.1–2.8；P =.04）。尽管儿童和青少年 OAU 或 OAL 后的再手术率相对较高，但很少需要翻修 OAU、OAL 或 ACI。接受开放式 OAU 的患者最终需要再次手术的几率高于接受开放式 OAL 的患者。[骨科。20XX;XX(X):xx–xx.]