Background:

The rate of anterior cruciate ligament (ACL) reconstruction is increasing over time in pediatric/adolescent populations, but there is less evidence to support how concomitant meniscal procedures are changing over time. There are also less data to suggest which characteristics are associated with meniscectomy versus meniscal repair treatment.

Hypothesis:

Age, sex, race/ethnicity, income, and insurance type may independently affect the rate of concomitant meniscal procedures and treatment modalities in pediatric patients with ACL reconstruction.

Study Design:

Descriptive epidemiology study.

Methods:

The Pediatric Health Information System database was queried for all patients aged ≤18 years who underwent ACL reconstruction with or without concomitant meniscal procedures from 2015 to 2019. Basic demographic data including age, sex, self-identified race/ethnicity, rural-urban commuting area code, predicted median income, and insurance status were collected. Linear regression was used to model trends and multiple logistic regression modeling was used to test for associations.

Results:

A total of 14,398 patients aged ≤18 years underwent ACL reconstruction during the study period, with 8337 patients (58%) having concomitant meniscal procedures with a 1.24-fold increase over 5 years. Of the concomitant meniscal treatment cohort, 41% had a meniscectomy and 59% had meniscal repair. There was a 0.82-fold change in meniscectomy and a 1.67-fold increase in meniscal repair during the study period. Male patients, older patients, Black race, living in an urban area, and those with nonprivate insurance had increased odds of undergoing a concomitant meniscal procedure (all P < .05). Patients of non-White race and those with nonprivate insurance had increased odds of having a meniscectomy versus meniscal repair (all P < .05). There were no associations detected between income bracket and the outcomes in this study.

Conclusion:

This study shows that in pediatric and adolescent patients undergoing ACL reconstruction, there was a rise in concomitant meniscal procedures from 2015 to 2019. In addition, patients of non-White race and those with nonprivate insurance have increased odds of undergoing meniscectomy versus meniscal repair.

中文翻译：

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性别、种族/民族和社会经济因素对儿科和青少年 ACL 重建半月板治疗的影响

背景：

在儿科/青少年人群中，前交叉韧带 (ACL) 重建率随着时间的推移而增加，但支持伴随半月板手术如何随时间变化的证据较少。也很少有数据表明哪些特征与半月板切除术与半月板修复治疗相关。

假设：

年龄、性别、种族/民族、收入和保险类型可能独立影响 ACL 重建儿科患者的伴随半月板手术率和治疗方式。

学习规划：

描述性流行病学研究。

方法：

查询了 2015 年至 2019 年所有接受或不伴有半月板手术的 ACL 重建的 18 岁以下患者的儿科健康信息系统数据库。基本人口统计数据包括年龄、性别、自我识别的种族/民族、城乡通勤区域收集了代码、预测的收入中位数和保险状况。线性回归用于模拟趋势，多元逻辑回归模型用于测试关联。

结果：

在研究期间，共有 14,398 名年龄≤18 岁的患者接受了 ACL 重建，其中 8,337 名患者（58%）同时进行了半月板手术，5 年内增加了 1.24 倍。在伴随的半月板治疗队列中，41% 进行了半月板切除术，59% 进行了半月板修复。在研究期间，半月板切除术发生了 0.82 倍的变化，半月板修复增加了 1.67 倍。男性患者、老年患者、黑人、居住在城市地区和有非私人保险的患者接受伴随半月板手术的几率增加（所有P < .05）。非白人和有非私人保险的患者接受半月板切除术的几率高于半月板修复术（所有P< .05)。本研究未发现收入等级与结果之间存在关联。

结论：

这项研究表明，从 2015 年到 2019 年，在接受 ACL 重建的儿科和青少年患者中，伴随的半月板手术有所增加。此外，非白人和非私人保险的患者接受半月板切除术与半月板修复的几率增加。