NATIONWIDE ETHNIC/RACIAL DIFFERENCES IN SURGICAL TREATMENT OF DISCOID MENISCUS IN CHILDREN: A PHIS DATABASE STUDY

BACKGROUND: Discoid meniscus, a congenital meniscus variant, may have greater incidence in Asian populations. No United States population-based studies have examined the discoid meniscus ethnic/racial distribution. HYPOTHESIS/PURPOSE: In pediatric patients undergoing meniscus surgery, we hypothesize that ethnic/racial variability exists in patients with discoid meniscus and this variability is different than in patients with isolated medial meniscus tears. METHODS: The Pediatric Health Information System (PHIS) was queried from 48 hospitals to examine patients 18 years of age and younger between 2015 and 2019, using ICD-10 codes. A cohort of patients treated surgically for discoid meniscus was compared to a cohort of patients treated surgically for medial meniscal tear. These two populations were compared based on age, gender, ethnicity/race, CPT(®) code, insurance, urban vs rural, and region of country. Univariate testing and multivariable logistic modeling were used to test for associations. RESULTS: A discoid meniscus cohort of 399 children (median age, 13.0 years) was compared to a medial meniscus tear cohort of 3157 children (median age, 16.0 years) (p<0.001) (Table 1). Hispanic/Latino children accounted for 36.8% of the discoid meniscus and 22.7% of the medial meniscus populations (p<0.001). Among pediatric patients that had surgery for discoid meniscus or medial meniscus, Hispanic/Latino children had 2.4 times the odds of surgery for discoid meniscus compared to white patients after adjusting for age and insurance (p<0.001) (Table 2). Asian children also had 2.4 times the odds of surgery for discoid meniscus compared to white patients (p=0.017). CONCLUSION: This study shows a significant association of ethnicity/race with discoid versus medial meniscus surgical treatment in children. Among pediatric patients that had surgery for discoid or medial meniscus, Hispanic/Latino and Asian patients were significantly more likely to have surgery for discoid meniscus than white patients. Hispanic/Latino children made up a greater percentage of the population having surgery for a discoid meniscus versus medial meniscus. When evaluating pediatric patients, younger age and Asian or Hispanic/Latino ethnicity should increase attention to the possibility of a discoid meniscus.