Applications and accuracy of 3D-printed surgical guides in traumatology and orthopaedic surgery: A systematic review and meta-analysis.

Autor: Hess S; Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Husarek J; Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital University of Bern Bern Switzerland.; Faculty of Medicine University of Bern Bern Switzerland.; Faculty of Medicine Medical University of Sofia Sofia Bulgaria., Müller M; Department of Emergency Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Eberlein SC; Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Klenke FM; Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Hecker A; Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital University of Bern Bern Switzerland.
Jazyk: angličtina
Zdroj: Journal of experimental orthopaedics [J Exp Orthop] 2024 Aug 12; Vol. 11 (3), pp. e12096. Date of Electronic Publication: 2024 Aug 12 (Print Publication: 2024).
DOI: 10.1002/jeo2.12096
Abstrakt: Background: Patient-Specific Surgical Guides (PSSGs) are advocated for reducing radiation exposure, operation time and enhancing precision in surgery. However, existing accuracy assessments are limited to specific surgeries, leaving uncertainties about variations in accuracy across different anatomical sites, three-dimensional (3D) printing technologies and manufacturers (traditional vs. printed at the point of care). This study aimed to evaluate PSSGs accuracy in traumatology and orthopaedic surgery, considering anatomical regions, printing methods and manufacturers.
Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies were eligible if they (1) assessed the accuracy of PSSGs by comparing preoperative planning and postoperative results in at least two different planes (2) used either computer tomography or magnetic resonance imaging (3) covered the field of orthopaedic surgery or traumatology and (4) were available in English or German language. The 'Quality Assessment Tool for Quantitative Studies' was used for methodological quality assessment. Descriptive statistics, including mean, standard deviation, and ranges, are presented. A random effects meta-analysis was performed to determine the pooled mean absolute deviation between preoperative plan and postoperative result for each anatomic region (shoulder, hip, spine, and knee).
Results: Of 4212 initially eligible studies, 33 were included in the final analysis (8 for shoulder, 5 for hip, 5 for spine, 14 for knee and 1 for trauma). Pooled mean deviation (95% confidence interval) for total knee arthroplasty (TKA), total shoulder arthroplasty (TSA), total hip arthroplasty (THA) and spine surgery (pedicle screw placement during spondylodesis) were 1.82° (1.48, 2.15), 2.52° (1.9, 3.13), 3.49° (3.04, 3.93) and 2.67° (1.64, 3.69), respectively. Accuracy varied between TKA and THA and between TKA and TSA.
Conclusion: Accuracy of PSSGs depends on the type of surgery but averages around 2-3° deviation from the plan. The use of PSSGs might be considered for selected complex cases.
Level of Evidence: Level 3 (meta-analysis including Level 3 studies).
Competing Interests: The authors declare no conflict of interest.
(© 2024 The Author(s). Journal of Experimental Orthopaedics published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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