Meta analysis of three-dimensional printing patient-specific instrumentation versus conventional instrumentation in total knee arthroplasty
10.3760/cma.j.issn.0529-5815.2017.10.012
- VernacularTitle: 三维打印个性化导板与传统截骨工具在全膝关节置换术中疗效比较的Meta分析
- Author:
Jiangtao REN
1
;
Cong XU
;
Jiansong WANG
;
Xianglin LIU
Author Information
1. Department of Joint Surgery, Affiliated Hospital of Chengde Medical University, Chengde 067000, HeBei Province, China
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement, knee;
Meta-analysis;
Three-dimensional;
Conventional instrumentation;
Individuality
- From:
Chinese Journal of Surgery
2017;55(10):775-781
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of three-dimensional printing patient-specific instrumentation(PSI) versus conventional instrumentation(CI) in the total knee arthroplasty.
Methods:According to "patient-specific" , "patient-matched" , "custom" , "Instrumentation" , "Guide Instrumentation" , "cutting blocks" , "total knee arthroplasty" , "total knee replacement" , "TKA" and "TKR" , the literature on PubMed, EMbase, Cochrane library, CBM and WanFang were searched. According to the inclusion and exclusion criteria, the high quality randomized control trial (RCT) studies about three-dimensional (3D) printing patient-specific instrumentation versus conventional instrumentation in the total knee arthroplasty were collected. The post-operative limb mechanical axis outlier, the position of the components outlier, post-operative knee function, operative time, post-operative blood transfusion and complications were analyzed by RevMan 5.3 software.
Results:A total of 13 high quality RCT studies were included. The results of Meta-analysis show that there were no statistical differences in the post-operative limb mechanical axis outlier(Z=0.55, P=0.58, 95% CI: 0.78 to 1.56), femoral coronal component outlier(Z=0.38, P=0.71, 95% CI: 0.69 to 1.72), tibia coronal component outlier(Z=1.95, P=0.05, 95% CI: 1.00 to 3.38), femoral rotation angle outlier(Z=0.36, P=0.72, 95% CI: 0.49 to 1.64), post-operative knee function(Z=1.18, P=0.24, 95% CI: -0.66 to 2.63), post-operative blood transfusions(Z=0.74, P=0.46, 95% CI: -0.10 to 0.05) and complications(Z=0.18, P=0.86, 95%CI: -0.07 to 0.05) between the PSI group and the CI group. But there are statistical differences in the operation time(Z=2.66, P=0.01, 95% CI: -15.97 to -2.41)and tibia sagittal component outlier (Z=3.69, P=0.00, 95% CI: 1.43 to 3.18)between the PSI group and the CI group.
Conclusions:In the primary total knee arthroplasty the PSI is not superior over the CI for the knee without severe knee varus or valgus deformity or contracture deformity, without the deformity around the knee and without the knee bone loss and obesity. The use of PSI in the primary total knee arthroplasty are not recommend.
