The efficacy of 3D-printed patient-specific instrument in assisting high tibial osteotomy: a meta-analysis
10.3760/cma.j.cn121113-20250301-00205
- VernacularTitle:3D打印个体化截骨导板辅助胫骨高位截骨的meta分析
- Author:
Zhihu ZHAO
1
;
Wei LUO
1
;
Xinlong MA
1
Author Information
1. 天津市天津医院数字骨科技术与临床应用中心，天津 300211
- Publication Type:Journal Article
- Keywords:
Knee joint;
Osteotomy;
Printing, three-dimensional;
Meta-analysis
- From:
Chinese Journal of Orthopaedics
2025;45(19):1251-1260
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy of 3D-printed patient-specific instrument (PSI) in assisting high tibial osteotomy (HTO).Methods:Clinical studies on 3D-printed PSI-assisted HTO were retrieved from various databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP, the Chinese Medical Journal Full-text Database, PubMed, Embase, and Web of Science. Key data extracted included the hip-knee-ankle (HKA) angle, weight-bearing line (WBL) ratio, mechanical medial proximal tibial angle (MPTA), number of intraoperative fluoroscopies, and operation time. Studies were categorized into a PSI group (using 3D-printed PSI for osteotomy) and a non-PSI group (without 3D-printed PSI assistance). Comparisons were made between pre- and post-operative radiographic improvements in the PSI group, as well as differences between post-operative outcomes and pre-operative planned values. Additionally, the number of fluoroscopies and operation time were compared between the PSI and non-PSI groups. Meta-analysis was performed using Stata 12.0 statistical softwar.Results:A total of 30 studies were included in the meta-analysis. The results indicated that in the PSI group, the post-operative WBL ratio [ WMD=-39.66, 95% CI(-43.19, -36.12), P<0.001], HKA [ WMD=-8.85, 95% CI(-10.17, -7.52), P<0.001], and MPTA [ WMD=-8.65, 95% CI(-9.61, -7.68), P<0.001] were significantly smaller compared to pre-operative values. However, there were no significant differences between the post-operative values and pre-operative planned values for the WBL ratio [ WMD=0.74, 95% CI(-0.17, 1.66), P=0.112], HKA [ WMD=0.20, 95% CI(-0.05, 0.45), P=0.116], or MPTA [ WMD=0.22, 95% CI(-0.04, 0.48), P=0.147] in the PSI group. Furthermore, the operation time [ WMD=-14.04, 95% CI(-17.66, -10.42), P<0.001] and the number of fluoroscopies [ WMD=-9.33, 95% CI(-12.36, -6.30), P<0.001] were significantly lower in the PSI group compared to the non-PSI group. Conclusion:3D-printed PSI-assisted HTO enhances precision, reduces operation time, and minimizes the number of intraoperative fluoroscopies.
