Department of Orthopedic, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519000, Guangdong Province, China.
J Orthop Surg Res. 2021 Nov 18;16(1):682. doi: 10.1186/s13018-021-02832-5.
Three-dimensional (3D) printing technology has developed rapidly in orthopaedic surgery and effectively achieves precise and personalized surgery. The purpose of this meta-analysis was to assess the efficacy of 3D printing technology in the management of displaced intra-articular calcaneal fractures (DICFs) by extended lateral approach (ELA).
We searched PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, and VANFUN databases were searched up to October 2020. All clinical studies comparing traditional surgery and 3D printing-assisted surgery in the management of DICFs were obtained, evaluating the quality of the included studies and extracting data. For each study, we assessed odds ratios (ORs), standard mean difference (SMD), and 95% confidence interval (95% CI) to assess and synthesize the outcomes.
Three RCTs and nine retrospective studies involving 732 patients were included met our inclusion criteria with 366 patients in the 3D group and 366 patients in the conventional group. The meta-analysis showed that there were significant differences of the operative time in the 3D group [SMD = - 1.86, 95% CI (- 2.23, - 1.40), P < 0.001], intraoperative blood loss [SMD = - 1.26, 95% CI (- 1.82, - 0.69), P < 0.001], the number of intraoperative X-ray exposures [SMD = - 0.66, 95% CI (- 1.20, - 0.12), P < 0.001], postoperative complications [OR = 0.49, 95% CI (0.31, 0.79), P < 0.001], excellent and good rate of calcaneal fracture outcome [OR = 4.09, 95% CI (2.03, 8.22), P < 0.001].
The current study indicates that 3D printing-assisted ELA surgery showed a better rate of excellent and good outcome, shorter operation time, less intraoperative blood loss, fewer intraoperative fluoroscopies, fewer complications. Besides, there is still a need for large-sample, high-quality, long-term randomized controlled trials to confirm the conclusion.
三维（3D）打印技术在骨科领域发展迅速，可实现精准化、个体化手术。本荟萃分析旨在评估 3D 打印技术通过外侧扩大入路（ELA）治疗关节内移位跟骨骨折（DICF）的疗效。
我们检索了 PubMed、Web of Science、Embase、Cochrane 图书馆、中国知网（CNKI）、维普数据库和万方数据库，检索时间截至 2020 年 10 月。获取了所有比较传统手术与 3D 打印辅助手术治疗 DICF 的临床研究，评估纳入研究的质量并提取数据。对于每项研究，我们评估了比值比（OR）、标准化均数差（SMD）和 95%置信区间（95%CI），以评估和综合结局。
纳入了 3 项 RCT 和 9 项回顾性研究，共 732 例患者，其中 3D 组 366 例，常规组 366 例。荟萃分析显示，3D 组的手术时间[SMD=-1.86，95%CI（-2.23，-1.40），P<0.001]、术中出血量[SMD=-1.26，95%CI（-1.82，-0.69），P<0.001]、术中 X 射线暴露次数[SMD=-0.66，95%CI（-1.20，-0.12），P<0.001]和术后并发症[OR=0.49，95%CI（0.31，0.79），P<0.001]差异均有统计学意义。3D 组的优良率[OR=4.09，95%CI（2.03，8.22），P<0.001]也优于常规组。
目前的研究表明，3D 打印辅助 ELA 手术具有更好的优良率，手术时间更短，术中出血量更少，术中 X 射线暴露次数更少，并发症更少。但仍需要大样本、高质量、长期的随机对照试验来证实这一结论。
