He Yanwei, Zhou Peng, He Chengsong
Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Rheumatology and Immunology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Ann Transl Med. 2022 Apr;10(7):403. doi: 10.21037/atm-21-7008.
The aim of the present study was to systematically evaluate the application value and complications of 3D printing technology on Schatzker tibial platform fracture surgery.
By searching the Cochrane Library, PubMed, Web of Science, Embase, Chinese Biomedical Literature Database (CBM), screening randomized controlled trials (RCTs), and two researchers included the study according to PICOS criteria and performed bias risk assessments. Quality evaluation and data extraction were performed for the included literatures, and meta-analysis was performed for RCTs included at using Review Manager 5.2 software.
A total of 15 articles were included in the present study, which included a total of 758 patients, 342 3D printing techniques, 416 conventional surgical procedures. Meta-analysis showed 3D printing operation time [risk difference (RD) =-0.12, 95% CI: -0.16, -0.08, I=46%, P<0.00001], surgical bleeding [odds ratio (OR) =0.59, 95% CI: 0.45-0.77, I=0%, P<0.001), intraoperative fluoroscopy (OR =0.59, 95% CI: 0.41-0.85, I=0%, P=0.004), fracture healing time (OR =0.46, 95% CI: 0.33-0.63, I=0%, P<0.00001), and complication morbidity (OR =0.60, 95% CI: 0.45-0.81, I=0%, P=0.001) were significantly lower than in the traditional group.
3D printing technology for tibia platform fracture surgery has advantages of reduced operation time, less surgical bleeding, less complications, less intraoperative perspective, fast fracture healing, and can improve the accuracy of tibial platform fracture reduction and postoperative knee function recovery.
本研究旨在系统评价3D打印技术在Schatzker胫骨平台骨折手术中的应用价值及并发症。
通过检索Cochrane图书馆、PubMed、Web of Science、Embase、中国生物医学文献数据库（CBM），筛选随机对照试验（RCT），两名研究人员根据PICOS标准纳入研究并进行偏倚风险评估。对纳入文献进行质量评价和数据提取，使用Review Manager 5.2软件对纳入的RCT进行荟萃分析。
本研究共纳入15篇文章，共758例患者，其中342例采用3D打印技术，416例采用传统手术方法。荟萃分析显示，3D打印组的手术时间[风险差（RD）=-0.12，95%可信区间（CI）：-0.16，-0.08，I²=46%，P<0.00001]、手术出血量[比值比（OR）=0.59，95%CI：0.45-0.77，I²=0%，P<0.001]、术中透视次数（OR =0.59，95%CI：0.41-0.85，I²=0%，P=0.004）、骨折愈合时间（OR =0.46，95%CI：0.33-0.63，I²=0%，P<0.00001）及并发症发生率（OR =0.60，95%CI：0.45-0.81，I²=0%，P=0.001）均显著低于传统组。
3D打印技术应用于胫骨平台骨折手术具有手术时间短、手术出血少、并发症少、术中透视少、骨折愈合快等优点，可提高胫骨平台骨折复位的准确性及术后膝关节功能恢复情况。
