A meta-analysis of efficacy and complications of 3D printing-assisted surgery for schatzker iv-vitibial plateau fractures

Weng NENGYUAN

ABSTRACT

BACKGROUND:

Although 3D printing technology has been gradually applied in the operation of tibial plateau fracture, there are still few reports about 3D printing assisted operation of Schatzker IV-VI tibial plateau fracture. Thus, it is necessary to make a meta-analysis and evaluation of the application value and complications of 3D printing assisted operation of Schatzker IV-VI tibial plateau fracture compared with traditional operation.

OBJECTIVE:

To evaluate the effect of 3D printing technology on therapeutic effect and complications of Schatzker IV-VI type tibial plateau fractures by meta-analysis.

METHODS:

PubMed, Cochrane Library, Web of Science, CNKI, CBM, and Wanfang databases were systematically searched by computer until December 2019. Two researchers independently screened the literature, evaluated the quality and extracted the data. The included literature was statistically analyzed using Stata 15.0 software. RESULTS AND

CONCLUSION:

(1) A total of 15 Chinese literatures were included, including a total of 758 patients, of which 342 underwent surgery assisted by 3D printing technology, 416 underwent traditional surgical treatment. (2) The results of meta-analysis showed Operation time [SMD=-2.023, 95%CI=-2.418~-1.628, P < 0.05], intraoperative blood loss [SMD=-1.981, 95%CI=-2.489~ -1.474, P < 0.05], intraoperative fluoroscopy [SMD=-3.183, 95%CI=-5.758~-0.608, P < 0.05], fracture healing time [SMD=-0.797, 95%CI=-1.504~-0.090, P < 0.05], and complication rate [RR=0.383, 95%CI=0.215~0.680, P < 0.05] were significantly lower in the 3D printing group than in the traditional group. (3) The Hospital for Special Surgery score at 6 months [RR=0.779, 95%CI=0.510~1.048, P < 0.05], the Hospital for Special Surgery score at 12 months [RR=0.603, 95%CI=0.334~0.871, P < 0.05], the excellent and good rate of Hospital for Special Surgery [RR=1.206, 95%CI=1.092~1.331, P < 0.05], and the excellent and good rate of Rasmussen score [RR=1.178, 95%CI=1.037~1.338, P < 0.05] were significantly better in the 3D printing group than in the traditional group. (4) The 3D printing technology in Schatzker type IV-VI tibial plateau fracture surgery has the advantages of shortening operation time, lessening intraoperative blood loss, few complications, less intraoperative fluoroscopy, and fast healing, which can improve the precision of tibial plateau fractures and postoperative knee function recovery.