The efficacy of 3D printing-assisted surgery for traumatic fracture: a meta-analysis

2019 ◽  
Vol 95 (1126) ◽  
pp. 414-419 ◽  
Author(s):  
Liang Xiong ◽  
Xiaoyang Li ◽  
Hui Li ◽  
Zhuoyuang Chen ◽  
Tao Xiao
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Comparative Studies ◽  
Meta Analysis ◽  
Mean Difference ◽  
Orthopaedic Trauma ◽  
Intraoperative Blood Loss ◽  
Conventional Surgery ◽  
3D Printing Technology ◽  
Operation Duration

BackgroundRecent years have witnessed a rapid development of three-dimensional (3D) printing technology applied in orthopaedic surgery. To be assisted by 3D printing is a potent method to realise accurate and individualised operation. The objective of this meta-analysis was to assess the efficacy of 3D printing technology in the management of trauma fractures.MethodsPubMed, Embase and the Cochrane Library were systematically searched up until January 2019 to identify relevant studies. All clinical studies comparing conventional surgery and 3D printing-assisted surgery in the management of orthopaedic trauma were obtained. The meta-analysis was performed with RevMan V.5.3 software.ResultsFour randomised controlled trials, four retrospective comparative studies and two prospective comparative studies involving 521 patients were included. Compared with conventional surgery, 3D printing-assisted surgery leads to shorter operation duration (mean difference (MD) −16.59 (95% CI −18.60 to –14.58), p<0.001), less intraoperative blood loss (standardised mean difference (SMD) −1.02 (95% CI –1.25 to –0.79), p<0.001) and fewer intraoperative fluroscopies (SMD −2.20 (95% CI –2.50 to –1.90), p<0.001). However, 3D printing-assisted surgery leads to longer hospital stay (MD 2.51 (95% CI 0.31 to –4.72), p=0.03). No significant results were found regarding fracture healing time, the rate of excellent and good outcomes, anatomical reduction and complications.ConclusionsThese results suggest that 3D printing-assisted surgery outperforms conventional surgery in the management of orthopaedic trauma fractures with shorter operation duration, less intraoperative blood loss and fewer intraoperative fluoroscopies.

scholarly journals Meta-Analysis of 3D Printing Applications in Traumatic Fractures

2021 ◽  
Vol 8 ◽  
Author(s):  
Sha Yang ◽  
Huapeng Lin ◽  
Cong Luo
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Fracture Union ◽  
Conventional Surgery ◽  
Traumatic Fracture ◽  
Operation Duration

Background: Traumatic fracture is a common orthopaedic disease, and application of 3D printing technology in fracture treatment, which entails utilisation of pre-operative printed anatomic fracture model, is increasingly gaining popularity. However, effectiveness of 3D printing-assisted surgery lacks evidence-based findings to support its application.Materials and Methods: Embase, PubMed and Cochrane Library databases were systematically searched until October, 2020 to identify relevant studies. All randomised controlled trials (RCTs) comparing efficacy of 3D printing-assisted surgery vs. conventional surgery for traumatic fractures were reviewed. RevMan V.5.3 software was used to conduct meta-analysis.Results: A total of 12 RCTs involving 641 patients were included. Pooled findings showed that 3D printing-assisted surgery had shorter operation duration [standardised mean difference (SMD) = −1.52, 95% confidence interval (CI) – 1.70 ~ −1.34, P &lt; 0.00001], less intraoperative blood loss (SMD = 1.34, 95% CI 1.74 ~ 0.94, P &lt; 0.00001), fewer intraoperative fluoroscopies (SMD = 1.25, 95% CI 1.64 ~ 0.87, P &lt; 0.00001), shorter fracture union time (SMD = −0.15, 95% CI −0.25 ~ −0.05, P = 0.003), and higher rate of excellent outcomes (OR = 2.40, 95% CI 1.07 ~ 5.37, P = 0.03) compared with conventional surgery. No significant differences in complication rates were observed between the two types of surgery (OR = 0.69, 95% CI 0.69 ~ 1.42, P = 0.32).Conclusions: Indicators including operation duration, intraoperative blood loss, number of intraoperative fluoroscopies, fracture union time, and rates of excellent outcomes showed that 3D printing-assisted surgery is a superior alternative in treatment of traumatic fractures compared with conventional surgery. Moreover, the current study did not report significant differences in incidence of complications between the two approaches.Systematic Review Registration: CRD42021239507.

scholarly journals 3D printing-assisted extended lateral approach for displaced intra-articular calcaneal fractures: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Guang Shi ◽  
Wei Liu ◽  
Ying Shen ◽  
Xiyu Cai
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Meta Analysis ◽  
Lateral Approach ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Calcaneal Fractures ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Extended Lateral Approach

Abstract Background 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). Methods 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. Results 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]. Conclusion 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.

scholarly journals A 3D Printing Personalized Percutaneous Nephroscope Puncture Guide Plate in Percutaneous Nephrolithotomy: A Pilot Study

2021 ◽  
Author(s):  
Gao Keyu ◽  
Li Shuaishuai ◽  
Ashok raj ◽  
Li Shuofeng ◽  
Liu Shuai ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Color Doppler ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Guide Plate ◽  
Significant Difference

Abstract Objective Using CTU, combined with 3D printing technology, digital design, the development of individualized PCNL) puncture guides, preliminary discussion of its feasibility for PCNL puncture positioning.Methods Twenty-two patients with renal calculi who underwent PCNL in the hospital of Xuzhou Medical University in 2017-2018, including 10 experimental groups, used 3D printing technology to make guides (puncture guides); simulated punctures in vitro, after clearing the needle angle, PCNL was performed in 10 patients and PCNL in 12 patients in the control group. The accuracy of puncture positioning, puncture time and intraoperative blood loss were compared between the two groups.Results In the experimental group, 10 patients had good puncture guide plate and the patient's skin. The puncture needle was puncture under the guidance of the guide plate and verified by the color Doppler. The 1 needle puncture was successful 100.00% (10/10), the positioning of the needle point, the depth of the puncture. The angles were consistent with the preoperative design. The success rate of 12 cases of color Doppler ultrasound in the control group was 75.00% (9/12). There was no significant difference between the two groups (P>0.05). The amount of hemorrhage was (7.78±0.94) min and (49.31±6.43) mL, respectively. The control group was (9.04±1.09) min and (60.08±12.18) mL, respectively. The two groups were statistically significant (P<0.05). Conclusion 3D printing personalized percutaneous nephrolithotomy guide can improve the accuracy of PCNL renal puncture channel positioning, shorten the puncture time and reduce intraoperative blood loss, and provide a new method for PCNL renal puncture positioning, which is worthy of further clinical exploration.

scholarly journals An Individualized Intra-Articular Stabilization Device Designed Based on 3D Printing Technology for Traumatic Instability of the Ulnohumeral Joint

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Rong-Feng She ◽  
Yi Zhang ◽  
Bin Zhang ◽  
Yuan-Zheng Wang ◽  
Qi-Xiang Huang
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Kirschner Wire ◽  
Operation Time ◽  
Clinical Effects ◽  
Intraoperative Blood Loss ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Mayo Score ◽  
The Mean

We aimed to design an individualized intra-articular stabilization device based on 3D printing technology and investigate the clinical effects of this device for treating traumatic instability of the ulnohumeral joint. This study enrolled nine patients with traumatic instability of the ulnohumeral joint (age: 47.2 ± 1.80   years ) who received treatment between March 2018 and March 2019 in our hospital. All patients underwent a thin-layer computed tomography (CT) scan of the elbow before surgery. The original injury and repair models of the elbow were printed using 3D printing technology based on CT data. An individualized intra-articular stabilization device was designed with a 2.0 mm Kirschner wire based on the repair model. Nine patients agreed to receive surgical treatment for elbow disease and placement of the intra-articular stabilization device. The nine patients underwent open reduction through a posterior median approach, and the intra-articular stabilization device was placed in the elbow. Operation time, intraoperative blood loss, and postoperative complications were recorded and followed up. The device was removed at two postoperative months, and the Mayo score was used to evaluate elbow function. Four months after removing the intra-articular stabilization device, elbow joint function was evaluated again using the Mayo score. The mean operation time was 100.1 ± 8.2   min , and the mean intraoperative blood loss was 35.5 ± 7.1   ml . No complications occurred after operation. Two months after surgery, eight patients received an excellent Mayo score, and one patient received a good Mayo score. Four months after removal of the intra-articular stabilization device, eight patients received an excellent Mayo score, and one patient received a good Mayo score. The individualized intra-articular stabilization device can increase ulnohumeral stability and achieve rapid functional recovery of the elbow.

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Predictive factors for intraoperative blood loss in surgery for adolescent idiopathic scoliosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chris Yuk Kwan Tang ◽  
Vijay H. D. Kamath ◽  
Prudence Wing Hang Cheung ◽  
Jason Pui Yin Cheung
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Predictive Factors ◽  
Posterior Spinal Fusion ◽  
Male Gender ◽  
Intraoperative Blood Loss ◽  
Operative Blood Loss ◽  
Operation Duration

Abstract Background Adolescent idiopathic scoliosis (AIS) is a common spinal deformity. Posterior spinal fusion remains an important surgical treatment for AIS. This study aims to determine the predictive factors for intraoperative blood loss in AIS surgery. Methods Patients who had undergone posterior spinal fusion for adolescent idiopathic scoliosis in a single university hospital were reviewed over a 7-year period. Predictive factors for intra-operative blood loss were studied by multivariate analysis to derive a regression model. Receiver operating characteristic analysis was performed to determine the cut-off values of factors contributing to significant intraoperative blood loss (≥500 ml). Results Two hundred and twelve patients were included. Intraoperative blood loss was found to be correlated with gender (rs = 0.30 (0.17–0.43)), preoperative hemoglobin level (rs = 0.20 (0.04–0.31)), preoperative Cobb angle (rs = 0.20 (0.02–0.29)), number of fused levels (rs = 0.46 (0.34–0.58)), operation duration (rs = 0.65 (0.54–0.75)), number of anchors (rs = 0.47 (0.35–0.59)), and p-value ranged from < 0.001 to < 0.05. Significant intraoperative blood loss was influenced by the male gender, operation duration greater than 257.5 min and more than 10 anchors used. Conclusions Male gender, increased operation duration and higher number of anchors predicted higher intra-operative blood loss.

Temporary Intraoperative Porto-Caval Shunts in Piggy-Back Liver Transplantation Reduce Intraoperative Blood Loss and Improve Postoperative Transaminases and Renal Function: A Meta-Analysis

2016 ◽  
Vol 40 (12) ◽  
pp. 2988-2998 ◽  
Author(s):  
Sebastian Pratschke ◽  
Alexandra Rauch ◽  
Markus Albertsmeier ◽  
Markus Rentsch ◽  
Michaela Kirschneck ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Renal Function ◽  
Blood Loss ◽  
Meta Analysis ◽  
Intraoperative Blood Loss

The efficacy and safety of topical tranexamic acid for spinal surgery: a meta-analysis

2021 ◽  
Vol 27 ◽  
Author(s):  
Tai Guo ◽  
Wenxia Xuan ◽  
Haoyu Feng ◽  
Junjie Wang ◽  
Xun Ma
Keyword(s):  
Blood Loss ◽  
Spinal Surgery ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Total Blood ◽  
Blood Content ◽  
Drainage Volume ◽  
Hidden Blood Loss ◽  
Postoperative Drainage

Background: Spinal surgeries are often accompanied by significant blood loss both intraoperatively and postoperatively. Excessive blood loss caused by surgery may lead to several harmful medical consequences. Tranexamic acid (TXA) is a kind of antifibrinolytic agent that has been widely used in spinal surgery. Currently, it is commonly accepted that intravenous TXA (ivTXA) can reduce blood loss in spinal fusion surgeries. Compared with ivTXA, topical TXA (tTXA) seems to be much easier to administer. This advantage provides a maximum concentration of TXA at the hemorrhagic site with little to no TXA entering the circulation. Objective: To evaluate the effect of tTXA on blood loss during and after spinal surgery via a comprehensive meta-analysis of the published data in randomized controlled trials (RCTs) and other comparative cohort studies. Methods: A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials were performed for RCTs and other comparative cohort studies on the effect of tTXA on blood loss during and after spinal surgery. The outcomes were total blood loss, hidden blood loss, intraoperative blood loss, total postoperative drainage volume, drainage tube duration postoperatively, drainage volume and drainage of blood content at postoperative day (POD) 1 and POD2, length of hospital stay, number of patients who received a blood transfusion, serum HB level at POD1, operative timespan, side effects, and complications. The final search was performed in October 2020. We followed the PRISMA guideline, and the registration number is INPLASY202160028. Results: In total, six studies with 481 patients were included. tTXA treatment, compared with the control conditions, can significantly reduce the total blood loss, hidden blood loss, total postoperative drainage volume, and several patients receiving blood transfusions; reduce the drainage volume and drainage of blood content at POD1; shorten the drainage tube duration postoperatively and length of hospital stay, and enhance the serum HB level at POD1 for spinal surgery. tTXA treatment did not significantly influence the intraoperative blood loss, drainage volume, or drainage of blood content at POD2 or the operative duration. Conclusion: Compared with control conditions, tTXA has high efficacy in reducing blood loss, and drainage volume enable quick rehabilitation and has a relatively high level of safety in spinal surgery.

Effects of Preoperative Iodine Administration on Thyroidectomy for Hyperthyroidism: A Systematic Review and Meta-analysis

2019 ◽  
Vol 160 (6) ◽  
pp. 993-1002 ◽  
Author(s):  
Chung-Hsin Tsai ◽  
Po-Sheng Yang ◽  
Jie-Jen Lee ◽  
Tsang-Pai Liu ◽  
Chi-Yu Kuo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operative Time ◽  
Meta Analysis ◽  
Thyroid Volume ◽  
Vocal Cord Palsy ◽  
Significant Heterogeneity ◽  
Intraoperative Blood Loss ◽  
Significant Difference ◽  
And Control

Objective The current guidelines recommend that potassium iodide be given in the immediate preoperative period for patients with Graves’ disease who are undergoing thyroidectomy. Nonetheless, the evidence behind this recommendation is tenuous. The purpose of this study is to clarify the benefits of preoperative iodine administration from published comparative studies. Data Sources We searched PubMed, Embase, Cochrane, and CINAHL from 1980 to June 2018. Review Methods Studies were included that compared preoperative iodine administration and no premedication before thyroidectomy. For the meta-analysis, studies were pooled with the random-effects model. Results A total of 510 patients were divided into the iodine (n = 223) and control (n = 287) groups from 9 selected studies. Preoperative iodine administration was significantly associated with decreased thyroid vascularity and intraoperative blood loss. Significant heterogeneity was present among studies. We found no significant difference in thyroid volume or operative time. Furthermore, the meta-analysis showed no difference in the risk of postoperative complications, including vocal cord palsy, hypoparathyroidism/hypocalcemia, and hemorrhage or hematoma after thyroidectomy. Conclusion Preoperative iodine administration decreases thyroid vascularity and intraoperative blood loss. Nonetheless, it does not translate to more clinically meaningful differences in terms of operative time and postoperative complications.

Sign in / Sign up

Export Citation Format

Share Document