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 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.

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 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 Laparoscopic Major Gastrointestinal Surgery Is Safe for Properly Selected Patient with COPD: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yulin Guo ◽  
Feng Cao ◽  
Yixuan Ding ◽  
Haichen Sun ◽  
Shuang Liu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Meta Analysis ◽  
Gastrointestinal Surgery ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Pulmonary Complications ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Intraoperative Blood Loss

Background. Laparoscopy has been widely applied in gastrointestinal surgery, with benefits such as less intraoperative blood loss, faster recovery, and shorter length of hospital stay. However, it remains controversial if laparoscopic major gastrointestinal surgery could be conducted for patients with chronic obstructive pulmonary disease (COPD) which was traditionally considered as an important risk factor for postoperative pulmonary complications. The present study was conducted to review and assess the safety and feasibility of laparoscopic major abdominal surgery for patient with COPD. Materials and Methods. Databases including PubMed, EmBase, Cochrane Library, and Wan-fang were searched for all years up to Jul 1, 2018. Studies comparing perioperative results for COPD patients undergoing major gastrointestinal surgery between laparoscopic and open approaches were enrolled. Results. Laparoscopic approach was associated with less intraoperative blood loss (MD = -174.03; 95% CI: −232.16 to -115.91, P < 0.00001; P < 0.00001, I2=93% for heterogeneity) and shorter length of hospital stay (MD = -3.30; 95% CI: −3.75 to -2.86, P < 0.00001; P = 0.99, I2=0% for heterogeneity). As for pulmonary complications, laparoscopic approach was associated with lower overall pulmonary complications rate (OR = 0.58; 95% CI: 0.48 to 0.71, P < 0.00001; P = 0.42, I2=0% for heterogeneity) and lower postoperative pneumonia rate (OR = 0.53; 95% CI: 0.41 to 0.67, P < 0.00001; P = 0.57, I2=0% for heterogeneity). Moreover, laparoscopic approach was associated with lower wound infection (OR = 0.51; 95% CI: 0.42 to 0.63, P < 0.00001; P = 0.99, I2=0% for heterogeneity) and abdominal abscess rates (OR = 0.59; 95% CI: 0.44 to 0.79, P < 0.0004; P = 0.24, I2=30% for heterogeneity). Conclusions. Laparoscopic major gastrointestinal surgery for properly selected COPD patient was safe and feasible, with shorter term benefits.

scholarly journals Comparison of Survival and Safety Between Total Omentectomy and Partial Omentectomy for Gastric Cancer: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yue-Xin Zhang ◽  
Han-Dong Liu ◽  
Ze-Hua Chen ◽  
Tao Jin ◽  
Jian-Kun Hu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Operation Time ◽  
Greater Omentum ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Free Survival

Background: The greater omentum can limit abdominal inflammation and act as a protective cushion, but it is always involved in dissemination of gastric cancer. The purpose of this meta-analysis was to compare the survival and safety between total omentectomy and partial omentectomy for gastric cancer.Methods: Two investigators independently conducted a systematic search of PubMed, Embase, CNKI, and Cochrane Library ranging from January 2000 to November 2020. The pooled odds ratio (ORs) and weighted mean difference (WMD) with the 95% confidence interval (95% CI) were used to assess perioperative and survival parameters.Results: A total of 2,031 patients in 11 studies (574 patients in the partial omentectomy group and 1,457 patients in the total omentectomy group) were included. The results found shorter operation time (WMD = −25.584; P = 0.000) and less intraoperative blood loss (WMD = −47.301; P = 0.050) in the partial omentectomy group, compared to total omentectomy. There were no significant differences in terms of incidence of complications (OR = 0.770; P = 0.164), blood transfusions rates (OR = 0.269; P = 0.161), time to first flatus (WMD = 0.160; P = 0.345), hospital stay (WMD = −1.258; P = 0.087), and number of harvested lymph nodes (WMD = 1.265; P = 0.662). For the disease-free survival (OR = 0.80; P = 0.381) and overall survival, there were no statistical differences between the two procedures.Conclusions: The partial omentectomy could reduce operation time and trended to decrease intraoperative blood loss. And the survival in patients with partial omentectomy seemed to be comparable to that of patients with total omentectomy.

scholarly journals The effect of three-dimensional (3D) printing on quantitative and qualitative outcomes in paediatric orthopaedic osteotomies: a systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. 130-138
Author(s):  
Mohsen Raza ◽  
Daniel Murphy ◽  
Yael Gelfer
Keyword(s):  
Systematic Review ◽  
3D Printing ◽  
Blood Loss ◽  
Operating Time ◽  
Three Dimensional ◽  
Patient Specific ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Significant Difference ◽  
Paediatric Orthopaedic

Three-dimensional (3D) printing technology is increasingly being utilized in various surgical specialities. In paediatric orthopaedics it has been applied in the pre-operative and intra-operative stages, allowing complex deformities to be replicated and patient-specific instrumentation to be used. This systematic review analyses the literature on the effect of 3D printing on paediatric orthopaedic osteotomy outcomes. A systematic review of several databases was conducted according to PRISMA guidelines. Studies evaluating the use of 3D printing technology in orthopaedic osteotomy procedures in children (aged ≤ 16 years) were included. Spinal and bone tumour surgery were excluded. Data extracted included demographics, disease pathology, target bone, type of technology, imaging modality used, qualitative/quantitative outcomes and follow-up. Articles were further categorized as either ‘pre-operative’ or ‘intra-operative’ applications of the technology. Twenty-two articles fitting the inclusion criteria were included. The reported studies included 212 patients. There were five articles of level of evidence 3 and 17 level 4. A large variety of outcomes were reported with the most commonly used being operating time, fluoroscopic exposure and intra-operative blood loss. A significant difference in operative time, fluoroscopic exposure, blood loss and angular correction was found in the ‘intra-operative’ application group. No significant difference was found in the ‘pre-operative’ category. Despite a relatively low evidence base pool of studies, our aggregate data demonstrate a benefit of 3D printing technology in various deformity correction applications, especially when used in the ‘intra-operative’ setting. Further research including paediatric-specific core outcomes is required to determine the potential benefit of this novel addition. Cite this article: EFORT Open Rev 2021;6:130-138. DOI: 10.1302/2058-5241.6.200092

scholarly journals A Systematic Review and Meta-Analysis of 3D Printing Technology for the Treatment of Acetabular Fractures

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Jin Cao ◽  
Huanye Zhu ◽  
Chao Gao
Keyword(s):  
Systematic Review ◽  
3D Printing ◽  
Meta Analysis ◽  
Three Dimensional ◽  
Operation Time ◽  
Final Analysis ◽  
Acetabular Fractures ◽  
Long Term Effects ◽  
Printing Technology ◽  
3D Printing Technology

Purpose. Three-dimensional (3D) printing technology has been widely used in orthopedics surgery. However, its efficacy in acetabular fractures remains unclear. The aim of this systematic review and meta-analysis was to examine the effect of using 3D printing technology in the surgery for acetabular fractures. Methods. The systematic review was performed following the PRISMA guidelines. Four major electronic databases were searched (inception to February 2021). Studies were screened using a priori criteria. Data from each study were extracted by two independent reviewers and organized using a standardized table. Data were pooled and presented in forest plots. Results. Thirteen studies were included in the final analysis. Four were prospective randomized trials, and nine used a retrospective comparative design. The patients aged between 32.1 (SD 14.6) years and 51.9 (SD 18.9) years. Based on the pooled analyses, overall, 3D printing-assisted surgery decreased operation time by 38.8 minutes (95% CI: -54.9, -22.8), intraoperative blood loss by 259.7 ml (95% CI: -394.6, -124.9), instrumentation time by 34.1 minutes (95% CI: -49.0, -19.1). Traditional surgery was less likely to achieve good/excellent function of hip (RR, 0.53; 95% CI: 0.34, 0.82) and more likely to have complications than 3D printing-assisted surgery (RR, 1.19; 95% CI: 1.07, 1.33). Conclusions. 3D printing technology demonstrated efficacy in the treatment of acetabular fractures. It may improve surgery-related and clinical outcomes. More prospective studies using a rigorous design (e.g., randomized trial with blinding) are warranted to confirm the long-term effects of 3D printing technology in orthopedics surgeries.

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