2023, Vol. 27 ›› Issue (4): 646-654

3D printing personalized osteotomy guide technology versus conventional total knee arthroplasty on the accuracy of lower limb force alignment: a meta-analysis

Chai Hao1, Yang Deyong1, Zhang Lei2, Shu Li1   

Abstract: OBJECTIVE: Many scholars have applied 3D printing personalized osteotomy guide technology in patients undergoing total knee arthroplasty. However, there is still a great controversy on whether 3D printing personalized osteotomy technology can obtain better lower limb force line and more satisfactory curative effect than conventional total knee arthroplasty. This study aimed to compare the accuracy and clinical efficacy of 3D printed personalized osteotomy guide and conventional total knee arthroplasty by meta-analysis.
METHODS: We retrieved controlled clinical trials which compared the 3D printing personalized osteotomy guide technology and conventional total knee arthroplasty respectively in Chinese databases (Wanfang, CNKI, VIP, and Chinese Biological Medicine) and English databases (Ovid, PubMed, Web of Science, Embase, and the Cochrane Library). Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of included studies. The data were analyzed by RevMan 5.3 software.  
RESULTS: (1) A total of 775 Chinese and English articles were retrieved and 30 controlled clinical trials were included for final analysis. (2) Meta-analysis results showed that compared with the conventional group, the hip-knee-ankle angle (MD=-0.51, 95%CI:-0.66 to -0.36, P < 0.000 01), deviation of femoral coronal alignment (MD=-0.33, 95%CI: -0.39 to -0.27, P < 0.000 01), the number of femoral coronal alignment outliers (RR=0.52, 95%CI:0.44-0.63, P < 0.000 01), the deviation of tibial coronal alignment (MD=-0.21, 95%CI:-0.32 to -0.10, P=0.000 2), the deviation of femoral sagittal alignment (SMD=-0.16, 95%CI:-0.26 to -0.07, P=0.000 09), the deviation of tibial sagittal alignment (MD=-0.21, 95%CI:-0.32 to -0.10, P=0.000 2), postoperative drainage volume (SMD=-1.11, 95%CI:-1.49 to -0.74, P < 0.000 1), and intraoperative bleeding (MD=-48.60, 95%CI:-68.50 to -28.69, P < 0.000 1) were less and KSS score (MD=3.29, 95%CI:1.35-5.23, P=0.000 9) was better in 3D printing personalized osteotomy guide group.
CONCLUSION: In this meta-analysis, 3D printing personalized osteotomy guide technology in total knee arthroplasty has advantages in lower limb force line and prosthesis position.
Key words: total knee arthroplasty, 3D printing, personalized osteotomy guide, conventional instrumentation, prosthesis force line, KSS function score, pain, meta-analysis