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Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature

Background: There has been an exponential growth in the use of advanced technologies for three-dimensional (3D) virtual pre- and intra-operative planning of pelvic ring injury surgery but potential benefits remain unclear. The purpose of this study was to evaluate differences in intra- and post-oper...

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Autores principales: Banierink, Hester, Meesters, Anne M. L., ten Duis, Kaj, Doornberg, Job N., El Moumni, Mostafa, Heineman, Erik, Reininga, Inge H. F., IJpma, Frank F. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470452/
https://www.ncbi.nlm.nih.gov/pubmed/34575708
http://dx.doi.org/10.3390/jpm11090930
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author Banierink, Hester
Meesters, Anne M. L.
ten Duis, Kaj
Doornberg, Job N.
El Moumni, Mostafa
Heineman, Erik
Reininga, Inge H. F.
IJpma, Frank F. A.
author_facet Banierink, Hester
Meesters, Anne M. L.
ten Duis, Kaj
Doornberg, Job N.
El Moumni, Mostafa
Heineman, Erik
Reininga, Inge H. F.
IJpma, Frank F. A.
author_sort Banierink, Hester
collection PubMed
description Background: There has been an exponential growth in the use of advanced technologies for three-dimensional (3D) virtual pre- and intra-operative planning of pelvic ring injury surgery but potential benefits remain unclear. The purpose of this study was to evaluate differences in intra- and post-operative results between 3D and conventional (2D) surgery. Methods: A systematic review was performed including published studies between 1 January 2010 and 22 May 2020 on all available 3D techniques in pelvic ring injury surgery. Studies were assessed for their methodological quality according to the Modified McMaster Critical Review form. Differences in operation time, blood loss, fluoroscopy time, screw malposition rate, fracture reduction and functional outcome between 3D-assisted and conventional (2D) pelvic injury treatment were evaluated and a best-evidence synthesis was performed. Results: Eighteen studies fulfilled the inclusion criteria, evaluating a total of 988 patients. Overall quality was moderate. Regarding intra-operative results of 3D-assisted versus conventional surgery: The weighted mean operation time per screw was 43 min versus 52 min; for overall operation time 126 min versus 141 min; blood loss 275 ± 197 mL versus 549 ± 404 mL; fluoroscopy time 74 s versus 125 s and fluoroscopy frequency 29 ± 4 versus 63 ± 3. In terms of post-operative outcomes of 3D-assisted versus conventional surgery: weighted mean screw malposition rate was 8% versus 18%; quality of fracture reduction measured by the total excellent/good rate by Matta was 86% versus 82% and Majeed excellent/good rate 88% versus 83%. Conclusion: The 3D-assisted surgery technologies seem to have a positive effect on operation time, blood loss, fluoroscopy dose, time and frequency as well as accuracy of screw placement. No improvement in clinical outcome in terms of fracture reduction and functional outcome has been established so far. Due to a wide range of methodological quality and heterogeneity between the included studies, results should be interpreted with caution.
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spelling pubmed-84704522021-09-27 Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature Banierink, Hester Meesters, Anne M. L. ten Duis, Kaj Doornberg, Job N. El Moumni, Mostafa Heineman, Erik Reininga, Inge H. F. IJpma, Frank F. A. J Pers Med Review Background: There has been an exponential growth in the use of advanced technologies for three-dimensional (3D) virtual pre- and intra-operative planning of pelvic ring injury surgery but potential benefits remain unclear. The purpose of this study was to evaluate differences in intra- and post-operative results between 3D and conventional (2D) surgery. Methods: A systematic review was performed including published studies between 1 January 2010 and 22 May 2020 on all available 3D techniques in pelvic ring injury surgery. Studies were assessed for their methodological quality according to the Modified McMaster Critical Review form. Differences in operation time, blood loss, fluoroscopy time, screw malposition rate, fracture reduction and functional outcome between 3D-assisted and conventional (2D) pelvic injury treatment were evaluated and a best-evidence synthesis was performed. Results: Eighteen studies fulfilled the inclusion criteria, evaluating a total of 988 patients. Overall quality was moderate. Regarding intra-operative results of 3D-assisted versus conventional surgery: The weighted mean operation time per screw was 43 min versus 52 min; for overall operation time 126 min versus 141 min; blood loss 275 ± 197 mL versus 549 ± 404 mL; fluoroscopy time 74 s versus 125 s and fluoroscopy frequency 29 ± 4 versus 63 ± 3. In terms of post-operative outcomes of 3D-assisted versus conventional surgery: weighted mean screw malposition rate was 8% versus 18%; quality of fracture reduction measured by the total excellent/good rate by Matta was 86% versus 82% and Majeed excellent/good rate 88% versus 83%. Conclusion: The 3D-assisted surgery technologies seem to have a positive effect on operation time, blood loss, fluoroscopy dose, time and frequency as well as accuracy of screw placement. No improvement in clinical outcome in terms of fracture reduction and functional outcome has been established so far. Due to a wide range of methodological quality and heterogeneity between the included studies, results should be interpreted with caution. MDPI 2021-09-18 /pmc/articles/PMC8470452/ /pubmed/34575708 http://dx.doi.org/10.3390/jpm11090930 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Banierink, Hester
Meesters, Anne M. L.
ten Duis, Kaj
Doornberg, Job N.
El Moumni, Mostafa
Heineman, Erik
Reininga, Inge H. F.
IJpma, Frank F. A.
Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature
title Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature
title_full Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature
title_fullStr Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature
title_full_unstemmed Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature
title_short Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome?—A Systematic Review of the Literature
title_sort does 3d-assisted operative treatment of pelvic ring injuries improve patient outcome?—a systematic review of the literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470452/
https://www.ncbi.nlm.nih.gov/pubmed/34575708
http://dx.doi.org/10.3390/jpm11090930
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