Clinical efficacy and safety of surgery combined with 3D printing for tibial plateau fractures: systematic review and meta-analysis

BACKGROUND: The aim of the present study was to systematically evaluate the application value and complications of 3D printing technology on Schatzker tibial platform fracture surgery. METHODS: By searching the Cochrane Library, PubMed, Web of Science, Embase, Chinese Biomedical Literature Database (CBM), screening randomized controlled trials (RCTs), and two researchers included the study according to PICOS criteria and performed bias risk assessments. Quality evaluation and data extraction were performed for the included literatures, and meta-analysis was performed for RCTs included at using Review Manager 5.2 software. RESULTS: A total of 15 articles were included in the present study, which included a total of 758 patients, 342 3D printing techniques, 416 conventional surgical procedures. Meta-analysis showed 3D printing operation time [risk difference (RD) =−0.12, 95% CI: −0.16, −0.08, I(2)=46%, P<0.00001], surgical bleeding [odds ratio (OR) =0.59, 95% CI: 0.45–0.77, I(2)=0%, P<0.001), intraoperative fluoroscopy (OR =0.59, 95% CI: 0.41–0.85, I(2)=0%, P=0.004), fracture healing time (OR =0.46, 95% CI: 0.33–0.63, I(2)=0%, P<0.00001), and complication morbidity (OR =0.60, 95% CI: 0.45–0.81, I(2)=0%, P=0.001) were significantly lower than in the traditional group. DISCUSSION: 3D printing technology for tibia platform fracture surgery has advantages of reduced operation time, less surgical bleeding, less complications, less intraoperative perspective, fast fracture healing, and can improve the accuracy of tibial platform fracture reduction and postoperative knee function recovery.