Purpose: To evaluate the accuracy and precision of postoperative coronal plane alignment using 3D printed patient specific instrumentation (PSI) in the setting of proximal tibial or distal femoral osteotomies. Methods: A systematic review evaluating the accuracy of 3D-printed PSI for coronal plane alignment correcting knee osteotomies was performed. The primary outcomes were accuracy of coronal plane limb alignment correction and number of correction outliers. Secondary variables were duration of surgery, number of intraoperative fluoroscopic images, complications, cost, and clinical outcomes (as applicable). Results: Ninety-three studies were identified and 14 were included in the final analysis. Overall, mean postoperative deviation from target correction ranged from 0.3° to 1° for all studies using hip-knee angle measurements and 2.3% to 4.9% for all studies using weight bearing line measurements. The incidence of correction outliers were assessed in eight total studies and ranged from 0 to 25% (total n = 10 knees) of patients corrected with 3D printed PSI. Osteotomies performed with 3D printed cutting guides or wedges demonstrated significantly shorter operative times (p < 0.05) and fewer intraoperative fluoroscopic images (p < 0.05) than control groups in four case-control studies. Conclusion: Patients undergoing PTO or DFO procedures with 3D printed patient specific cutting guides and wedges had highly accurate coronal plane alignment with a low rate of outliers. Patients treated with 3D printed PSI also demonstrated significantly shorter operative times and decreased intraoperative fluoroscopy when compared to conventional techniques. Level of evidence: Level IV, systematic review of Level III-IV studies.

Improved Accuracy of Coronal Alignment Can Be Attained Using 3D printed PSI for Knee Osteotomies: A Systemic Review of Level III-IV studies

Familiari, Filippo;
2022-01-01

Abstract

Purpose: To evaluate the accuracy and precision of postoperative coronal plane alignment using 3D printed patient specific instrumentation (PSI) in the setting of proximal tibial or distal femoral osteotomies. Methods: A systematic review evaluating the accuracy of 3D-printed PSI for coronal plane alignment correcting knee osteotomies was performed. The primary outcomes were accuracy of coronal plane limb alignment correction and number of correction outliers. Secondary variables were duration of surgery, number of intraoperative fluoroscopic images, complications, cost, and clinical outcomes (as applicable). Results: Ninety-three studies were identified and 14 were included in the final analysis. Overall, mean postoperative deviation from target correction ranged from 0.3° to 1° for all studies using hip-knee angle measurements and 2.3% to 4.9% for all studies using weight bearing line measurements. The incidence of correction outliers were assessed in eight total studies and ranged from 0 to 25% (total n = 10 knees) of patients corrected with 3D printed PSI. Osteotomies performed with 3D printed cutting guides or wedges demonstrated significantly shorter operative times (p < 0.05) and fewer intraoperative fluoroscopic images (p < 0.05) than control groups in four case-control studies. Conclusion: Patients undergoing PTO or DFO procedures with 3D printed patient specific cutting guides and wedges had highly accurate coronal plane alignment with a low rate of outliers. Patients treated with 3D printed PSI also demonstrated significantly shorter operative times and decreased intraoperative fluoroscopy when compared to conventional techniques. Level of evidence: Level IV, systematic review of Level III-IV studies.
2022
Three-dimensional printing
knee osteotomy
patient-specific instrumentation
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12317/75736
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