The Knee · 2026
Accuracy, patient-reported and surgical-related outcomes in patient-specific 3D-printed versus standard high tibial osteotomy: A systematic review with meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Correia Rodrigo, Gomes Eluana, Valente Cristina, Delgado Diego, Sánchez Mikel, Andrade Renato, Espregueira-Mendes João
Аннотация
BACKGROUND: Patient-specific instrumentation (PSI) aims to maximise the correction accuracy during high tibial osteotomy (HTO). The aim was to evaluate the correction accuracy of knee alignment and the surgical-related outcomes of PSI HTO in knees with osteoarthritis and compare the results against standard HTO.
METHODS: Databases were searched for studies using PSI HTO for the treatment of knee osteoarthritis. Meta-analyses were reported as mean differences (MDs) for continuous outcomes or proportions and risk ratio (RR) for dichotomous outcomes, with 95% confidence intervals (CIs).
RESULTS: Twenty-one trials (16 studies) comprising 825 patients (52.1 ± 6.0 years, 57.6% men) were included (n = 530 PSI, n = 231 standard HTO, n = 64 navigated HTO). Meta-analyses of PSI showed that postoperative medial proximal tibial angle, mechanical femorotibial angle and posterior tibial slope were not significantly different from the planned. Hip-knee-ankle angle was significantly lower than planned (MD = -0.79, 95% CI -1.17 to -0.41). Visual analogue scale decreased significantly (MD = -3.94, 95% CI -5.39 to -2.5) and Functional Knee Society Score improved significantly (MD = 23.99, 95% CI 15.11 to 32.87). Comparing PSI and standard HTO, PSI was significantly shorter (MD = -19.52, 95% CI -28.92 to -10.11) and required significantly fewer fluoroscopies (MD = -16.65, 95% CI -32.34 to -0.96). Proportion of complications in PSI was 17.8% and led to 1.2% for reinterventions. No significant difference between PSI and standard HTO for risk of complications was observed (RR = 0.90, 95% CI 0.47 to 1.73).
CONCLUSION: Patient-specific HTO leads to high accuracy in correction, improvement in clinical outcomes, and reduced surgery time and number of fluoroscopies.
METHODS: Databases were searched for studies using PSI HTO for the treatment of knee osteoarthritis. Meta-analyses were reported as mean differences (MDs) for continuous outcomes or proportions and risk ratio (RR) for dichotomous outcomes, with 95% confidence intervals (CIs).
RESULTS: Twenty-one trials (16 studies) comprising 825 patients (52.1 ± 6.0 years, 57.6% men) were included (n = 530 PSI, n = 231 standard HTO, n = 64 navigated HTO). Meta-analyses of PSI showed that postoperative medial proximal tibial angle, mechanical femorotibial angle and posterior tibial slope were not significantly different from the planned. Hip-knee-ankle angle was significantly lower than planned (MD = -0.79, 95% CI -1.17 to -0.41). Visual analogue scale decreased significantly (MD = -3.94, 95% CI -5.39 to -2.5) and Functional Knee Society Score improved significantly (MD = 23.99, 95% CI 15.11 to 32.87). Comparing PSI and standard HTO, PSI was significantly shorter (MD = -19.52, 95% CI -28.92 to -10.11) and required significantly fewer fluoroscopies (MD = -16.65, 95% CI -32.34 to -0.96). Proportion of complications in PSI was 17.8% and led to 1.2% for reinterventions. No significant difference between PSI and standard HTO for risk of complications was observed (RR = 0.90, 95% CI 0.47 to 1.73).
CONCLUSION: Patient-specific HTO leads to high accuracy in correction, improvement in clinical outcomes, and reduced surgery time and number of fluoroscopies.