Efficacy and safety of three-dimensional printing technology assisted open reduction and internal fixation versus conventional surgery in the treatment of acetabular fractures: a meta-analysis of randomized controlled trials.

PURPOSE: The objective of this meta-analysis was to assess the influence of three-dimensional (3D) printing technology on open reduction and internal fixation (ORIF) of acetabular fractures from current randomized controlled trials (RCTs).

METHODS

A structured meta-analysis was conducted, and we searched online databases for published RCTs related to 3D printing and acetabular fracture, including PubMed, Cochrane Library, ScienceDirect, Wan fang, and CNKI up to November 2024. The outcome data of intraoperative blood loss, operation time, hip function (Harris score), quality of fracture reduction (Matta score) and incidence of complications were extracted. Stata16.0 and RevMan5.3 were used for our meta-analysis.

RESULTS

19 RCTs met our inclusion criteria and a total of 1046 patients were included in this meta-analysis. The meta-analysis showed significant difference in intraoperative blood loss (WMD = -274.65, 95% CI [-326.47, -222.83]), operation time (WMD = -53.26, 95% CI [-63.72, -42.80]), intraoperative fluoroscopy (WMD = -5.24, 95% CI [-6.57, -3.91]), instrumentation time (WMD = -35.31, 95% CI [-53.42, -17.21]), and post-surgery Matta score (RR = 1.17, 95% CI [1.09, 1.25]), incidence rate of complications (RR = 0.34, 95%CI [0.22, 0.52]). There is no significant difference in time from injury to operation (WMD=-0.06, 95%CI [-0.36, 0.24]) and Harris score (RR = 1.22, 95%CI [0.83, 1.79]) between two groups.

CONCLUSION

3D printing group showed reduced intraoperative blood loss, shorter operation time, faster instrumentation, less intraoperative fluoroscopy, better post-surgery reduction, and reduced incidence rate of complications. Therefore, based on existing research, ORIF guided by 3D printing technology should be a more effective method for treating acetabular fractures.