Comparing the outcomes between conventional osteotomy and with the adjunct use of 3-dimensional printing in paediatric deformity osteotomy correction: a systematic review and meta-analysis.

Recent advancements in medical technology have introduced three-dimensional (3D) printing as a promising adjunct to conventional osteotomy. This review aims to evaluate the clinical, radiological outcomes and complications of patients who underwent conventional osteotomy compared to osteotomy with the adjunct use of 3D printing in paediatric deformity correction. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The current study searched from inception to April 2023. All studies that compared outcomes between conventional osteotomy and osteotomy with the adjunct use of 3D printing in paediatric deformity correction in both upper and lower limbs were included. A total of 13 publications with 482 patients were included in this review. In terms of intraoperative parameters, the 3D group had a shorter operative time by 21.3 min [95% confidence interval (CI): 15.92-26.85] and less radiation exposure of -3.42 times (95% CI: -4.57 to -2.28). For radiological outcomes, 3D group had a smaller mean osteotomy error of -2.03 degrees (95% CI: -3.84 to -0.22) and 1.94 times higher odds (95% CI: 1.08-3.48) of having better radiological outcomes. The conventional osteotomy group has possibly a 1.4 risk (95% CI: 0.32-1.59) of growth plate, articular or risk of avascular necrosis compared to 3D templated group. The findings of this meta-analysis support the use of 3D printing as an adjunct in paediatric deformity correction for better intraoperative outcomes, reduce radiation exposure and better radiological accuracy in both upper and lower limb surgery.