A novel approach using 3-D printing in the Irish National Centre for pelvic and acetabular surgery

Downey, Colum; McCarrick, Cathleen; Fenelon, Christopher; Murphy, Evelyn P.; OʼDaly, Brendan J.; Leonard, Michael

doi:10.1007/s11845-019-02055-y

Cited by 12 publications

(15 citation statements)

References 26 publications

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“…Overall, four studies found a significantly lower number or time of intraoperative fluoroscopy in the 3D printing group than in the control group. In one study [ 35 ], there was no significant difference in radiation exposure during the surgery.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of 3D Printing Technology for the Treatment of Acetabular Fractures

Cao

Zhu

Gao

2021

BioMed Research International

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Purpose. Three-dimensional (3D) printing technology has been widely used in orthopedics surgery. However, its efficacy in acetabular fractures remains unclear. The aim of this systematic review and meta-analysis was to examine the effect of using 3D printing technology in the surgery for acetabular fractures. Methods. The systematic review was performed following the PRISMA guidelines. Four major electronic databases were searched (inception to February 2021). Studies were screened using a priori criteria. Data from each study were extracted by two independent reviewers and organized using a standardized table. Data were pooled and presented in forest plots. Results. Thirteen studies were included in the final analysis. Four were prospective randomized trials, and nine used a retrospective comparative design. The patients aged between 32.1 (SD 14.6) years and 51.9 (SD 18.9) years. Based on the pooled analyses, overall, 3D printing-assisted surgery decreased operation time by 38.8 minutes (95% CI: -54.9, -22.8), intraoperative blood loss by 259.7 ml (95% CI: -394.6, -124.9), instrumentation time by 34.1 minutes (95% CI: -49.0, -19.1). Traditional surgery was less likely to achieve good/excellent function of hip (RR, 0.53; 95% CI: 0.34, 0.82) and more likely to have complications than 3D printing-assisted surgery (RR, 1.19; 95% CI: 1.07, 1.33). Conclusions. 3D printing technology demonstrated efficacy in the treatment of acetabular fractures. It may improve surgery-related and clinical outcomes. More prospective studies using a rigorous design (e.g., randomized trial with blinding) are warranted to confirm the long-term effects of 3D printing technology in orthopedics surgeries.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of 3D Printing Technology for the Treatment of Acetabular Fractures

Cao

Zhu

Gao

2021

BioMed Research International

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“…Three randomised controlled trials [38,43,44], one prospective cohort study [40], ten case control studies [30][31][32]34,35,41,42,[45][46][47], and five case series [29,33,36,37] were included. The methodological quality of the papers varied from low (Table 3) to good (Table 4).…”

Section: Methodological Quality Assessmentmentioning

confidence: 99%

“…Additionally, one study using 3D prints reported a fluoroscopy dose of 1078.1 ± 800.3 mGycm 2 in the 3D-assisted group and 727.1 ± 349.4 mGycm 2 in the conventional group The weighted mean of three studies reporting on fluoroscopy frequency was 9.3 ± 5.9 times in the 3D-assisted group and 22.5 ± 20.4 times in the conventional group [30,45,46]. Additionally, one study using 3D prints reported a fluoroscopy dose of 1078.1 ± 800.3 mGycm 2 in the 3D-assisted group and 727.1 ± 349.4 mGycm 2 in the conventional group [40]. In addition, one study using 3D prints and pre-contouring of implants reported a significant decrease (p < 0.001) in fluoroscopy time in the 3D-assisted group (4.2 ± 1.8 s) compared to the conventional group (7.7 ± 2.6 s) [38].…”

Section: Surgical Outcomesmentioning

confidence: 98%

“…Nine of these full-text articles were excluded due to the following reasons: foreign language article on 3D printing and pre-contouring the implant (N = 1); case reports (N = 2); descriptive study (N = 1); biomechanical study (N = 1); conference abstract (N = 1); outcome measurements unclear (N = 3). In total, 19 studies met the inclusion criteria for this systematic review (Figure 1) [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. The included studies enrolled a total of 753 patients (median sample size 27; range 10-146).…”

Section: Search and Study Characteristicsmentioning

confidence: 99%

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Does 3D-Assisted Acetabular Fracture Surgery Improve Surgical Outcome and Physical Functioning?—A Systematic Review

Meesters

Trouwborst

Vries

et al. 2021

JPM

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Three-dimensional technology is increasingly being used in acetabular fracture treatment. No systematic reviews are available about the added clinical value of 3D-assisted acetabular fracture surgery compared to conventional surgery. Therefore, this study aimed to investigate whether 3D-assisted acetabular fracture surgery compared to conventional surgery improves surgical outcomes in terms of operation time, intraoperative blood loss, intraoperative fluoroscopy usage, complications, and postoperative fracture reduction, and whether it improves physical functioning. Pubmed and Embase databases were searched for articles on 3D technologies in acetabular fracture surgery, published between 2010 and February 2021. The McMaster critical review form was used to assess the methodological quality. Differences between 3D-assisted and conventional surgery were evaluated using the weighted mean and odds ratios. Nineteen studies were included. Three-dimensional-assisted surgery resulted in significantly shorter operation times (162.5 ± 79.0 versus 296.4 ± 56.0 min), less blood loss (697.9 ± 235.7 mL versus 1097.2 ± 415.5 mL), and less fluoroscopy usage (9.3 ± 5.9 versus 22.5 ± 20.4 times). The odds ratios of complications and fracture reduction were 0.5 and 0.4 for functional outcome in favour of 3D-assisted surgery, respectively. Three-dimensional-assisted surgery reduces operation time, intraoperative blood loss, fluoroscopy usage, and complications. Evidence for the improvement of fracture reduction and functional outcomes is limited.

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“…Besides, the number of medical specialists in other areas of medicine using fluoroscopy is immerging. However, studies indicate poor knowledge about exposure to radiation, its detrimental effect, and associated long-term risk, using C-arm fluoroscopy [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A Simulation Study With Electronic Dosimeter to Estimate Patient and Personnel Dose in Orthopedic Surgery

Omojola

Akpochafor

Adeneye

2020

J. Res. Orthop. Sci.

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Background: The use of mini C-arm is required in many orthopedic surgeries as an image-guided tool. Studies have shown an unnecessarily high dose to patients if exposures are not properly optimized. Also, scatter radiation to personnel may increase the risk of cancer if an appropriate protective device is not used. Objectives: This study aims to determine the patient’s dose and scatter radiation to the surgeon, anesthetist, and scrub nurse. Also, a comparison will be made with other studies on this topic. Methods: A phantom was designed to simulate a patient on the operating table to produce scatter radiation. In the same vein, a mobile mini C-arm unit was positioned with the x-ray tube beneath the head and the image receptor above the operating table. Measurements were made with a measuring tape from the central axis to the position of the surgeon, anesthetist, and scrub nurse. The Entrance Surface Dose (ESD) was determined by placing the electronic dosimeter at the surface of the phantom to estimate the patient dose. Similarly, each personnel dose/dose rate from the central axis was determined using a similar detector. Results: The total average time for most orthopedic surgeries in the studied facility was 3.3 minutes. The estimated ESD to the patient was 25.03 µSv and the scatter radiation per patient reaching the simulated anesthetist, scrub nurse, and surgeon was, 3.75, 3.59, and 7.72 µSv, respectively. The estimated dose values per year to anesthetist, scrub nurse, and surgeon were 390, 373.36, and 802 µSv, respectively. Conclusion: The personnel recommended limit dose rate was <20000 µSv/y. The technical factor used and total exposure time from this study could have affected the radiation dose. This study showed that personnel was safe even without the use of lead apron. Nevertheless, the use of an appropriate protective device should be encouraged to ensure safety.

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A novel approach using 3-D printing in the Irish National Centre for pelvic and acetabular surgery

Cited by 12 publications

References 26 publications

A Systematic Review and Meta-Analysis of 3D Printing Technology for the Treatment of Acetabular Fractures

A Systematic Review and Meta-Analysis of 3D Printing Technology for the Treatment of Acetabular Fractures

Does 3D-Assisted Acetabular Fracture Surgery Improve Surgical Outcome and Physical Functioning?—A Systematic Review

A Simulation Study With Electronic Dosimeter to Estimate Patient and Personnel Dose in Orthopedic Surgery

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