The effect of three-dimensional (3D) printing on quantitative and qualitative outcomes in paediatric orthopaedic osteotomies: a systematic review

Abstract

Three-dimensional (3D) printing technology is increasingly being utilized in various surgical specialities. In paediatric orthopaedics it has been applied in the pre-operative and intra-operative stages, allowing complex deformities to be replicated and patient-specific instrumentation to be used. This systematic review analyses the literature on the effect of 3D printing on paediatric orthopaedic osteotomy outcomes. A systematic review of several databases was conducted according to PRISMA guidelines. Studies evaluating the use of 3D printing technology in orthopaedic osteotomy procedures in children (aged ≤ 16 years) were included. Spinal and bone tumour surgery were excluded. Data extracted included demographics, disease pathology, target bone, type of technology, imaging modality used, qualitative/quantitative outcomes and follow-up. Articles were further categorized as either ‘pre-operative’ or ‘intra-operative’ applications of the technology. Twenty-two articles fitting the inclusion criteria were included. The reported studies included 212 patients. There were five articles of level of evidence 3 and 17 level 4. A large variety of outcomes were reported with the most commonly used being operating time, fluoroscopic exposure and intra-operative blood loss. A significant difference in operative time, fluoroscopic exposure, blood loss and angular correction was found in the ‘intra-operative’ application group. No significant difference was found in the ‘pre-operative’ category. Despite a relatively low evidence base pool of studies, our aggregate data demonstrate a benefit of 3D printing technology in various deformity correction applications, especially when used in the ‘intra-operative’ setting. Further research including paediatric-specific core outcomes is required to determine the potential benefit of this novel addition. Cite this article: EFORT Open Rev 2021;6:130-138. DOI: 10.1302/2058-5241.6.200092

Forearm segmental bone defect: Successful management using the Masquelet Technique with the aid of 3D printing technology

“…The complexity of the case, depicted by the association of the radial multiplanar deformity with the ulnar atrophic nonunion, made surgical planning exceptionally challenging. We decided therefore to avail of 3D printing technology, a powerful tool whose use is being increasingly applied in the deformity correction field with advantages both in the pre-operative and in the intra-operative phases [7] . Indeed, the use of a 3D model allowed us to better understand the deformity and to simulate the radius osteotomy with the aid of a 3D cutting guide in order to determine the precise wedge size.…”

Patient-Specific Guided Osteotomy to Correct a Symptomatic Malunion of the Left Forearm

“…Because of this, we have not obtained a postoperative CT scan to evaluate the performed corrective osteotomy. On the other hand, however, it has been shown that the use of 3D planning and printing reduces operating time, intraoperative blood loss, and fluoroscopic exposure [9].…”

“…In recent years, there has been an increased interest in the use of 3D analysis and printing in (paediatric) orthopaedics [8][9][10]. Nowadays, a corrective osteotomy is often preceded by preoperative planning based on 3D analyses of the malunion.…”

From Three-Dimensional (3D)- to 6D-Printing Technology in Orthopedics: Science Fiction or Scientific Reality?

“…Specifically, the 3D-printing facilities in orthopedic surgery have been investigated since the early 2000s, giving promising results. Currently, 3D printing is widely used in complex trauma cases [ 7 ], for the management of common childhood orthopedic disorders [ 8 , 9 ], in arthroplasty or extensive reconstructive procedures [ 10 , 11 ], as well as for the treatment of complicated cases in orthopedic oncology [ 12 ].…”