Abstract
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.
Highlights
Acetabular fractures are fractures involving the hip socket, which might have major impacts on the patient’s mobility, social activities, and the ability to work
3D technology has increasingly been used in acetabular fracture treatment
In 400 patients, a 3D print and plate precontouring of the implant was used (14 studies); in 69 patients, a patient-specific implant was used; and in 9 patients, only 3D printing for pre- and intraoperative fracture visualisation was used
Summary
Acetabular fractures are fractures involving the hip socket, which might have major impacts on the patient’s mobility, social activities, and the ability to work. These severe injuries usually occur due to high-energy trauma mechanisms (i.e., car accidents) in young patients [1]. Acetabular fractures are increasingly caused by low-energy trauma mechanisms (i.e., fall at ground level) in frail elderly [1]. Acetabular fractures are complex fractures, due to the three-dimensional (3D) geometry of the pelvis and displacement of fracture fragments in multiple directions. 3D technology has increasingly been used in acetabular fracture treatment
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