Intraoperative application of three-dimensional printed guides in total hip arthroplasty: A systematic review

Table 1 Study characteristics of included studies

Ref.	Year	Study design	Navigation type	Patients, n	Hips, n
Dos Santos-Vaquinhas et al[22]	2022	Comparative study with retrospective cohort	3D model print	45	45
Xu et al[23]	2015	Retrospective cohort	3D model print	10	14
Zhang et al[24]	2022	Retrospective cohort	3D model print	17	21
Chen et al[25]	2022	RCT	3D printed Guides	60	60
Kida et al[26]	2023	Prospective cohort	3D printed Guides	23	23
Mishra et al[27]	2020	RCT	3D printed Guides	36	36
Tu et al[28]	2022	Prospective cohort	3D printed Guides	12	12
Yan et al[29]	2020	RCT	3D printed Guides	25	25

3D: Three-dimensional; RCT: Randomized controlled trial.

Table 2 Tubular presentation of QUADAS-2 results for included studies

Ref.	Risk of bias				Applicability concerns
	Patient selection	Index test	Reference standard	Flow and timing	Patient selection	Index test	Reference standard
Dos Santos-Vaquinhas et al[22]	+	+	+	+	+	+	+
Xu et al[23]	+	+	+	+	+	+	+
Zhang et al[24]	+	-	-	-	+	+	+
Chen et al[25]	+	+	+	+	+	+	+
Kida et al[26]	+	+	+	+	+	+	+
Mishra et al[27]	+	+	+	+	+	+	+
Tu et al[28]	?	-	-	-	+	+	+
Yan et al[29]	+	+	+	+	+	+	+
	+	Low risk	-	High risk	?	Unknown risk

Table 3 Outcome measures of articles reporting three-dimensional printed models

Ref.	Outcomes
	Number of hips	Mean (range) follow-up in months	Cup size planning accuracy1	Mean operating time in min	HHS2	Complications1	Vertical distance in mm3	Horizontal distance in mm3
Dos Santos-Vaquinhas et al[22]	45	32.4 (12-60)	19/21 vs 14/24 (P = 0.045)	156.15 ± 43.03 vs 187.5 ± 54.38 (P = 0.045)	57.15 ± 15.41–83.74 ± 8.49 vs 53.12 ± 15.62–75.59 ± 11.46 (P = 0.019)	Intraoperative 4/21 vs 10/24 (P = 0.003)	0.7 [(-5.0)-15] vs -3.3 [(-32.0)-8.0] (P = 0.102)	1.2 [(-9.0)-7.0)] vs 1.0 [(-8.0)-15.0] (P = 0.884)
Xu et al[23]	14	23.1 ± 5.9 (14-30)	10/14 (3/14 < 2 mm diff) vs 1/14 (5/14 < 2 mm diff)		37.7 ± 6.8–83.3 ± 5.7 (P < 0.01)		18.8 (11.5-25.8)	21.7 (15.0-31.2)
Zhang et al[24]	21	18.35 ± 6.86 (12-36)	15/17 (ICC = 0.930)		38.33 ± 6.07–88.61 ± 3.44 (P < 0.05)		40.48 ± 8.42–15.12 ± 1.25 (P < 0.05)	41.49 ± 5.17–32.49 ± 2.83 (P < 0.05)

¹Intervention vs control.

²Harris hip score (preoperative–postoperative; intervention vs control; P value between postoperative values for intervention vs control or preoperative-postoperative when no control group was used).

³Distance to center of rotation of the hip (preoperative–postoperative; intervention vs control).

ICC: Intraclass correlation coefficient.

Table 4 Outcome measures of articles reporting three-dimensional printed acetabular guides

Ref.	Outcomes
	Number of hips	Mean (range) follow-up in months	Cup size planning accuracy1	Postoperative cup inclination angle as °1	Postoperative cup anteversion angle as °1	Mean operating time in min1	HHS2	Intraoperative blood loss in mL1
Chen et al[25]	60	3	83.3% (93.3% < 2 mm) vs 73.3% (80% < 2 mm) (P = 0.532)	Absolute error: 2.6 (0-8.0) vs 5.0 (0-15.0) (P = 0.004)	Absolute error: 2.5 (0.3-7.3) vs 5.2 (0.1-14.0) (P < 0.001)	100.2 ± 13.4 vs 106.7 ± 24.4		290 ± 70.3 vs 251.7 ± 93.3
Kida et al[26]	23	0.5		39.37 ± 8.18	25.86 ± 7.87
Mishra et al[27]	36		18/18 vs 6/18	43.28 (38-46) vs 44.11 (34-50)	14.22 (8-27) vs 13.42 (5-36)	99.39 vs 92.33		519.44 vs 495.56
Tu et al[28]	12	72.42 (38–135)		42.6 ± 4.2	12.5 ± 3.6	280.8 ± 106.8	34.2 ± 3.7- 85.2 ± 4.2 (P < 0.001)	590.35 ± 112.47
Yan et al[29]	25	19.2 (14.4–45.6)		42.25 ± 4.55 vs 38.60 ± 3.25	17.30 ± 5.12 vs 15.01 ± 5.68	57.8 ± 3.73 vs 62.1 ± 4.19 (P = 0.008)	93.9 ± 2.87 vs 91.8 ± 3.69 (P = 0.009)	169 ± 34.1 vs 219 ± 38.0 (P = 0.002)

¹Intervention vs control.

²Harris hip score (preoperative–postoperative; intervention vs control; P value between postoperative values). P values are displayed for all studies that provided P values in their comparisons.