Clinical Outcomes of Three-Dimensional Printed Implants in Bone Tumor Surgery: A Meta-Analysis

BACKGROUND: The advent of three-dimensional (3D) printing has helped to revolutionize the field of orthopaedic surgery, particularly in the realm of preoperative planning and education. Another application of 3D printing in orthopaedic surgery is the production of patient-specific prostheses for reconstruction. The goal of this study was to analyze the use of 3D-printed prostheses in the setting of orthopaedic oncologic surgical resection and reconstruction. METHODS: A systematic meta-analysis was conducted using data from previous trials comparing 3D-printed prostheses (3DPs) with historical reconstruction across multiple anatomic locations, including the spine, pelvis, and extremities, in musculoskeletal oncology. Key outcomes assessed were surgical duration, intraoperative blood loss, complication rates, dislocation rates, resection accuracy, and functional outcomes using Musculoskeletal Tumor Society scores. RESULTS: A total of eight studies involving 237 patients (113 in the 3D-printed prosthesis group and 124 in the control group) were included. Compared with historical reconstruction, 3DP use showed a significant reduction in surgical duration (mean difference -37.6 minutes; 95% confidence interval [CI], -59.3 to -15.8; P = 0.0007) and postoperative complications (Odds Ratio [OR], 0.20; 95% CI, 0.07 to 0.59; P = 0.0038). The 3DP group also demonstrated significantly lower recurrence (OR, 0.34; 95% CI, 0.13 to 0.88; P = 0.026) and higher resection accuracy in the subset of studies reporting this outcome (OR, 14.36; 95% CI, 2.22 to 92.64; P = 0.0051). Functional outcomes improved with 3DP reconstruction, with a higher Musculoskeletal Tumor Society score (mean difference +3.78; 95% CI, 2.09 to 5.48; P < 0.001). CONCLUSION: Patient-specific 3D-printed protheses were associated with improved functional outcomes and favorable perioperative and oncologic end points, including shorter surgical time, fewer complications, and lower recurrence. These findings emphasize the value of 3DP technology in enhancing patient outcomes; however, owing to substantial heterogeneity and limited study volume, additional high-quality, randomized studies are needed to validate its broader clinical influence.