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La impresión 3D en la cirugía de reemplazo articular: prótesis de rodilla personalizadas.

Authors: Marco Díaz, Laura;

La impresión 3D en la cirugía de reemplazo articular: prótesis de rodilla personalizadas.

Abstract

Introducción: La artrosis de rodilla es una de las enfermedades más comunes e invalidantes y la artroplastia de rodilla es el único tratamiento definitivo en la actualidad. En los últimos años se han diseñado modelos que utilizan guías de corte personalizadas para cada paciente que conseguirían reducir la pérdida sanguínea, el tiempo quirúrgico, disminuir la tasa de complicaciones, además de obtener una alineación más anatómica de los componentes así como unos mejores resultados clínicos. Objetivos: Determinar si el uso de PSI tiene mejores resultados radiológicos y clínicos, una menor pérdida de sangre, un acortamiento del tiempo quirúrgico así como menos complicaciones que la artroplastia convencional. Métodos: Esta revisión incluye 14 estudios obtenidos en una búsqueda en PubMed y Cochrane, los cuales comparaban la artroplastia personalizada con la artroplastia tradicional. Todos los datos sobre el número de pacientes, las pérdidas de seguimiento, resultados y limitaciones de cada estudio se resumieron en una tabla. Posteriormente se analizó la calidad metodológica de cada uno de ellos. Resultados: 3 estudios aportan resultados radiológicos positivos para el grupo de PSI, 1 ensayo describe mejores resultados clínicos para el grupo de instrumental personalizado, 4 estudios reportan un menor tiempo quirúrgico con el uso de material personalizado. El resto no mostraron resultados significativamente diferentes entre ambos grupos. Tras el análisis de riesgo de sesgo, cuatro trabajos fueron clasificados como riesgo moderado y los diez restantes presentaron riesgo de sesgo alto. Conclusión: El uso de instrumental personalizado para cada paciente no puede ser recomendado por encima de la artroplastia tradicional en pacientes con artrosis en la práctica clínica diaria ya que no se han demostrado mejores resultados, ni radiológicos ni clínicos.

Introduction: Knee osteoarthritis is one of the most common and disabling diseases and nowadays knee arthroplasty in the only definitive treatment. Recently procedures, which utilize personalized cutting guides for each patient, have been designed. This technic would reduce blood loss, surgery time, and rate of complication, in addition to obtaining more accurate alignment of components as well improving clinical results. Objectives: Resolve if PSI instrumentation has better radiological and clinical results, less blood loss, reduces surgical time and complications than conventional arthroplasty. Methods: This review includes 14 studies obtained in a research in PubMed and Cochrane, which compared the use of patient-specific cutting guides with traditional arthroplasty. All data on number of patient, lost of follow up, software, measurements and limitations of each study is summarized in a chart. After that, the methodological quality of each of them was analysed. Results: 3 clinical trials provided positive radiological results in the group of PSI, 1 study described better clinical outcomes in the personalized group, 4 studies report shorter surgical time with the use of patient specific instrumentation. The rest of the reviewed studies did not describe significant differences between both groups. After analysing the risk of bias, 4 papers were classified as moderated risk, and the remaining ten presented high risk. Conclusion: Patient-specific instrumentation could not be widely recommended beyond conventional surgery in patients who undergone osteoarthritis as it has not demonstrated better results, either radiological or clinical

Treball Final de Grau en Medicina. Codi: MD1158. Curs acadèmic: 2018/2019.

Country
Spain
Related Organizations
Keywords

Knee Osteoarthritis, Grau en Medicina, Total Knee Arthroplasty, Bachelor's Degree in Medicine, Patientspecific Instrumentation, Guías de corte personalizadas,, Grado en Medicina, Patient-specific Cutting Guides, Artroplastia total de rodilla, Instrumental específico para el paciente, Artrosis de rodilla

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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