Use of Three-dimensional Printed Carpal Bones for Various Carpal Pathologies: A Systematic Review

Three-dimensional (3D) printing technology allows for patient-specific anatomical reconstruction. This study aims to summarize and critique the current literature on 3D-printed carpal bone implants used in various carpal pathologies.

Web of Science, PubMed, Scopus, Google Scholar, and Cochrane Central Register of Controlled Trials databases were searched from January 1901 to October 2022. PRISMA guidelines were adhered to, and the study was registered on PROSPERO. Articles utilizing 3D printed carpal bone implants were selected based on pre-determined inclusion and exclusion criteria. The outcomes included intraoperative/postoperative complications, visual analogue score (VAS), disabilities of the arm, shoulder and hand (DASH) score, radial and ulna deviation. The Murad tool was used to assess the quality of case reports and Newcastle Ottawa scale was used to assess the observational studies.

A total of 6 studies comprising of 47 patients (34 males) were included. The average age was 35.3 years and indications for 3D printed implants included Fenton syndrome, Kienböck’s disease, and scaphoid non-union with and without necrosis. The overall postoperative VAS ranged from 0 to 1.4 and a significant reduction was noted from preoperatively with both rest and loading. The overall postoperative DASH score ranged from 9.2 to 25 and significant improvement was noted from preoperatively. The radial deviation ranged from 16.4° to 28.5° and while ulna deviation was from 23.8° to 36.4°. Only one complication was reported in included studies, a dislocation of the prosthesis. The overall quality of included studies was poor.

3D-printed carpal bone implants improved outcomes in pain and function with minimal complications. The current study only reported only one complication postoperatively with no intraoperative complications. These results suggest that while 3D-printed carpal bone implants are still being optimized, large-scale clinical studies comparing the current options with the standard of care would provide better insights for recommendations and counseling.