Evidence map›Paper›PMID 41692426›Full record

Trial reportOrthopaedic surgery2026

The Efficiency and Cost-Effectiveness of 3D-Printed Patient-Specific Guide Plate for Patients Undergoing Open-Wedge High Tibial Osteotomy: A Multicentered Randomized Controlled Trial.

Runhua Zhou, Yanjie Guo, Ruixin Wang, Manrong Xu, Qinglin Kang, Yun Shen, Jia Xu, Da Zhong, Shengdi Lu

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Orthopaedic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Runhua ZhouDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yanjie GuoDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ruixin WangSchool of Public Health, Fudan University, Shanghai, China.
Manrong XuDepartment of Endocrinology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0002-0519-1593
Qinglin KangDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0001-9825-0451
Yun ShenPennington Biomedical Research Center, Baton Rouge, Louisiana, USA.ORCID https://orcid.org/0000-0002-9850-122X
Jia XuDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0002-4899-0715
Da ZhongDepartment of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.ORCID https://orcid.org/0000-0001-5733-0754
Shengdi LuDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0001-5313-2902

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOpen-wedge high tibial osteotomy (OWHTO) is established for young, active patients with medial knee osteoarthritis. Patient-specific 3D-printed guide plates have been introduced to improve surgical precision and efficiency, but evidence of clinical and economic benefit is limited. We aimed to determine whether a 3D-printed patient-specific guide plate improves efficiency, functional outcomes, and cost-effectiveness compared to standard OWHTO.

methodsIn this multicenter randomized trial, patients scheduled for OWHTO were allocated to either conventional planning (control) or surgery using a patient-specific 3D-printed guide plate between November 2020 and June 2024. The primary endpoint was the 12-month Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Secondary outcomes included knee range of motion (flexion in degrees), 30-s chair-stand test (number of stands), operative time, and health economic measures (direct costs and quality-adjusted life years). Analyses were by intention-to-treat using appropriate statistical tests.

resultsA total of 180 patients (mean age 55 years, 56.7% male) were randomized equally between groups. At 12 months, mean WOMAC pain was 15.2 (SD 8.4) in the guide-plate group and 15.6 (SD 8.7) in controls, with no significant difference (p = 0.74). The guide-plate group showed significantly greater knee flexion (mean 128° vs. 122°; p = 0.04) and a higher 30-s chair-stand count (14.2 vs. 12.5 stands; p = 0.02) than controls. There were no other significant between-group differences in clinical scores. Mean total cost per patient was not statistically significant in the ITT analysis (p = 0.094). Quality-adjusted life years did not differ between groups, yielding no cost-effectiveness advantage. These findings echo prior reports that OWHTO techniques with higher costs have similar patient outcomes.

conclusionUsing a 3D-printed patient-specific guide plate did not improve the primary pain outcome or overall functional outcome compared to standard OWHTO. It yielded minor gains in knee flexion and chair-stand performance, but at greater cost. No overall cost-effectiveness benefit was observed. Routine use of this technology for OWHTO is not supported by our findings. LEVEL OF EVIDENCE: Level I, randomized controlled trial.

trial registrationChinese Clinical Trial Registry (https://www.chictr.org.cn/): ChiCTR2000038619.

Indexed as

Bone PlatesOsteoarthritis, KneeOsteotomyPrinting, Three-DimensionalTibiaCost-Effectiveness AnalysisFemaleHumansMaleMiddle AgedRange of Motion, Articularcost–benefit analysisosteoarthritisosteotomypatient‐specific instrumentationrandomized controlled trial

Identifiers

PMID41692426
PMCPMC12967555

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.