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The Efficiency and Cost-Effectiveness of 3D-Printed Patient-Specific Guide Plate for Patients Undergoing Open-Wedge
Runhua Zhou1, Yanjie Guo1, Ruixin Wang2
1Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Orthopaedic Surgery
|February 15, 2026
Summary
Patient-specific 3D-printed guide plates for open-wedge high tibial osteotomy (OWHTO) did not improve pain outcomes. While offering minor gains in knee flexion and function, this technology showed no cost-effectiveness advantage over standard OWHTO.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Health Economics
Background:
- Open-wedge high tibial osteotomy (OWHTO) is a common procedure for medial knee osteoarthritis in active patients.
- Patient-specific 3D-printed guide plates aim to enhance surgical precision and efficiency in OWHTO.
- Limited evidence exists regarding the clinical and economic benefits of 3D-printed guide plates in OWHTO.
Purpose of the Study:
- To compare the efficiency, functional outcomes, and cost-effectiveness of OWHTO using 3D-printed patient-specific guide plates versus standard OWHTO.
- To evaluate the impact of 3D-printed guide plates on patient-reported pain, knee range of motion, and functional tests.
- To assess the economic implications, including direct costs and quality-adjusted life years.
Main Methods:
- A multicenter randomized controlled trial involving 180 patients undergoing OWHTO.
- Patients were allocated to either conventional planning (control) or surgery with a 3D-printed patient-specific guide plate.
- Primary endpoint: 12-month Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Secondary outcomes included range of motion, chair-stand test, operative time, and health economic measures.
Main Results:
- No significant difference in 12-month WOMAC pain scores between the guide-plate group and controls (p=0.74).
- The guide-plate group demonstrated significantly improved knee flexion (128° vs. 122°, p=0.04) and 30-second chair-stand test performance (14.2 vs. 12.5 stands, p=0.02).
- No significant differences in other clinical scores, operative time, total costs, or quality-adjusted life years were observed, indicating no cost-effectiveness advantage.
Conclusions:
- 3D-printed patient-specific guide plates did not improve the primary pain outcome or overall functional outcome in OWHTO compared to standard techniques.
- Minor improvements in knee flexion and chair-stand performance were noted, but these did not translate to overall functional gains or cost-effectiveness.
- The routine use of 3D-printed patient-specific guide plates for OWHTO is not supported by the current findings due to increased costs without significant clinical benefits.
