背景：近年来，3D打印技术辅助全髋关节置换在术前规划、术中指导定位、制作个体化植入物等方面发挥着重要作用，对髋关节疾病的治疗具有重要的临床意义。

目的：运用系统评价和Meta分析评价术前计划应用3D打印模型辅助全髋关节置换的临床疗效。

方法：电子检索PubMed、Embase、Cochrane Libray、中国知网、万方医学数据库，检索时间为数据库建立到2019年12月，以“全髋关节置换”“人工髋关节置换”“3D打印”“hip arthroplasty”“hip replacement”“THA”“3D Printing”“Three Dimensional Printing”等为关键词检索，纳入比较3D打印模型辅助与非3D打印辅助人工髋关节置换手术治疗髋关节疾病的的临床对照试验。根据纳入与排除标准筛选文献、提取数据并采用Cochrane 5.1.0 偏倚风险评估工具对纳入研究质量进行评价，随后采用RevMan 5.3软件进行数据分析。

结果与结论：①共纳入14篇对照研究，受试者共601例，其中3D打印组279例，非3D打印组322例；②Meta 结果显示：在初次髋关节置换中，3D打印组手术时间短于非3D打印组[SMD=-0.89，95%CI(-1.15，-0.64)，P＜0.05]，两组Harris评分比较差异无显著性意义[SMD=0.64，95%CI(-0.26，1.54)，P＞0.05]。在翻修手术中，3D打印组手术时间短于非3D打印组[SMD=-1.39，95%CI(-1.92，-0.86)，P＜0.05]，Harris评分高于非3D打印组[SMD=1.51，95%CI(0.05，2.96)，P＜0.05]。3D打印组术中出血量、术后引流量均少于非3D打印组[SMD=-1.90，95%CI(-2.82，-0.99)，P＜0.05；SMD=-2.87，95%CI(-3.36，-2.37)，P＜0.05]，前倾角及外展角较非3D打印组更接近术前设计角度[SMD=-1.24，95%CI(-1.57，-0.91)，P＜0.05；SMD=-1.71，95%CI(-2.96，-0.45)，P＜0.05]。③结果表明与传统全髋关节置换相比，3D打印辅助全髋关节置换能明显缩短手术时间、减少术中出血量与术后引流量、提高全髋关节置换的精确度，且更能缓解疼痛，提高生活质量。但由于纳入的文献质量不高，仍需要更高质量的大样本、多中心的随机对照试验以证实临床疗效。

国家自然科学基金项目()，项目负责人：何海军

BACKGROUND:Three-dimensional (3D) printing-assisted total hip arthroplasty plays an important role in preoperative planning,intraoperative guidance and positioning,and production of individualized has important clinical significance for the treatment of hip joint diseases.

OBJECTIVE:To evaluate the clinical efficacy of preoperative planning using 3D printed models to assist total hip arthroplasty by systematic evaluation and meta-analysis.

METHODS:PubMed,Embase,Cochrane Libray,CNKI,Wanfang databases were retrieved electronically for the articles published before December 2019.The keywords were“hip arthroplasty,hip replacement,THA,3D printing,three dimensional printing”in Chinese and English, clinical controlled trials of 3D printed models versus non-3D printed models to assist total hip arthroplasty in the treatment of hip joint diseases were literature was screened according to the inclusion and exclusion criteria;data were extracted;and the quality of the included studies was evaluated using the Cochrane 5.1.0 bias risk assessment tool,followed by data analysis using RevMan 5.3 software.

RESULTS AND CONCLUSION:(1) Fourteen controlled studies were included,involving 601 participants,including 279 cases in the 3D group and 322 cases in the traditional surgery group.(2) Meta-analysis results showed that during the first hip arthroplasty,the operation time in the 3D group was shorter than that in the traditional surgery group [SMD=-0.89,95%CI(-1.15,-0.64),P＜0.05].There was no significant difference in the Harris score between two groups [SMD=0.64,95%CI(-0.26,1.54),P＞0.05].During revision surgery,the operation time in the 3D group was shorter than that in the traditional surgery group[SMD=-1.39,95%CI(-1.92,-0.86),P＜0.05],and Harris score was higher than that in the traditional surgery group[SMD=1.51,95%CI(-0.05,2.96),P＜0.05].The intraoperative blood loss and postoperative drainage volume in the 3D group were less than those in the traditional surgery group [SMD=-1.90,95%CI(-2.82,-0.99),P＜0.05;SMD=-2.87,95%CI(-3.36,-2.37),P＜0.05].The anteversion angle and abduction angle in the 3D group were closer to the preoperative design angle compared with the traditional surgery group [SMD=-1.24,95%CI(-1.57,-0.91),P＜0.05;SMD=-1.71,95%CI(-2.96,-0.45),P＜0.05].(3)These results show that compared with traditional total hip arthroplasty,3D printing assisted total hip arthroplasty can significantly shorten the operation time,reduce the amount of intraoperative blood loss and postoperative drainage,improve the accuracy of total hip arthroplasty,and can better relieve pain,and improve the quality of ,due to the low quality of the included literature,high-quality large-sample,multi-center randomized controlled trials are still needed to confirm the clinical efficacy.