{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:59:00Z","timestamp":1773021540359,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Open\u2010wedge high tibial osteotomy (OWHTO) is established for young, active patients with medial knee osteoarthritis. Patient\u2010specific 3D\u2010printed 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\u2010printed patient\u2010specific guide plate improves efficiency, functional outcomes, and cost\u2010effectiveness compared to standard OWHTO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter randomized trial, patients scheduled for OWHTO were allocated to either conventional planning (control) or surgery using a patient\u2010specific 3D\u2010printed guide plate between November 2020 and June 2024. The primary endpoint was the 12\u2010month Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Secondary outcomes included knee range of motion (flexion in degrees), 30\u2010s chair\u2010stand test (number of stands), operative time, and health economic measures (direct costs and quality\u2010adjusted life years). Analyses were by intention\u2010to\u2010treat using appropriate statistical tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 180 patients (mean age 55\u2009years, 56.7% male) were randomized equally between groups. At 12\u2009months, mean WOMAC pain was 15.2 (SD 8.4) in the guide\u2010plate group and 15.6 (SD 8.7) in controls, with no significant difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.74). The guide\u2010plate group showed significantly greater knee flexion (mean 128\u00b0 vs. 122\u00b0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and a higher 30\u2010s chair\u2010stand count (14.2 vs. 12.5 stands;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) than controls. There were no other significant between\u2010group differences in clinical scores. Mean total cost per patient was not statistically significant in the ITT analysis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.094). Quality\u2010adjusted life years did not differ between groups, yielding no cost\u2010effectiveness advantage. These findings echo prior reports that OWHTO techniques with higher costs have similar patient outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Using a 3D\u2010printed patient\u2010specific 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\u2010stand performance, but at greater cost. No overall cost\u2010effectiveness benefit was observed. Routine use of this technology for OWHTO is not supported by our findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      Chinese Clinical Trial Registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/\">https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                      ): ChiCTR2000038619\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70259","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T01:07:08Z","timestamp":1771204028000},"page":"474-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Efficiency and Cost\u2010Effectiveness of\n                    <scp>3D<\/scp>\n                    \u2010Printed Patient\u2010Specific Guide Plate for Patients Undergoing Open\u2010Wedge High Tibial Osteotomy: A Multicentered Randomized Controlled Trial"],"prefix":"10.1111","volume":"18","author":[{"given":"Runhua","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Orthopedics Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanjie","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruixin","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0519-1593","authenticated-orcid":false,"given":"Manrong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-0451","authenticated-orcid":false,"given":"Qinglin","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9850-122X","authenticated-orcid":false,"given":"Yun","family":"Shen","sequence":"additional","affiliation":[{"name":"Pennington Biomedical Research Center  Baton Rouge Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4899-0715","authenticated-orcid":false,"given":"Jia","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5733-0754","authenticated-orcid":false,"given":"Da","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital Central South University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5313-2902","authenticated-orcid":false,"given":"Shengdi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Pennington Biomedical Research Center  Baton Rouge Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,15]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.12.021"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4816-z"},{"issue":"18","key":"e_1_2_14_4_1","first-page":"1568","article-title":"Return to Work and Sport Following High Tibial Osteotomy: A Systematic Review","volume":"98","author":"Ekhtiari S.","year":"2016","journal-title":"Journal of Bone and Joint Surgery. 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