***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study develops and vali date s a novel patient-specific navigational template for total knee arthroplasty ( TKA ) . A total of 70 patients who underwent TKA were r and omized and divided into conventional method group and navigational template group . In the navigational template group , the patient-specific navigational templates were design ed and used intraoperatively to assist 35 patients with knee arthroplasty . Information on operation time and blood loss was recorded . After surgery , the positions of the prosthesis were evaluated using CT scan and X-rays . Analysis showed significant differences in errors between the two techniques . In addition , mean operation time and mean blood loss were statistically and significantly lower in the navigational template group than in the conventional group . Overall , the navigational template method showed a high degree of accuracy and efficacy BACKGROUND Sagittal split ramus osteotomy ( SSRO ) can be associated with  postoperative neurosensory disturbances . This study aim ed to evaluate the effectiveness of computer-assisted SSRO in reducing the incidence and severity of neurosensory alterations , using a surgical guide fabricated by computer-aided design and rapid prototyping ( to guide bone cutting lateral to the inferior alveolar nerve ) . METHODS A prospect i ve double-blind , r and omized controlled , clinical trial of computer-assisted SSRO vs conventional SSRO ( assigned in a split-mouth design ) in eight patients , mean age 23 ( range 18 - 30 ) years , who participated in one session preoperatively and three sessions at 1 week and 1 , 3 and 6 months postoperatively . At each session , subjective oral sensation was scored and quantitative sensory tests were performed . Neurosensory changes were compared between the two sides . RESULTS The results showed that on the computer-assisted SSRO sides , patients had lower postoperative abnormal thresholds for the Semmes-Weinstein monofilaments on lower lip and chin ( p < 0.05 at 3 months ) and for the two-point discrimination on lower lip ( p < 0.05 at 1 week ) and chin ( p < 0.05 at 6 months ) , with fewer abnormal self-reported changes in lower lip sensation ( p < 0.05 at 1 week ) after surgery . CONCLUSIONS These findings imply that computer-assisted SSRO is associated with better levels of neurosensory function after surgery Objective : To investigate the efficacy of 3-D printed bone models as a tool to facilitate initiation of bisphosphonate treatment among individuals who were newly diagnosed with osteoporosis . Design : Fifty eight participants with estimated fracture risk above that at which guidelines recommend pharmacological intervention were r and omised to receive either a st and ard physician interview or an interview augmented by the presentation of 3-D bone models . Main outcome measures : Participants ’ beliefs about osteoporosis and bisphosphonate treatment , initiation of bisphosphonate therapy assessed at two months using self-report and pharmacy dispensing data . Results : Individuals in the 3-D bone model intervention condition were more emotionally affected by osteoporosis immediately after the interview ( p = .04 ) and reported a greater underst and ing of osteoporosis at follow-up ( p = .04 ) , than the control group . While a greater proportion of the intervention group initiated an oral bisphosphonate regimen ( alendronate )  ( 52 % ) in comparison with the control group ( 21 % ) , the overall initiation of medication for osteoporosis , including  infusion ( zoledronate ) , did not differ significantly ( intervention group 62 % , control group 45 % , p = .19 ) . Conclusion : The presentation of 3-D bone models during a medical consultation can modify cognitive and emotional representations relevant to treatment initiation among people with osteoporosis and might facilitate commencement of bisphosphonate treatment Purpose Due to the complexity of acetabulum , achieving anatomical contouring intra-operatively is difficult for surgeon . A 3D ( dimensional ) real model can facilitate us both in contouring the plate pre-operatively and in better pre-operative planning . Patient-specific pre-contoured plate in acetabular fracture has been studied by few research ers but r and omized case – control study was lacking . Hence , we conducted a case – control study to evaluate the accuracy of patient-specific pre-contoured plate . Material s and methods Prospect i ve r and omized case control study was conducted . 21 patients were included . 10 patients were distributed in “ case ” group and remaining 11 in “ control ” group . Inclusion criteria : Displaced acetabulum fractures with displacement of ≥3 mm in adults who reported within 3 weeks of injury . Exclusion criteria were : Open fractures , associated Morel-Lavallée lesion and patients with > 3 weeks old fracture . In case group , patient-specific real 3D model of fractured acetabulum was generated using rapid prototyping technology and plates were contoured pre-operatively . Control group was treated using intra-operative contoured plates . Both the groups were compared using parameters : Blood loss , Surgery time , post-operative reduction on X-ray , post-surgical residual displacement and reduction achieved as evaluated by CT scan . Results Reduced blood loss ( 100 ml less in case group ) and surgical time ( 12 min less in case group ) and better post-operative reduction were observed in case than control . In control group , 4 patients even had step of 2–3 mm , which was not seen in case group . All the pre-contoured plates fitted well to the pelvis intra-operatively . Reduction achieved as evaluated by CT was more in “ case ” group with statistically significant outcomes ( p < 0.05 ) . Conclusion Patient-specific pre-contoured plate made using 3D model is a better implant than intra-operatively contoured plate . Real-time 3D pelvis model is an accurate technique for pre-operative planning in acetabular fractures Prototyping technologies for reconstructions consist of obtaining a 3‐dimensional model of the object of interest . Solid models are constructed by the deposition of material s in successive layers . The purpose of this study was to perform a double‐blind , r and omized , prospect i ve study to evaluate the efficacy of prototype use in head and neck surgeries Background Computer-assisted surgery plays an increasingly important role in m and ibular reconstruction , ensuring the best possible masticatory function and aesthetic outcome . Methods Twenty patients were r and omly assigned to computer-assisted or conventional m and ibular reconstruction with vascularized iliac crest bone graft in a prospect i ve study design .Virtual surgical planning was based on preoperative CT- data using specific surgical planning software . A rapid prototyping guide transferred the virtual surgery plan to the operation site . During surgery the transplant ischemic time , reconstruction time , time for shaping the transplant and amount of bone removed were measured . Additionally , the difference in the intercondylar distance before and after surgery was calculated . Results Computer-assisted surgery shortened the time of transplant ischemia ( P < 0.005 ) and defect reconstruction ( P < 0.001 ) compared to conventional surgery . The time to saw and shape the transplant at the donor site was shorter using conventional surgery ( P < 0.005 ) ; therefore , the overall time for surgery did n’t change ( P = 0.527 ) . In the computer-assisted group , the amount of bone harvested equaled the defect size , whereas the transplant size in the conventional group exceeded the defect site by 16.8 ± 5.6 mm ( P < 0.001 ) on average . The intercondylar distance before compared to after surgery was less affected in the computer-assisted than in the conventional group ( P < 0.001 ) . Conclusions The presented study shows that computer-assisted surgery can help reduce the time for m and ibular defect reconstruction and consequently the transplant ischemic time . In the computer-assisted group , the iliac crest donor site defect was downsized and the postoperative condyle position was less altered , reducing possible risks of postoperative complications and donor site morbidity . Trial Registration Abstract The aim of the study was to evaluate the efficacy  custom 3D-printed osteo synthesis plates in the treatment of intercondylar humeral fractures . Thirteen patients with distal intercondylar humeral fractures were r and omized to undergo surgery using either conventional plates ( n = 7 ) or 3D-printed plates ( n = 6 ) at our institution from March to October 2014 . Both groups were compared in terms of operative time and elbow function at 6 month follow-up . All patients were followed-up for a mean of 10.6 months ( range : 6–13 months ) . The 3D-printing group had a significantly shorter mean operative time ( 70.6 ± 12.1 min ) than the conventional plates group ( 92.3 ± 17.4 min ) . At the last follow-up period , there was no significant difference between groups in the rate of patients with good or excellent elbow function , although the 3D-printing group saw a slightly higher rate of good or excellent evaluations ( 83.1 % ) compared to the conventional group ( 71.4 % ) . Custom 3D printed osteo synthesis plates  are safe and effective for the treatment of intercondylar humeral fractures and significantly reduce operative time To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication , thirty patients with trimalleolar fractures were r and omly divided into the 3D printing assisted- design operation group ( Group A ) and the no-3D printing assisted- design group ( Group B ) . In Group A , 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment . All patients underwent open reduction and internal fixation .  A question naire was design ed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype . Meanwhile , the operation time and the intraoperative blood loss were compared between the two groups . The fracture prototypes were accurately printed , and the average overall score of the verisimilitude and effectiveness of the 3D-printed prototypes was relatively high . Both the operation time and the intraoperative blood loss in Group A were less than those in Group B ( P < 0.05 ) . Patient satisfaction using the 3D-printed prototype and the communication score were 9.3 ± 0.6 points . A 3D-printed prototype can faithfully reflect the anatomy of the fracture site ; it can effectively help the doctors plan the operation and represent an effective tool for physician-patient communication BACKGROUND The considerable variation in anatomical abnormalities of hip joints associated with different types of developmental dysplasia of hip ( DDH ) makes reconstruction in total hip arthroplasty ( THA ) difficult . It is desirable to create patient-specific design s for THA procedures . In the cases of adult single DDH , an accuracy-improved method has been developed for acetabular cup prosthesis implantation of hip arthroplasty . METHODS From October 2007 to November 2008 , 22 patients with single DDH ( according to the Crowe st and ard , all dysplasia hips were classified as type I ) were scanned with spiral CT pre-operatively . These patients scheduled for THA were r and omly assigned to undergo either conventional THA ( control group , n = 11 ) or navigation template implantation ( NT group , n = 11 ) . In the NT group , three-dimensional ( 3D ) CT pelvis image data were transferred to a computer workstation and 3D models of the hip were reconstructed using the Mimics software . The 3D models were then processed by the Imageware software . In brief , a template that best fitted the location and shape of the acetabular cup was ' reversely ' built from the 3D model , the rotation centre of the pathological hip determined by mirroring that of the healthy site , and a guiding hole in the template was then design ed . The navigational templates were manufactured using a rapid prototyping machine . These navigation templates guide acetabular component placement . RESULTS Based on the predetermined abduction angle 45 ° and anteversion angle 18 ° , after 1 year follow-up , the NT group showed significantly smaller differences ( 1.6 ° ± 0.4 ° , 1.9 ° ± 1.1 ° ) from the predetermined angles than those in the control group ( 5.8 ° ± 2.9 ° , 3.9 ° ± 2.5 ° ) ( P < 0.05 ) . CONCLUSIONS The template design s facilitated accurate placement of acetabular components in dysplasia of acetabulum . The hip 's center of rotation in DDH could be established using computer-aided design , which provides a useful method for the accurate location of prosthesis with a low cost-performance ratio without excessive technical workload on the surgical team OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The 
    Output:
    
The main benefits of these devices were decreased surgical operation times and increased surgical accuracy .
CONCLUSIONS All medical fields that assessed 3D-printed devices concluded that they were clinical ly effective .
The fields that most rigorously assessed 3D-printed devices were oral and maxillofacial surgery and the musculoskeletal system , both of which concluded that the 3D-printed devices outperformed their conventional comparators .
However , the efficacy and effectiveness of 3D-printed devices remain undetermined for the majority of medical fields .