(TKP2021-EGA-23) Támogató: Innovációs és Technológiai Minisztérium
Background/Objectives: Cranioplasty (CP) is associated with high complication rates
(20–50%), and the optimal choice between patient-specific implants (PSIs) and hand-molded
(HM) alternatives remains debated. This systematic review and meta-analysis aims to
compare surgical and postoperative outcomes between PSIs and HM implants. Methods:
A systematic search was performed in three databases to identify studies reporting
surgical site infection (SSI), implant removal, reoperation, operative time or cosmetic
outcome for PSIs and/or HM implants. Two-arm studies of the same material were analyzed
separately from pooled single- and two-arm studies. Results: 125 observational studies
involving 10,034 patients were included. In two-arm comparisons, PSIs reduced implant
removal for titanium (OR 0.34, p = 0.053) and PMMA (OR 0.56, p = 0.188), while SSI
rates showed no meaningful difference between groups. In one-arm analyses, PSIs demonstrated
lower explantation probabilities (titanium 6.1%, PMMA 7.9%) compared with HM alternatives
(titanium 9.9%, PMMA 14.2%), alongside shorter operation times and fewer reoperations.
Cosmetic outcomes consistently favored PSIs. Conclusions: PSIs demonstrate advantages
in efficiency, durability, and esthetics compared with HM implants, supporting their
preferential use where resources allow. HM implants remain a cost-effective option
in resource-limited settings. Due to the observational nature of the included studies
and differences in study populations across arms, the findings should be interpreted
with caution.
