A radiographic artificial intelligence tool to identify candidates suitable for partial knee arthroplasty.

IF 2 3区医学 Q2 ORTHOPEDICS

Archives of Orthopaedic and Trauma Surgery Pub Date : 2024-11-01 Epub Date: 2024-10-03 DOI:10.1007/s00402-024-05589-8

Thomas J York, Bartosz Szyszka, Angela Brivio, Omar Musbahi, David Barrett, Justin P Cobb, Gareth G Jones

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引用次数: 0

Abstract

Introduction: Knee osteoarthritis is a prevalent condition frequently necessitating knee replacement surgery, with demand projected to rise substantially. Partial knee arthroplasty (PKA) offers advantages over total knee arthroplasty (TKA), yet its utilisation remains low despite guidance recommending consideration alongside TKA in shared decision making. Radiographic decision aids exist but are underutilised due to clinician time constraints.

Materials and methods: This research develops a novel radiographic artificial intelligence (AI) tool using a dataset of knee radiographs and a panel of expert orthopaedic surgeons' assessments. Six AI models were trained to identify PKA candidacy.

Results: 1241 labelled four-view radiograph series were included. Models achieved statistically significant accuracies above random assignment, with EfficientNet-ES demonstrating the highest performance (AUC 95%, F1 score 83% and accuracy 80%).

Conclusions: The AI decision tool shows promise in identifying PKA candidates, potentially addressing underutilisation of this procedure. Its integration into clinical practice could enhance shared decision making and improve patient outcomes. Further validation and implementation studies are warranted to assess real-world utility and impact.

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用于识别适合进行部分膝关节置换术的候选者的放射学人工智能工具。

导言：膝关节骨性关节炎是一种常见疾病，经常需要进行膝关节置换手术，预计需求量将大幅增加。与全膝关节置换术（TKA）相比，部分膝关节置换术（PKA）具有优势，但尽管指导意见建议在共同决策中将其与全膝关节置换术一起考虑，但其使用率仍然很低。放射影像决策辅助工具已经存在，但由于临床医生的时间限制而未得到充分利用：本研究利用膝关节X光片数据集和骨科外科医生专家小组的评估结果，开发了一种新型放射学人工智能（AI）工具。对六个人工智能模型进行了训练，以识别 PKA 候选者：结果：共纳入了1241张标注了四视角的X光片系列。模型的准确率高于随机分配，EfficientNet-ES的准确率最高（AUC为95%，F1分数为83%，准确率为80%）：人工智能决策工具在识别 PKA 候选者方面显示出良好的前景，有可能解决该手术利用不足的问题。将其融入临床实践可加强共同决策，改善患者预后。有必要开展进一步的验证和实施研究，以评估其在现实世界中的实用性和影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Orthopaedic and Trauma Surgery 医学-外科

CiteScore

4.30

自引率

13.00%

发文量

424

审稿时长

2 months

期刊介绍： "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).