Indian Journal of Orthopaedics最新文献

{"title":"Proximal Fibulectomy for Giant Cell Tumours: What Works!","authors":"Ashwin Prajapati, Harsha S. S. Tadala, Ashish Gulia, Ajay Puri","doi":"10.1007/s43465-024-01231-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01231-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Giant cell tumor of bone (GCTB) is the most common primary tumor of proximal fibula. Because of its close proximity to vascular structures, common peroneal nerve (CPN) and attachment of lateral collateral ligament (LCL), proximal fibulectomy poses unique challenges. We analyzed oncological and functional outcome of patients who underwent proximal fibulectomy for GCTB of proximal fibula.</p><h3 data-test=\"abstract-sub-heading\">Material and methods</h3><p>Between January 2006 and December 2020, 23 patients underwent proximal fibulectomy for GCTB of proximal fibula, four were recurrent tumors. Mean resection length was 9 cm (5 to 15 cm). The LCL and biceps tendon were not reconstructed in 22 cases. The common peroneal nerve was sacrificed in seven patients including three recurrent cases. Functional status was assessed using the Musculoskeletal Tumour Society (MSTS) scoring system.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>There were two vascular complications and one infection. With 4 patients lost to follow up, mean follow up was 90 months (12 to 197). No patient had local or distant recurrence. Mean MSTS score was 26 (21 to 30). Eleven of 23 patients (48%) had loss of common peroneal nerve function with poorer functional outcome. No patient had symptoms suggestive of knee instability.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Proximal fibulectomy is oncologically safe. Reconstruction of the LCL attachment is not mandatory and patients do not have symptomatic knee instability. Functional outcomes are compromised after sacrifice of common peroneal nerve and may be potentially improved with tendon transfers at index surgery.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"17 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reverse Allograft Prosthetic-Composite Versus Endoprosthesis Reconstruction for Massive Proximal Humerus Bone Loss: A Systematic Review and Meta-analysis of Outcomes and Complications","authors":"Kevin A. Hao, Caroline T. Gutowski, Victoria E. Bindi, Ramesh C. Srinivasan, Jonathan O. Wright, Joseph J. King, Thomas W. Wright, Catherine J. Fedorka, Bradley S. Schoch, Keegan M. Hones","doi":"10.1007/s43465-024-01248-7","DOIUrl":"https://doi.org/10.1007/s43465-024-01248-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>This systematic review and meta-analysis sought to compare the clinical outcomes after proximal humerus reconstruction with a reverse allograft-prosthetic composite (APC) versus reverse endoprosthesis.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Per PRISMA guidelines, we queried PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases to identify articles reporting clinical outcomes of reverse APC or reverse endoprosthesis reconstruction of the proximal humerus for massive bone loss secondary to tumor, fracture, or failed arthroplasty. We compared postoperative range of motion, outcome scores, and the incidence of complications and revision surgery.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Of 259 unique articles, 18 articles were included (267 APC, 260 endoprosthesis). There were no significant differences between the APC and endoprosthesis cohort for postoperative forward elevation (<i>P</i> = .231), external rotation (<i>P</i> = .634), ASES score (<i>P</i> = .420), Constant score (<i>P</i> = .414), MSTS (<i>P</i> = .815), SST (<i>P</i> = .367), or VAS (<i>P</i> = .714). Rate of complications was 15% (31/213) in the APC cohort and 19% (27/144) in the endoprosthesis cohort. The rate of revision surgery was 12% after APC cohort and 7% after endoprosthesis. APC-specific complications included a 10% APC nonunion/malunion/resorption rate and 6% APC fracture/fragmentation rate.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>Reverse APC and endoprosthesis are reasonable options for proximal humerus reconstruction. APC carries additional risks for complications, warranting evaluation of patients’ healing capacity and surgeon experience.</p><h3 data-test=\"abstract-sub-heading\">Level of Evidence</h3><p>Level IV; Systematic Review.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"15 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Observational Study of Clinico-radiological Co-relation of Carrying Angle in Children","authors":"Gauri A. Patki, Binoti A. Sheth, Lomash Bharati","doi":"10.1007/s43465-024-01254-9","DOIUrl":"https://doi.org/10.1007/s43465-024-01254-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>The purpose of this study is to establish the correlation of clinically measured carrying angle with four radiological angles, i.e., Humerus–Elbow–Wrist angle (HEWA), Humero-ulnar angle, Metaphyseal–Diaphyseal angle, and Baumann’s angle, and to find out which of the above-mentioned angles co-relates best with the clinically measured carrying angle.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We studied 100 patients in the age group of 2–12 years after Ethics committee approval and informed consent from parents. Clinical angle was measured using goniometer and radiological angles marked on antero-posterior elbow X-ray using a standard method. Collected data were studied using statistical tests to find out correlation.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Pearson correlation coefficient for humerus–elbow–wrist angle found to be 0.674 followed by Humero-Ulnar angle (<i>r</i> = 0.417). Regression coefficient for humerus–elbow–wrist angle is 0.635 (<i>p</i> value &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Humerus–Elbow–Wrist angle correlates better compared to other radiological angles in assessment of varus–valgus angulations of elbow &amp; will not only play a vital role in pre- operative planning of deformity corrections but also in the evaluation &amp; comparison of the post-operative functional outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"74 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence of Patellofemoral Joint Osteoarthritis in Long-Term Postoperative Cases of Open-Wedge High Tibial Osteotomy: Differences in Symptoms Based on Patient-Standing Type Evaluation with and Without Patellofemoral Joint Osteoarthritis","authors":"Noriyuki Gomi, Hiroaki Muramoto, Yusuke Kataoka","doi":"10.1007/s43465-024-01250-z","DOIUrl":"https://doi.org/10.1007/s43465-024-01250-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To examine the frequency of patellofemoral joint (PFJ) osteoarthritis (OA) and its symptoms in the long-term course of open-wedge high tibial osteotomy (OWHTO).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We analyzed 113 joints of 91 patients. OA and osteonecrosis (ON) developed in 91 and 22 joints, after an average postoperative period of 127.5 ± 19.5 months. For X-ray evaluation, the standing femorotibial angle (FTA), % mechanical axis (%MA), Caton–Deschamps index (CDI), patellar tilt angle (TA), lateral patellar shift (LPS), and PFJ space width (medial [MJS] and lateral [LJS]) were analyzed. PFJ-associated symptoms were evaluated using the hospital for special surgery patellar score (HSS-PS) and knee injury and osteoarthritis outcome score patellofemoral subscale (KOOS-PF). Statistical analysis was performed with paired and unpaired t tests, and a risk rate of less than 1% was significantly judged.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Preoperative FTA and CDI decreased from 180.8° to 170.0° and 0.88 to 0.70 at the final follow-up. Preoperative %MA lateralized from 20.8 to 66.0 at the final follow-up. TA and LPS values decreased significantly compared with before surgery until plate removal. The MJS and LJS significantly decreased, and OA with a joint space &lt; 3 mm occurred in 14 cases. However, HSS-PS and KOOS-PF scores were not significantly different between the groups with and without OA.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>PFJ OA occurred in 12.4% cases in the long-term postoperative course of OWHTO; however, no symptomatic difference was found in the group with or without OA.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"8 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delirium in Lower Limb Trauma: The Incidence and Risk Factors in a Prospective Observational Study","authors":"Aravind Balachandran, Manoj Nagar, Prateek Behera, Priyanka Kashyap","doi":"10.1007/s43465-024-01251-y","DOIUrl":"https://doi.org/10.1007/s43465-024-01251-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Delirium poses a significant challenge in musculoskeletal trauma patients, particularly the elderly, contributing to elevated morbidity and mortality. Despite unclear pathogenesis, various risk factors have been identified. This prospective observational study, conducted in a tertiary center, aims to estimate delirium incidence and identify associated risk factors in adult patients undergoing lower limb trauma surgeries.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Between August 2021 and December 2022, 150 patients with lower limb trauma admitted for surgery were included. Initial assessments recorded Mini-Mental State Examination scores, Injury Severity Scores, and potential risk factors. Confusion Assessment Method scoring done preoperatively (excluding emergencies) and postoperatively on days 2 and 5 or at discharge. Daily delirium screening utilized Nursing 4-Abbreviated Trauma score, with severity assessed using CAM-Severity score. Risk factor analysis categorized patients into Group A (delirium) and Group B (non-delirium), with primary endpoint being delirium occurrence.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study revealed a 10% delirium incidence. Delirium severity ranged from mild to severe. The median age (in years) was 79 vs 46 in delirium and non-delirium group respectively. Delirium patients had longer hospital stay (13 vs 8, <i>p</i> value 0.011). Similarly, factors like female gender, delayed surgery, hyponatremia, hypoproteinaemia, increased injury severity, midazolam use during induction, multiple blood transfusions, and heightened postoperative pain intensity were found significant (<i>p</i> value &lt; 0.05).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>This study enhances our understanding of delirium in lower limb trauma patients undergoing surgeries. Identified risk factors offer insights for targeted interventions, emphasizing the need for comprehensive preoperative assessments and management strategies to reduce delirium incidence and improve patient outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"42 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructing Quadriceps Tendon Disruptions in Post Total Knee Arthroplasty Patients with an Autogenous Peroneal Tendon Graft: A Viable Alternative","authors":"Rajeev K. Sharma, Udit Vinayak, Jitendra Wadhwani, Sanika Rapole","doi":"10.1007/s43465-024-01247-8","DOIUrl":"https://doi.org/10.1007/s43465-024-01247-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Quadriceps tendon disruption post-total knee arthroplasty (TKA) is rare. Existing reconstruction procedures use allografts or synthetic meshes with varied success. This study evaluates outcomes with autogenous peroneal tendon grafts, a cost-effective alternative, compared to synthetic polypropylene mesh for quadriceps reconstruction.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>16 patients who underwent extensor mechanism reconstruction between 2017 and 2021were retrospectively analysed. Parameters evaluated included type of reconstruction, extensor lag, IKDC (International Knee Documentation Committee) Score and AOFAS-Hindfoot-score (American Orthopaedic Foot and Ankle Society).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>At final follow-up, extensor lag for peroneal autograft group was 6.6° ± 1.5 and for synthetic polypropylene mesh group, 7.2° ± 0.7. Both groups improved in IKDC score (<i>p</i> &lt; 0.01) AOFAS-Hindfoot-score was comparable for peroneal autograft patients with opposite side (<i>p</i> = 0.15).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Autogenous peroneal tendon graft for quadriceps reconstruction could be viable, cost-effective alternative to allografts or synthetic meshes, with good clinical outcomes.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3><p> Graphical abstract depicting the harvesting of the peronei grafts and their passage through the quadriceps tendon. Sonographic image showing the preoperative presence of a gap in the quadriceps tendon which is reconstructed post-operatively</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"21 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responsible Use of Generative Artificial Intelligence for Research and Writing: Summarizing ICMJE Guideline","authors":"Himel Mondal, Shaikat Mondal, Ayesha Juhi","doi":"10.1007/s43465-024-01258-5","DOIUrl":"https://doi.org/10.1007/s43465-024-01258-5","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"8 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Mal-alignment of the CLS Spotorno Femoral Stem Correlate with Functional Outcome of Patients Undergoing Total Hip Arthroplasty? An Evaluation at Mid-term Follow Up","authors":"Jagprit Singh, Mandeep Singh Dhillon, Sandeep Patel, Mahesh Prakash, Sameer Aggarwal, Prasoon Kumar","doi":"10.1007/s43465-024-01236-x","DOIUrl":"https://doi.org/10.1007/s43465-024-01236-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The straight and thin design of the CLS Spotorno stem makes it prone for coronal plane mal-alignment, with potential for cortical impingement; reactive osteogenesis and thigh pain have been documented in this situation with some stems. The literature is scarce about the effect of distal mal-alignment with this particular stem, and its relationship with thigh pain, functional outcomes and stem survival. We assessed functional outcomes with incidence of varus/valgus CLS stem alignment, and correlated stem subsidence of these thin stems with hip scores.</p><h3 data-test=\"abstract-sub-heading\">Methodology</h3><p>Hip arthroplasty cases with CLS Spotorno stems, operated between 2015 and 2022, with a minimum follow up of 18 months were evaluated. Radiology included 100% pelvis x-rays with bilateral hips (anteroposterior with 15° internal rotation plus lateral views); parameters documented were coronal mal-alignment, stem subsidence, any pedestal formation and heterotrophic ossification (HO); special note was made of any thigh pain, and functional outcomes were recorded using mHHS and SF-36 scores.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We evaluated 65 patients with 79 operated hips at an average follow up of 5.26 years. 31.6% (25/79) stems were neutrally aligned, 64.6% (51/79) were in varus alignment and 3.8% (3/79) were in valgus alignment. The mean subsidence was 3.15 mm + 2.26 and 3 cases had Pedestal formation at the stem tip. There was no correlation between varus/valgus stem positions with the mHHS (<i>p</i> = 0.271) and SF-36 score (<i>p</i> = 0.553), which also did not correlate with the stem subsidence. HO formation was seen in 16 hips (20.3%), but no cases in our series needed revision during follow up.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Significant distal malalignment with some subsidence were noted in the hips studied; despite these radiological issues, there were excellent mid-term outcomes and good stems survival, implying that distal malposition may have no bearing on functional outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"110 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Cruciate Ligament and Posterolateral Corner Reconstruction: Clinical Outcomes Following Popliteal Tendon Tenodesis and Popliteal Tendon Reconstruction","authors":"Leonardo Adeo Ramos, Edilson Andrade, Gabriel Taniguti, Renan Moukbel Chaim, Alexandre Pedro Nicolini, Jorge Yamashita, Diego Costa Astur","doi":"10.1007/s43465-024-01243-y","DOIUrl":"https://doi.org/10.1007/s43465-024-01243-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Injuries to the posterolateral compartment (PLC) of the knee require special attention, as incorrect diagnosis and treatment may lead to considerable morbidity. However, no gold standard treatment has been established for PLC injuries.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>38 patients with concomitant (posterior cruciate ligament (PCL) and PLC injuries were divided into two groups according to surgical treatment of the proximal popliteal tendon injury. They were treated with anatomic popliteal tendon, lateral collateral ligament (LCL), and popliteofibular ligament (PFL) reconstruction (group 1; <i>n</i> = 19) and were treated with popliteal tendon tenodesis, LCL, and PFL reconstruction (group 2; <i>n</i> = 19). The Lysholm score, dial test, and lateral compartment opening on varus stress X-ray were used as outcome measurements evaluated before surgery and at 6, 12, and 24 months of follow-up.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Overall, there was a progressive improvement in the Lysholm score and the lateral opening on varus stress radiography during the evaluated periods for both groups (<i>p</i> &lt; 0.001). Patients from group 2 recorded better Lysholm scores than those from group 1 at 12- and 24-month follow-up (<i>p</i> = 0.02). Dial test was negative in all patients after 6, 12, and 24 months.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Patients with popliteal tendon tenodesis were found to have better Lysholm scores than patients with reconstruction after 12 and 24 months of follow-up. There was no difference in the lateral joint opening evaluated by stress radiography between groups. These results show that tenodesis could be a viable treatment option for lateral femoral condyle popliteal disruptions in the context of PLC and PCL combined injuries, and should be considered in the surgical planning process.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"287 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Screening of Hip X-rays for Osteoporosis by Singh’s Index Using Machine Learning Algorithms","authors":"Vijaya Kalavakonda, Sameer Mohamed, Lal Abhay, Sathish Muthu","doi":"10.1007/s43465-024-01246-9","DOIUrl":"https://doi.org/10.1007/s43465-024-01246-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Osteoporosis is a significant and growing global public health problem, projected to increase in the next decade. The Singh Index (SI) is a simple, semi-quantitative evaluation tool for diagnosing osteoporosis with plain hip radiographs based on the visibility of the trabecular pattern in the proximal femur. This work aims to develop an automated tool to diagnose osteoporosis using SI of hip radiograph images with the help of machine learning algorithms.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We used 830 hip X-ray images collected from Indian men and women aged between 20 and 70 which were annotated and labeled for appropriate SI. We employed three state-of-the-art machine learning algorithms—Vision Transformer (ViT), MobileNet-V3, and a Stacked Convolutional Neural Network (CNN)—for image pre-processing, feature extraction, and automation. Each algorithm was evaluated and compared for accuracy, precision, recall, and generalization capabilities to diagnose osteoporosis.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The ViT model achieved an overall accuracy of 62.6% with macro-averages of 0.672, 0.597, and 0.622 for precision, recall, and F1 score, respectively. MobileNet-V3 presented a more encouraging accuracy of 69.6% with macro-averages for precision, recall, and F1 score of 0.845, 0.636, and 0.652, respectively. The stacked CNN model demonstrated the strongest performance, achieving an accuracy of 93.6% with well-balanced precision, recall, and F1-score metrics.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The superior accuracy, precision-recall balance, and high F1-scores of the stacked CNN model make it the most reliable tool for screening radiographs and diagnosing osteoporosis using the SI.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"57 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}