Bone & Joint Research最新文献

{"title":"Appropriate sagittal positioning of femoral components in total knee arthroplasty to prevent fracture and loosening.","authors":"Qian Wan, Qing Han, Yang Liu, Hao Chen, Aobo Zhang, Xue Zhao, Jincheng Wang","doi":"10.1302/2046-3758.1310.BJR-2023-0362.R2","DOIUrl":"10.1302/2046-3758.1310.BJR-2023-0362.R2","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the optimal sagittal positioning of the uncemented femoral component in total knee arthroplasty to minimize the risk of aseptic loosening and periprosthetic fracture.</p><p><strong>Methods: </strong>Ten different sagittal placements of the femoral component, ranging from -5 mm (causing anterior notch) to +4 mm (causing anterior gap), were analyzed using finite element analysis. Both gait and squat loading conditions were simulated, and Von Mises stress and interface micromotion were evaluated to assess fracture and loosening risk.</p><p><strong>Results: </strong>During gait, varied sagittal positioning did not lead to excessive Von Mises stress or micromotion. However, under squat conditions, posterior positioning (-4 and -5 mm) resulted in stress exceeding 150 MPa at the femoral notch, indicating potential fracture risk. Conversely, +1 mm and 0 mm sagittal positions demonstrated minimal interface micromotion.</p><p><strong>Conclusion: </strong>Slightly anterior sagittal positioning (+1 mm) or neutral positioning (0 mm) effectively reduced stress concentration at the femoral notch and minimized interface micromotion. Thus, these positions are deemed suitable to decrease the risk of aseptic loosening and periprosthetic femoral fracture.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"611-621"},"PeriodicalIF":4.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The degenerated glenohumeral joint.","authors":"Stefan Toegel, Luca Martelanz, Juergen Alphonsus, Lena Hirtler, Ruth Gruebl-Barabas, Melanie Cezanne, Mario Rothbauer, Philipp Heuberer, Reinhard Windhager, Leo Pauzenberger","doi":"10.1302/2046-3758.1310.BJR-2024-0026.R1","DOIUrl":"10.1302/2046-3758.1310.BJR-2024-0026.R1","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to define the histopathology of degenerated humeral head cartilage and synovial inflammation of the glenohumeral joint in patients with omarthrosis (OmA) and cuff tear arthropathy (CTA). Additionally, the potential of immunohistochemical tissue biomarkers in reflecting the degeneration status of humeral head cartilage was evaluated.</p><p><strong>Methods: </strong>Specimens of the humeral head and synovial tissue from 12 patients with OmA, seven patients with CTA, and four body donors were processed histologically for examination using different histopathological scores. Osteochondral sections were immunohistochemically stained for collagen type I, collagen type II, collagen neoepitope C1,2C, collagen type X, and osteocalcin, prior to semiquantitative analysis. Matrix metalloproteinase (MMP)-1, MMP-3, and MMP-13 levels were analyzed in synovial fluid using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Cartilage degeneration of the humeral head was associated with the histological presentation of: 1) pannus overgrowing the cartilage surface; 2) pores in the subchondral bone plate; and 3) chondrocyte clusters in OmA patients. In contrast, hyperplasia of the synovial lining layer was revealed as a significant indicator of inflammatory processes predominantly in CTA. The abundancy of collagen I, collagen II, and the C1,2C neoepitope correlated significantly with the histopathological degeneration of humeral head cartilage. No evidence for differences in MMP levels between OmA and CTA patients was found.</p><p><strong>Conclusion: </strong>This study provides a comprehensive histological characterization of humeral cartilage and synovial tissue within the glenohumeral joint, both in normal and diseased states. It highlights synovitis and pannus formation as histopathological hallmarks of OmA and CTA, indicating their roles as drivers of joint inflammation and cartilage degradation, and as targets for therapeutic strategies such as rotator cuff reconstruction and synovectomy.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"596-610"},"PeriodicalIF":4.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in traumatology.","authors":"Rosmarie Breu, Carolina Avelar, Zsolt Bertalan, Johannes Grillari, Heinz Redl, Richard Ljuhar, Stefan Quadlbauer, Thomas Hausner","doi":"10.1302/2046-3758.1310.BJR-2023-0275.R3","DOIUrl":"10.1302/2046-3758.1310.BJR-2023-0275.R3","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to create artificial intelligence (AI) software with the purpose of providing a second opinion to physicians to support distal radius fracture (DRF) detection, and to compare the accuracy of fracture detection of physicians with and without software support.</p><p><strong>Methods: </strong>The dataset consisted of 26,121 anonymized anterior-posterior (AP) and lateral standard view radiographs of the wrist, with and without DRF. The convolutional neural network (CNN) model was trained to detect the presence of a DRF by comparing the radiographs containing a fracture to the inconspicuous ones. A total of 11 physicians (six surgeons in training and five hand surgeons) assessed 200 pairs of randomly selected digital radiographs of the wrist (AP and lateral) for the presence of a DRF. The same images were first evaluated without, and then with, the support of the CNN model, and the diagnostic accuracy of the two methods was compared.</p><p><strong>Results: </strong>At the time of the study, the CNN model showed an area under the receiver operating curve of 0.97. AI assistance improved the physician's sensitivity (correct fracture detection) from 80% to 87%, and the specificity (correct fracture exclusion) from 91% to 95%. The overall error rate (combined false positive and false negative) was reduced from 14% without AI to 9% with AI.</p><p><strong>Conclusion: </strong>The use of a CNN model as a second opinion can improve the diagnostic accuracy of DRF detection in the study setting.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"588-595"},"PeriodicalIF":4.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employing single-cell RNA sequencing coupled with an array of bioinformatics approaches to ascertain the shared genetic characteristics between osteoporosis and obesity.","authors":"Dingzhuo Liu, Fangming Cao, Dian Liu, Hao Li, Lin Tao, Yue Zhu","doi":"10.1302/2046-3758.1310.BJR-2023-0366.R1","DOIUrl":"10.1302/2046-3758.1310.BJR-2023-0366.R1","url":null,"abstract":"<p><strong>Aims: </strong>This study examined the relationship between obesity (OB) and osteoporosis (OP), aiming to identify shared genetic markers and molecular mechanisms to facilitate the development of therapies that target both conditions simultaneously.</p><p><strong>Methods: </strong>Using weighted gene co-expression network analysis (WGCNA), we analyzed datasets from the Gene Expression Omnibus (GEO) database to identify co-expressed gene modules in OB and OP. These modules underwent Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment and protein-protein interaction analysis to discover Hub genes. Machine learning refined the gene selection, with further validation using additional datasets. Single-cell analysis emphasized specific cell subpopulations, and enzyme-linked immunosorbent assay (ELISA), protein blotting, and cellular staining were used to investigate key genes.</p><p><strong>Results: </strong>WGCNA revealed critical gene modules for OB and OP, identifying the <i>Toll-like receptor</i> (<i>TLR</i>) signalling pathway as a common factor. <i>TLR2</i> was the most significant gene, with a pronounced expression in macrophages. Elevated TLR2 expression correlated with increased adipose accumulation, inflammation, and osteoclast differentiation, linking it to OP development.</p><p><strong>Conclusion: </strong>Our study underscores the pivotal role of <i>TLR2</i> in connecting OP and OB. It highlights the influence of <i>TLR2</i> in macrophages, driving both diseases through a pro-inflammatory mechanism. These insights propose <i>TLR2</i> as a potential dual therapeutic target for treating OP and OB.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"573-587"},"PeriodicalIF":4.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11482281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanism research of elastic fixation promoting fracture healing based on proteomics and fracture microenvironment.","authors":"Weiyong Wu, Zhihui Zhao, Yongqing Wang, Meiyue Liu, Genbao Zhu, Lili Li","doi":"10.1302/2046-3758.1310.BJR-2023-0257.R2","DOIUrl":"10.1302/2046-3758.1310.BJR-2023-0257.R2","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to demonstrate the promoting effect of elastic fixation on fracture, and further explore its mechanism at the gene and protein expression levels.</p><p><strong>Methods: </strong>A closed tibial fracture model was established using 12 male Japanese white rabbits, and divided into elastic and stiff fixation groups based on different fixation methods. Two weeks after the operation, a radiograph and pathological examination of callus tissue were used to evaluate fracture healing. Then, the differentially expressed proteins (DEPs) were examined in the callus using proteomics. Finally, in vitro cell experiments were conducted to investigate hub proteins involved in this process.</p><p><strong>Results: </strong>Mean callus volume was larger in the elastic fixation group (1,755 mm³ (standard error of the mean (SEM) 297)) than in the stiff fixation group (258 mm³ (SEM 65)). Pathological observation found that the expression levels of osterix (OSX), collagen, type I, alpha 1 (COL1α1), and alkaline phosphatase (ALP) in the callus of the elastic fixation group were higher than those of the stiff fixation group. The protein sequence of the callus revealed 199 DEPs, 124 of which were highly expressed in the elastic fixation group. In the in vitro study, it was observed that a stress of 200 g led to upregulation of thrombospondin 1 (THBS1) and osteoglycin (OGN) expression in bone marrow mesenchymal stem cells (BMSCs). Additionally, these genes were found to be upregulated during the osteogenic differentiation process of the BMSCs.</p><p><strong>Conclusion: </strong>Elastic fixation can promote fracture healing and osteoblast differentiation in callus, and the ability of elastic fixation to promote osteogenic differentiation of BMSCs may be achieved by upregulating genes such as THBS1 and OGN.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"559-572"},"PeriodicalIF":4.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of intra-articular-only meropenem after one-stage revision for treating Escherichia coli-induced periprosthetic joint infection in a rat model.","authors":"Yicheng Li, Shalitanati Wuermanbieke, Fei Wang, Wenbo Mu, Baochao Ji, Xiaobin Guo, Chen Zou, Yanyang Chen, Xiaogang Zhang, Li Cao","doi":"10.1302/2046-3758.1310.BJR-2024-0119.R1","DOIUrl":"10.1302/2046-3758.1310.BJR-2024-0119.R1","url":null,"abstract":"<p><strong>Aims: </strong>The optimum type of antibiotics and their administration route for treating Gram-negative (GN) periprosthetic joint infection (PJI) remain controversial. This study aimed to determine the GN bacterial species and antibacterial resistance rates related to clinical GN-PJI, and to determine the efficacy and safety of intra-articular (IA) antibiotic injection after one-stage revision in a GN pathogen-induced PJI rat model of total knee arthroplasty.</p><p><strong>Methods: </strong>A total of 36 consecutive PJI patients who had been infected with GN bacteria between February 2015 and December 2021 were retrospectively recruited in order to analyze the GN bacterial species involvement and antibacterial resistance rates. Antibiotic susceptibility assays of the GN bacterial species were performed to screen for the most sensitive antibiotic, which was then used to treat the most common GN pathogen-induced PJI rat model. The rats were randomized either to a PJI control group or to three meropenem groups (intraperitoneal (IP), IA, and IP + IA groups). After two weeks of treatment, infection control level, the side effects, and the volume of antibiotic use were evaluated.</p><p><strong>Results: </strong><i>Escherichia coli</i> was the most common pathogen in GN-PJI, and meropenem was the most sensitive antibiotic. Serum inflammatory markers, weightbearing activity, and Rissing score were significantly improved by meropenem, especially in the IA and IP + IA groups ( p < 0.05). Meropenem in the IA group eradicated <i>E. coli</i> from soft-tissue, bone, and prosthetic surfaces, with the same effect as in the IP + IA group. Radiological results revealed that IA and IP + IA meropenem were effective at relieving bone damage. Haematoxylin and eosin staining also showed that IA and IP + IA meropenem improved synovial inflammation and bone destruction. No pathological changes in the main organs or abnormal serum markers were observed in any of the meropenem-treated rats. The IA group required the lowest amount of meropenem, followed by the IP and IP + IA groups.</p><p><strong>Conclusion: </strong>IA-only meropenem with a two-week treatment course was effective and safe for PJI control following one-stage revision in a rat model, with less meropenem use.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"546-558"},"PeriodicalIF":4.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synovial vancomycin and meropenem concentrations in periprosthetic joint infection treated by single-stage revision combined with intra-articular infusion.","authors":"Chen Zou, Wentao Guo, Wenbo Mu, Tuerhongjiang Wahafu, Yicheng Li, Long Hua, Boyong Xu, Li Cao","doi":"10.1302/2046-3758.1310.BJR-2024-0024.R2","DOIUrl":"10.1302/2046-3758.1310.BJR-2024-0024.R2","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to determine the concentrations of synovial vancomycin and meropenem in patients treated by single-stage revision combined with intra-articular infusion following periprosthetic joint infection (PJI), thereby validating this drug delivery approach.</p><p><strong>Methods: </strong>We included 14 patients with PJI as noted in their medical records between November 2021 and August 2022, comprising eight hip and seven knee joint infections, with one patient experiencing bilateral knee infections. The patients underwent single-stage revision surgery, followed by intra-articular infusion of vancomycin and meropenem (50,000 µg/ml). Synovial fluid samples were collected to assess antibiotic concentrations using high-performance liquid chromatography.</p><p><strong>Results: </strong>The peak concentrations of vancomycin and meropenem in the joint cavity were observed at one hour post-injection, with mean values of 14,933.9 µg/ml (SD 10,176.3) and 5,819.1 µg/ml (SD 6,029.8), respectively. The trough concentrations at 24 hours were 5,495.0 µg/ml (SD 2,360.5) for vancomycin and 186.4 µg/ml (SD 254.3) for meropenem. The half-life of vancomycin was 6 hours, while that of meropenem ranged between 2 and 3.5 hours. No significant adverse events related to the antibiotic administration were observed.</p><p><strong>Conclusion: </strong>This method can achieve sustained high antibiotic concentrations within the joint space, exceeding the reported minimum biofilm eradication concentration. Our study highlights the remarkable effectiveness of intra-articular antibiotic infusion in delivering high intra-articular concentrations of antibiotics. The method provided sustained high antibiotic concentrations within the joint cavity, and no severe side-effects were observed. These findings offer evidence to improve clinical treatment strategies. However, further validation is required through studies with larger sample sizes and higher levels of evidence.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"535-545"},"PeriodicalIF":4.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low incidence of acute kidney injury with combined intravenous and topical antibiotic infusions in periprosthetic joint infection after total knee arthroplasty.","authors":"Wenbo Mu, Boyong Xu, Fei Wang, Yilixiati Maimaitiaimaier, Chen Zou, Li Cao","doi":"10.1302/2046-3758.1310.BJR-2024-0114.R1","DOIUrl":"10.1302/2046-3758.1310.BJR-2024-0114.R1","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to assess the risk of acute kidney injury (AKI) associated with combined intravenous (IV) and topical antibiotic therapy in patients undergoing treatment for periprosthetic joint infections (PJIs) following total knee arthroplasty (TKA), utilizing the Kidney Disease: Improving Global Outcomes (KDIGO) criteria for classification.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 162 knees (162 patients) that received treatment for PJI post-TKA with combined IV and topical antibiotic infusions at a single academic hospital from 1 January 2010 to 31 December 2022. The incidence of AKI was evaluated using the KDIGO criteria, focussing on the identification of significant predictors and the temporal pattern of AKI development.</p><p><strong>Results: </strong>AKI was identified in 9.26% (15/162) of the cohort, predominantly presenting as stage 1 AKI, which was transient in nature and resolved prior to discharge. The analysis highlighted moderate anaemia and lower baseline serum creatinine levels as significant predictors for the development of AKI. Notably, the study found no instances of severe complications such as wound dehiscence, skin erosion, or the need for haemodialysis following treatment.</p><p><strong>Conclusion: </strong>The findings suggest that the combined use of IV and topical antibiotic therapy in the management of PJIs post-TKA is associated with a low incidence of primarily transient stage 1 AKI. This indicates a potentially favourable renal safety profile, advocating for further research to confirm these outcomes and potentially influence treatment protocols in PJI management.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"525-534"},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed-methods approach exploring acceptability and feasibility of trials designed to test drugs targeting prevention of post-traumatic osteoarthritis after knee injury.","authors":"Raneem Kalsoum,Catherine J Minns Lowe,Sophie Gilbert,Andrew W McCaskie,Martyn Snow,Karina Wright,Geoff Bruce,Deborah J Mason,Fiona E Watt","doi":"10.1302/2046-3758.139.bjr-2024-0109","DOIUrl":"https://doi.org/10.1302/2046-3758.139.bjr-2024-0109","url":null,"abstract":"AimsTo explore key stakeholder views around feasibility and acceptability of trials seeking to prevent post-traumatic osteoarthritis (PTOA) following knee injury, and provide guidance for next steps in PTOA trial design.MethodsHealthcare professionals, clinicians, and/or researchers (HCP/Rs) were surveyed, and the data were presented at a congress workshop. A second and related survey was then developed for people with joint damage caused by knee injury and/or osteoarthritis (PJDs), who were approached by a UK Charity newsletter or Oxford involvement registry. Anonymized data were collected and analyzed in Qualtrics.ResultsSurvey responses (n = 19 HCP/Rs, 39 PJDs) supported studies testing pharmacological agents preventing PTOA. All HCP/Rs and 30/31 (97%) PJDs supported the development of new treatments that improved or delayed knee symptoms and damage to knee structure. PJDs thought that improving structural knee damage was more important than knee symptoms. Both groups found studies more acceptable as expected future benefit and risk of PTOA increased. All drug delivery routes were acceptable. Workshop participants (around n = 60) reflected survey views. Discussions suggested that stratifying using molecular testing for likely drug response appeared to be more acceptable than using characteristics such as sex, age, and BMI.ConclusionOur findings supported PTOA drug intervention studies, including situations where there is low risk of disease, no expected benefit of treatment, and frequent treatment administration. PJDs appeared less risk-averse than HCP/Rs. This work reinforces the benefits of consensus and involvement work in the co-creation of PTOA drug trial design. Involvement of key stakeholders, such as PJDs with different risks of OA and regulatory representatives, are critical for trial design success.","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"64 1","pages":"513-524"},"PeriodicalIF":4.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Practice Integration of Artificial Intelligence (CPI-AI) framework.","authors":"Luke Farrow,Dominic Meek,Georgios Leontidis,Marion Campbell,Ewen Harrison,Lesley Anderson","doi":"10.1302/2046-3758.139.bjr-2024-0135.r1","DOIUrl":"https://doi.org/10.1302/2046-3758.139.bjr-2024-0135.r1","url":null,"abstract":"Despite the vast quantities of published artificial intelligence (AI) algorithms that target trauma and orthopaedic applications, very few progress to inform clinical practice. One key reason for this is the lack of a clear pathway from development to deployment. In order to assist with this process, we have developed the Clinical Practice Integration of Artificial Intelligence (CPI-AI) framework - a five-stage approach to the clinical practice adoption of AI in the setting of trauma and orthopaedics, based on the IDEAL principles (https://www.ideal-collaboration.net/). Adherence to the framework would provide a robust evidence-based mechanism for developing trust in AI applications, where the underlying algorithms are unlikely to be fully understood by clinical teams.","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"48 1","pages":"507-512"},"PeriodicalIF":4.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}