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Kunze KN, Williams RJ, Ranawat AS, Pearle AD, Kelly BT, Karlsson J, Martin RK, Pareek A. Artificial intelligence (AI) and large data registries: Understanding the advantages and limitations of contemporary data sets for use in AI research. Knee Surg Sports Traumatol Arthrosc 2024; 32:13-18. [PMID: 38226678 DOI: 10.1002/ksa.12018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 01/17/2024]
Affiliation(s)
- Kyle N Kunze
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA
| | - Riley J Williams
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA
| | - Anil S Ranawat
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA
| | - Andrew D Pearle
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA
| | - Bryan T Kelly
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - R Kyle Martin
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ayoosh Pareek
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA
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Vaish A, Migliorini F, Vaishya R. Artificial intelligence in foot and ankle surgery: current concepts. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:1011-1016. [PMID: 37626240 PMCID: PMC10692015 DOI: 10.1007/s00132-023-04426-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/27/2023]
Abstract
The twenty-first century has proven that data are the new gold. Artificial intelligence (AI) driven technologies might potentially change the clinical practice in all medical specialities, including orthopedic surgery. AI has a broad spectrum of subcomponents, including machine learning, which consists of a subdivision called deep learning. AI has the potential to increase healthcare delivery, improve indications and interventions, and minimize errors. In orthopedic surgery. AI supports the surgeon in the evaluation of radiological images, training of surgical residents, and excellent performance of machine-assisted surgery. The AI algorithms improve the administrative and management processes of hospitals and clinics, electronic healthcare databases, monitoring the outcomes, and safety controls. AI models are being developed in nearly all orthopedic subspecialties, including arthroscopy, arthroplasty, tumor, spinal and pediatric surgery. The present study discusses current applications, limitations, and future prospective of AI in foot and ankle surgery.
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Affiliation(s)
- Abhishek Vaish
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospital, Sarita Vihar, 110076, New Delhi, India
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre of Aachen, Pauwelsstraße 30, 52064, Aachen, Germany.
- Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100 Bolzano, Italy.
| | - Raju Vaishya
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospital, Sarita Vihar, 110076, New Delhi, India
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Diniz P, Lacerda D, Mendes B, Pereira H, Ferreira FC, Kerkhoffs GMMJ. Return-to-performance in elite soccer players after Achilles tendon ruptures: a study using a weighted plus/minus metric and matched-control analysis. Knee Surg Sports Traumatol Arthrosc 2023; 31:6059-6068. [PMID: 37853243 PMCID: PMC10719144 DOI: 10.1007/s00167-023-07607-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Studies have shown decreased match participation and shortened careers in athletes suffering Achilles tendon ruptures (ATRs), but assessment using a true performance metric is lacking. Plus/minus (PM) metrics provide a practical and objective approach to player performance assessment and are commonly used in other sports. This study aimed to quantify and compare individual player performance variations in elite football league players who sustained ATRs and returned to play within 1 year compared to those without ATRs, using a PM metric. METHODS Player and team data were sourced from Transfermarkt.com. Male players sustaining ATRs between 2007 and 2018 were identified through injury reports. A control group (CTRL) was matched by position, age, height, and league, with a 6:1 ratio of controls to ATR subjects. The day of injury was considered "time zero". Year -1 corresponds to the 360 days preceding injury, and Year 1 to the interval between 360 and 720 days after. Performance in the player's main team was evaluated using a previously validated weighted PM metric. Only data from Year -1 and Year 1 were used for ATR versus CTRL group comparisons. Statistical significance was set at p < 0.05. RESULTS The ATR group included 125 athletes. Data from more than 76,000 matches were analyzed. No statistically significant differences in net weighted PM metric between Year -1 and Year 1 were found. CONCLUSION No differences were found between athletes suffering from ATRs and controls regarding the weighted PM metric. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Pedro Diniz
- Department of Orthopaedic Surgery, Hospital de Sant'Ana, Rua de Benguela, 501, 2775-028, Parede, Portugal.
- Department of Bioengineering and iBB-Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
- Fisiogaspar, Lisbon, Portugal.
| | - Diogo Lacerda
- Department of Orthopaedic Surgery, Hospital de Sant'Ana, Rua de Benguela, 501, 2775-028, Parede, Portugal
| | | | - Hélder Pereira
- Orthopaedic Department, Centro Hospitalar Póvoa de Varzim, Vila do Conde, Portugal
- Ripoll y De Prado Sports Clinic: FIFA Medical Centre of Excellence, Murcia-Madrid, Spain
- University of Minho ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Frederico Castelo Ferreira
- Department of Bioengineering and iBB-Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
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Salimi M, Parry JA, Shahrokhi R, Mosalamiaghili S. Application of artificial intelligence in trauma orthopedics: Limitation and prospects. World J Clin Cases 2023; 11:4231-4240. [PMID: 37449222 PMCID: PMC10337008 DOI: 10.12998/wjcc.v11.i18.4231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/23/2023] [Accepted: 05/08/2023] [Indexed: 06/26/2023] Open
Abstract
The varieties and capabilities of artificial intelligence and machine learning in orthopedic surgery are extensively expanding. One promising method is neural networks, emphasizing big data and computer-based learning systems to develop a statistical fracture-detecting model. It derives patterns and rules from outstanding amounts of data to analyze the probabilities of different outcomes using new sets of similar data. The sensitivity and specificity of machine learning in detecting fractures vary from previous studies. AI may be most promising in the diagnosis of less-obvious fractures that are more commonly missed. Future studies are necessary to develop more accurate and effective detection models that can be used clinically.
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Affiliation(s)
- Maryam Salimi
- Department of Orthopaedic Surgery, Denver Health Medical Center, Denver, CO 80215, United States
| | - Joshua A Parry
- Department of Orthopaedic Surgery, Denver Health Medical Center, Denver, CO 80215, United States
| | - Raha Shahrokhi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7138433608, Iran
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Gupta P, Kingston KA, O’Malley M, Williams RJ, Ramkumar PN. Advancements in Artificial Intelligence for Foot and Ankle Surgery: A Systematic Review. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114221151079. [PMID: 36817020 PMCID: PMC9929923 DOI: 10.1177/24730114221151079] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Background There has been a rapid increase in research applying artificial intelligence (AI) to various subspecialties of orthopaedic surgery, including foot and ankle surgery. The purpose of this systematic review is to (1) characterize the topics and objectives of studies using AI in foot and ankle surgery, (2) evaluate the performance of their models, and (3) evaluate their validity (internal or external validation). Methods A systematic literature review was conducted using PubMed/MEDLINE and Embase databases in December 2022. All studies that used AI or its subsets machine learning (ML) and deep learning (DL) in the setting of foot and ankle surgery relevant to orthopaedic surgeons were included. Studies were evaluated for their demographics, subject area, outcomes of interest, model(s) tested, model(s)' performance, and validity (internal or external). Results A total of 31 studies met inclusion criteria: 14 studies investigated AI for image interpretation, 13 studies investigated AI for clinical predictions, and 4 studies were grouped as "other." Studies commonly explored AI for ankle fractures, calcaneus fractures, hallux valgus, Achilles tendon pathologies, plantar fasciitis, and sports injuries. For studies reporting the area under the receiver operating characteristic curve (AUC), AUCs ranged from 0.64 (poor) to 0.99 (excellent). Two studies (6.45%) reported external validation. Conclusion Applications of AI in the field of foot and ankle surgery are expanding, particularly for image interpretation and clinical predictions. Current model performances range from poor to excellent, and most studies lack external validation, demonstrating a need for further research prior to deploying AI-based clinical applications. Level of Evidence Level III, retrospective cohort study.
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Affiliation(s)
- Puneet Gupta
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | - Martin O’Malley
- Hospital for Special Surgery, New York, NY, USA,Brooklyn Nets, National Basketball Association (NBA), Brooklyn, NY, USA
| | - Riley J. Williams
- Hospital for Special Surgery, New York, NY, USA,Brooklyn Nets, National Basketball Association (NBA), Brooklyn, NY, USA
| | - Prem N. Ramkumar
- Hospital for Special Surgery, New York, NY, USA,Brooklyn Nets, National Basketball Association (NBA), Brooklyn, NY, USA,Prem N. Ramkumar, MD, MBA, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021-4898, USA.
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