Clinical Application of Artificial Intelligence Preoperative Planning System Combined with Expert Database Retrieval in Complex Revision Hip Surgery

Summary

This study proposes a novel artificial intelligence preoperative planning approach based on expert surgical case database retrieval in revision hip arthroplasty. Additionally, the technique was initially employed in five patients, exhibiting a reduction in operative time and intraoperative hemorrhage.

Abstract

Accurate preoperative planning in revision hip arthroplasty is crucial for achieving successful outcomes. To enhance the intuitive evaluation of acetabular bone defect severity and leverage previous successful experience in revision hip arthroplasty, this study proposes a novel approach based on expert surgical case database retrieval and is initially implemented in clinical application. In this study, five patients who required revision hip arthroplasty were preoperatively planned to employ the expert case database surgical planning system.The patient's imaging data was entered into the system and matched with cases in the expert case database. Based on the expert's surgical experience, a revision surgery plan was recommended. If no suitable case was found, the model and position of the prosthesis were planned based on patient-specific reconstruction results. A total of five patients were enrolled in this study, four males and one female, with a mean age of 50.6 years. The diagnosis was aseptic prosthesis loosening after hip arthroplasty. The mean operative time was 123.2 min, and the mean intraoperative hemorrhage was 672 mL. No intraoperative complications, such as vascular or nerve injury, were observed. In Case 2, for instance, the application of this innovative planning scheme enabled the surgeon to delineate the revision surgery plan for this patient in the preoperative period, thereby reducing the operative time and intraoperative hemorrhage. Furthermore, patients could be apprised of the outcomes of analogous cases in advance. Leveraging a big data analysis approach through our comprehensive case database enables automated identification of matching expert treatment plans throughout the entire process. This particularly benefits inexperienced orthopedic surgeons by providing accurate guidance on surgical strategies to assist them in selecting appropriate prosthetic sizes and mounting positions. Additionally, the matching results can offer patients visualizations depicting predicted postoperative outcomes.

Introduction

The increasing prevalence of primary total hip arthroplasty (THA) has led to a corresponding rise in the necessity for revision arthroplasty due to a number of factors, including aseptic loosening, infection, recurrent dislocation, and periprosthetic fracture¹. Compared to primary hip arthroplasty, revision hip surgery is a more technically complex and clinically challenging procedure, with higher mortality rates², higher healthcare costs³, and greater complication risks⁴.

In revision hip arthroplasty, the reconstruction of acetabular bone loss a....

Protocol

The study received permission from the Ethics Committee of Luoyang Orthopedic-Traumatological Hospital of Henan Province. Additionally, this study was based on imaging data and would not harm the volunteers or disclose their information. Therefore, by national legislation and institutional requirements, there was no need for participants or their legal guardians/next of kin to sign an informed consent form.

1. Image import

1. Import the original CT data of the patient's bilateral total hip. Open the medical image processing software, select Import Data and click Local Data to i....

Discussion

Due to significant anatomical damage, the intricate soft tissue condition after hip arthroplasty, and the presence of severe metal artifacts often associated with metal implants, it is frequently necessary for experienced medical professionals to utilize 3D reconstruction to comprehensively analyze imaging results and clinical manifestations in order to evaluate specific bone defects in patients and subsequently plan suitable acetabular prostheses^9,10. However, e.......

Materials

Name	Company	Catalog Number	Comments
PyCharm	JetBrains	243.21565.199	The Python IDE for data science and web development