Detection of Prosthetic Loosening in Hip and Knee Arthroplasty Using Machine Learning: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data and Literature Sources
2.2. Study Selection
2.3. Data Extraction
2.4. Statistical Analyses
3. Results
3.1. Identification of Studies
3.2. Study Characteristics and Quality of Included Studies
3.3. Descriptive Statistics
3.4. Quality Assessment and Publication Biases
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Country | Design | Index Test | Eligibility Criteria | Reference Standard | Arthroplasty Type | Failure Detection | Number of Loosening vs. Non-Loosening | Type of Validation | Data Source |
---|---|---|---|---|---|---|---|---|---|---|
Borjali et al., 2019 [32] | USA | Retrospective study | X-ray | Yes | Operation record | THA | Loosening | 17 THAs vs. 23 THAs | Five-fold cross validation | Single center |
Shah et al., 2020 [36] | USA | Retrospective study | X-ray Demographic & comorbidity data | Yes | Operation record | THA TKA | Loosening | 137 TKAs, 85 THAs vs. 217 TKAs. 258 THAs | Training 60% Validation 20% Test 20% | Single center from 2012–2018 |
Loppini et al., 2022 [34] | Italy | Retrospective study | X-ray | Yes | Operation record | THA | Loosening malposition wear infection | 420 failed THA vs. 210 normal THA 922 failed images vs. 931 non-failed images | Training 63% Validation 27% Test 10% | Single center from 2009–2019 |
Lau et al., 2022 [33] | Hong Kong | Retrospective study | X-ray Clinical information | Yes | Operation record | TKA | Loosening | 206 TKAs vs. 234 TKAs | Test 75% (345 images) Validation 25% (95 images) | Single center |
Rahman et al., 2022 [35] | Qatar | Retrospective study | X-ray | Yes | Research results | THA | Loosening | 112 THAs vs. 94 THAs | Five-fold cross validation Training 70% Validation 10% Test 20% | Images from published article |
Study | AI Method | Pre-Processing | Augmentations | Model Structure | AUC | Accuracy | Sensitivity | Specificity | AI vs. Expert Doctor |
---|---|---|---|---|---|---|---|---|---|
Borjali et al., 2019 [32] | DL | Transfer learning | Reorientation, magnification | DenseNet Re-trained CNN Pre-trained CNN | Pre-trained 0.950 Re-trained 0.800 | Pre-trained 0.950 | Pre-trained 0.940 | Pre-trained 0.960 | Orthopaedic surgeon; accuracy 0.770 sensitivity 0.530 specificity 0.960 |
Shah et al., 2020 [36] | DL | Resize segmentation Ttransfer learning | None | ResNet AlexNet Inception DenseNet | Resnet 0.882 Alexnet 0.901 Inception 0.922 DenseNet 0.953 Best-model overall 0.883 TKA 0.858 THA 0.901 | Best model overall 0.702 TKA 0.698 THA 0.703 | Best model overall 0.956 TKA 0.952 THA 0.946 | None | |
Loppini et al., 2022 [34] | DL | Resize transfer learning | Transformation Horizontal flip Rotation Zoom | DenseNet | 0.993 | Training 0.990 Validation 0.975 Test 0.968 | 0.968 | 0.968 | None |
Lau et al., 2022 [33] | DL | Transfer learning | None | Xception | Pre-trained test 0.935 | 0.963 | 0.961 | 0.909 | Two senior orthopaedic specialists with 15–20 years’ experience; accuracy 0.921 |
Rahman et al., 2022 [35] | DL | Cropping resize normalization transfer-learning | Rotation Scaling translation | Resnet18 Resnet50 Resnet101 InceptionV3 DenseNet161 DenseNet201 Mobilentetv2 Googlenet Staking approach | DenseNet201 Staking approach using Random forest | DenseNet 0.947 Random forest 0.961 | DenseNet 0.9467 Random forest 0.964 | DenseNet 0.945 Random forest 0.964 | None |
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Kim, M.-S.; Kim, J.-J.; Kang, K.-H.; Lee, J.-H.; In, Y. Detection of Prosthetic Loosening in Hip and Knee Arthroplasty Using Machine Learning: A Systematic Review and Meta-Analysis. Medicina 2023, 59, 782. https://doi.org/10.3390/medicina59040782
Kim M-S, Kim J-J, Kang K-H, Lee J-H, In Y. Detection of Prosthetic Loosening in Hip and Knee Arthroplasty Using Machine Learning: A Systematic Review and Meta-Analysis. Medicina. 2023; 59(4):782. https://doi.org/10.3390/medicina59040782
Chicago/Turabian StyleKim, Man-Soo, Jae-Jung Kim, Ki-Ho Kang, Jeong-Han Lee, and Yong In. 2023. "Detection of Prosthetic Loosening in Hip and Knee Arthroplasty Using Machine Learning: A Systematic Review and Meta-Analysis" Medicina 59, no. 4: 782. https://doi.org/10.3390/medicina59040782