Fully automated assessment of the knee alignment on long leg radiographs following corrective knee osteotomies in patients with valgus or varus deformities.

Autor: Mitterer JA; Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria., Huber S; Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria.; Center for Anatomy and Cell Biology, Medical University Vienna Speising, Währinger Straße 13, 1090, Vienna, Austria., Schwarz GM; Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria.; Center for Anatomy and Cell Biology, Medical University Vienna Speising, Währinger Straße 13, 1090, Vienna, Austria.; Department of Orthopaedic and Trauma-Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria., Simon S; Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria.; 2nd Department, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria., Pallamar M; Department of Pediatric Orthopaedics, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria., Kissler F; 1st Department, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria., Frank BJH; Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria.; 2nd Department, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria., Hofstaetter JG; Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria. researchlab@oss.at.; 2nd Department, Orthopaedic Hospital Vienna Speising, Speisinger Straße 109, 1130, Vienna, Austria. researchlab@oss.at.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 Mar; Vol. 144 (3), pp. 1029-1038. Date of Electronic Publication: 2023 Dec 13.
DOI: 10.1007/s00402-023-05151-y
Abstrakt: Introduction: The assessment of the knee alignment on long leg radiographs (LLR) postoperative to corrective knee osteotomies (CKOs) is highly dependent on the reader's expertise. Artificial Intelligence (AI) algorithms may help automate and standardise this process. The study aimed to analyse the reliability of an AI-algorithm for the evaluation of LLRs following CKOs.
Materials and Methods: In this study, we analysed a validation cohort of 110 postoperative LLRs from 102 patients. All patients underwent CKO, including distal femoral (DFO), high tibial (HTO) and bilevel osteotomies. The agreement between manual measurements and the AI-algorithm was assessed for the mechanical axis deviation (MAD), hip knee ankle angle (HKA), anatomical-mechanical-axis-angle (AMA), joint line convergence angle (JLCA), mechanical lateral proximal femur angle (mLPFA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibia angle (mMPTA) and mechanical lateral distal tibia angle (mLDTA), using the intra-class-correlation (ICC) coefficient between the readers, each reader and the AI and the mean of the manual reads and the AI-algorithm and Bland-Altman Plots between the manual reads and the AI software for the MAD, HKA, mLDFA and mMPTA.
Results: In the validation cohort, the AI software showed excellent agreement with the manual reads (ICC: 0.81-0.99). The agreement between the readers (Inter-rater) showed excellent correlations (ICC: 0.95-0. The mean difference in the DFO group for the MAD, HKA, mLDFA and mMPTA were 0.50 mm, - 0.12°, 0.55° and 0.15°. In the HTO group the mean difference for the MAD, HKA, mLDFA and mMPTA were 0.36 mm, - 0.17°, 0.57° and 0.08°, respectively. Reliable outputs were generated in 95.4% of the validation cohort.
Conclusion:  he application of AI-algorithms for the assessment of lower limb alignment on LLRs following CKOs shows reliable and accurate results.
Level of Evidence: Diagnostic Level III.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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