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Artificial intelligence and machine learning in orthopedic surgery: a systematic review protocol.

Nicola Maffulli1,2,3, Hugo C Rodriguez4,5,6, Ian W Stone4

  • 1Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Fisciano, Italy.

Journal of Orthopaedic Surgery and Research
|October 20, 2020
PubMed
Summary

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This article outlines a structured plan to review how computer-based learning tools are currently being used to improve diagnosis and predict patient recovery in orthopedic surgery.

Area of Science:

  • Orthopedic surgery outcomes research within musculoskeletal medicine
  • Artificial intelligence applications in clinical diagnostics

Background:

No prior work has comprehensively synthesized the current state of computational intelligence within the orthopedic domain. While cardiology and radiology have rapidly adopted these advanced digital tools, the surgical subspecialty remains behind. This gap motivated a formal investigation into existing literature. Prior research has shown that automated algorithms can enhance decision-making in other medical fields. That uncertainty drove the need for a rigorous examination of current surgical practices. The current landscape lacks a clear understanding of how these technologies impact patient care. Researchers now recognize the importance of evaluating these digital advancements systematically. This project addresses the urgent requirement for a structured overview of recent technological progress.

Purpose Of The Study:

The primary aim of this study is to provide an updated assessment of technological progress within the orthopedic surgical field. This project addresses the specific problem of uneven adoption of digital intelligence across medical specialties. The researchers seek to evaluate how automated tools assist in establishing accurate clinical diagnoses. They also intend to investigate the capacity of these systems to predict post-operative complications. This motivation stems from the recent surge in research that lacks a cohesive systematic overview. The team aims to distinguish between preliminary studies and those demonstrating real-world clinical utility. By synthesizing this information, the authors hope to clarify the current role of advanced algorithms in patient care. This systematic review will establish a clear baseline for future technological integration in surgery.

Keywords:
Artificial intelligenceMachine learningOrthopedic surgeryPRISMApredictive analyticsclinical decision supportsurgical outcomesdigital medicine

Frequently Asked Questions

The researchers propose comparing standard clinical diagnostic practices against those augmented by machine learning algorithms to determine if predictive accuracy improves for post-operative complications.

The study utilizes the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure rigorous screening and assessment of literature by at least two independent reviewers.

The authors require that studies focus on orthopedic interventions or musculoskeletal injuries, excluding animal research and papers lacking clinical data to ensure relevance to human surgical outcomes.

The team will search PubMed, ScienceDirect, and Google Scholar to identify primary studies, case reports, and existing reviews published in five languages up to September 2020.

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Main Methods:

The review approach involves a comprehensive search across three major academic databases for relevant literature. Investigators will screen articles published in five distinct languages to ensure a broad international perspective. Two independent reviewers will evaluate every identified reference based on predefined eligibility criteria. The team follows established PRISMA guidelines to maintain high standards of transparency and reproducibility. Researchers will specifically target studies focusing on human musculoskeletal injuries and surgical interventions. Any investigation failing to provide clinical data or involving animal subjects will be excluded from the final analysis. The protocol mandates registration on the PROSPERO database before the formal commencement of the study. This structured design ensures that the final synthesis remains focused on practical clinical applications.

Main Results:

Key findings from the literature are expected to reveal a significant prevalence of uncontrolled studies regarding digital diagnostic tools. The authors anticipate identifying a smaller subset of papers that describe actual clinical care outcomes. This review will compare traditional diagnostic gold standards against those utilizing automated algorithmic support. The study intends to map the current progress of digital intelligence in surgical decision-making. Researchers expect to find evidence regarding the prediction of post-operative complications and recovery trajectories. The synthesis will exclude meta-analyses to focus on primary research and case reports. Findings will characterize the current maturity level of these technologies within the orthopedic field. The final report will summarize the state of evidence as of September 2020.

Conclusions:

The authors propose that this review will clarify the current status of digital intelligence in surgical practice. They expect to identify a high volume of preliminary research rather than robust clinical trials. This synthesis will highlight the disparity between theoretical models and practical patient care applications. The team anticipates that findings will underscore the necessity for more rigorous cohort studies. Future efforts should prioritize large-scale randomized trials to validate these automated diagnostic tools. This review will provide a baseline for assessing the reliability of predictive algorithms in surgery. The authors intend to map out how these technologies influence post-operative complication rates. This work serves as a foundational step toward integrating advanced computation into standard orthopedic workflows.

The protocol measures the ability of algorithms to identify diagnoses and predict recovery outcomes, specifically comparing these results against established gold standard clinical practices.

The researchers propose that this systematic review will provide a necessary update on technological advances, potentially revealing a need for more high-quality randomized controlled trials in the field.