Does Artificial Intelligence Outperform Humans Using Fluoroscopic-Assisted Computer Navigation for Total Hip Arthroplasty?

Justin M Cardenas ¹, Dan Gordon ², Bradford S Waddell ¹

⁰W.B. Carrell Memorial Clinic, Adult Hip and Knee Reconstruction, Dallas, TX, USA.

Arthroplasty Today +

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June 6, 2024

View abstract on PubMed

Summary

Artificial intelligence (AI) and human control in total hip arthroplasty navigation show similar accuracy for acetabular component positioning and leg length discrepancy. This study found no significant difference between AI-assisted and manual navigation systems in achieving optimal surgical outcomes.

Area Of Science

Orthopedic Surgery
Medical Technology
Artificial Intelligence

Background

Accurate implant positioning is crucial for successful total hip arthroplasty (THA).
Intraoperative fluoroscopic-assisted computer navigation can enhance THA accuracy.
The comparative accuracy of AI-driven versus human-controlled navigation for acetabular component position and leg length discrepancy (LLD) remains unstudied.

Purpose Of The Study

To compare the accuracy of AI-controlled navigation software with human-controlled software in assessing acetabular component position and LLD during THA.

Main Methods

A retrospective analysis of 420 primary THAs using fluoroscopic-assisted computer navigation.
Two cohorts were compared: 211 THAs with manual (human technician) navigation and 209 THAs with AI-automated navigation.
Acetabular component inclination, anteversion, and LLD were recorded intraoperatively and compared with postoperative radiographs.

Main Results

Cup placement within the Lewinnek "safe zone" was high in both groups (94% manual vs. 95% AI, P = 1.0).
Accuracy for LLD within ±2 mm was similar (69% manual vs. 66% AI, P = 0.47).
High accuracy for LLD within ±5 mm was also observed in both groups (99% manual vs. 98% AI, P = 0.45).

Conclusions

AI-controlled and human-controlled navigation platforms demonstrate comparable accuracy in achieving optimal acetabular component positioning and LLD during THA.
The findings suggest AI can be a reliable tool in navigation-assisted THA without compromising accuracy.

Keywords:

Artificial intelligence Computer navigation Direct anterior approach Fluoroscopy Total hip arthroplasty