Back to Search
Start Over
Preoperative prediction for periprosthetic bone loss and individual evaluation of bisphosphonate effect after total hip arthroplasty using artificial intelligence.
- Source :
-
Bone & joint research [Bone Joint Res] 2024 Apr 18; Vol. 13 (4), pp. 184-192. Date of Electronic Publication: 2024 Apr 18. - Publication Year :
- 2024
-
Abstract
- Aims: This study was designed to develop a model for predicting bone mineral density (BMD) loss of the femur after total hip arthroplasty (THA) using artificial intelligence (AI), and to identify factors that influence the prediction. Additionally, we virtually examined the efficacy of administration of bisphosphonate for cases with severe BMD loss based on the predictive model.<br />Methods: The study included 538 joints that underwent primary THA. The patients were divided into groups using unsupervised time series clustering for five-year BMD loss of Gruen zone 7 postoperatively, and a machine-learning model to predict the BMD loss was developed. Additionally, the predictor for BMD loss was extracted using SHapley Additive exPlanations (SHAP). The patient-specific efficacy of bisphosphonate, which is the most important categorical predictor for BMD loss, was examined by calculating the change in predictive probability when hypothetically switching between the inclusion and exclusion of bisphosphonate.<br />Results: Time series clustering allowed us to divide the patients into two groups, and the predictive factors were identified including patient- and operation-related factors. The area under the receiver operating characteristic (ROC) curve (AUC) for the BMD loss prediction averaged 0.734. Virtual administration of bisphosphonate showed on average 14% efficacy in preventing BMD loss of zone 7. Additionally, stem types and preoperative triglyceride (TG), creatinine (Cr), estimated glomerular filtration rate (eGFR), and creatine kinase (CK) showed significant association with the estimated patient-specific efficacy of bisphosphonate.<br />Conclusion: Periprosthetic BMD loss after THA is predictable based on patient- and operation-related factors, and optimal prescription of bisphosphonate based on the prediction may prevent BMD loss.<br />Competing Interests: Y. Inaba reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Stryker, Smith & Nephew, and Zimmer Biomet, not related to this study.<br /> (© 2024 Morita et al.)
Details
- Language :
- English
- ISSN :
- 2046-3758
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Bone & joint research
- Publication Type :
- Academic Journal
- Accession number :
- 38631686
- Full Text :
- https://doi.org/10.1302/2046-3758.134.BJR-2023-0188.R1