Evidence map›Paper›PMID 40333699›Full record

SynthesisPloS one2025

Application of artificial intelligence in X-ray imaging analysis for knee arthroplasty: A systematic review.

Zhihong Zhang, Xu Hui, Huimin Tao, Zhenjiang Fu, Zaili Cai, Sheng Zhou, Kehu Yang

Abstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Zhihong ZhangDepartment of The First Clinical Medical College of Gansu, University of Chinese Medicine, Lanzhou, Gansu, China.
Xu HuiDepartment of Evidence-Based Medicine Centre, School of Basic Medical Science, Lanzhou University, Lanzhou, Gansu, China.
Huimin TaoDepartment of The First Clinical Medical College of Gansu, University of Chinese Medicine, Lanzhou, Gansu, China.
Zhenjiang FuDepartment of The First Clinical Medical College of Gansu, University of Chinese Medicine, Lanzhou, Gansu, China.
Zaili CaiDepartment of Radiology, Renhuai People's Hospital, Zuiyi, Guizhou, China.
Sheng ZhouDepartment of The First Clinical Medical College of Gansu, University of Chinese Medicine, Lanzhou, Gansu, China.ORCID https://orcid.org/0009-0005-0427-7597
Kehu YangDepartment of Evidence-Based Medicine Centre, School of Basic Medical Science, Lanzhou University, Lanzhou, Gansu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundArtificial intelligence (AI) is a promising and powerful technology with increasing use in orthopedics. The global morbidity of knee arthroplasty is expanding. This study investigated the use of AI algorithms to review radiographs of knee arthroplasty.

methodsThe Ovid-Embase, Web of Science, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), WeiPu (VIP), WanFang, and China Biology Medicine (CBM) databases were systematically screened from inception to March 2024 (PROSPERO study protocol registration: CRD42024507549). The quality assessment of the diagnostic accuracy studies tool assessed the risk of bias.

resultsA total of 21 studies were included in the analysis. Of these, 10 studies identified and classified implant brands, 6 measured implant size and component alignment, 3 detected implant loosening, and 2 diagnosed prosthetic joint infections (PJI). For classifying and identifying implant brands, 5 studies demonstrated near-perfect prediction with an area under the curve (AUC) ranging from 0.98 to 1.0, and 10 achieved accuracy (ACC) between 96-100%. Regarding implant measurement, one study showed an AUC of 0.62, and two others exhibited over 80% ACC in determining component sizes. Moreover, Artificial intelligence showed good to excellent reliability across all angles in three separate studies (Intraclass Correlation Coefficient > 0.78). In predicting PJI, one study achieved an AUC of 0.91 with a corresponding ACC of 90.5%, while another reported a positive predictive value ranging from 75% to 85%. For detecting implant loosening, the AUC was found to be at least as high as 0.976 with ACC ranging from 85.8% to 97.5%.

conclusionsThese studies show that AI is promising in recognizing implants in knee arthroplasty. Future research should follow a rigorous approach to AI development, with comprehensive and transparent reporting of methods and the creation of open-source software programs and commercial tools that can provide clinicians with objective clinical decisions.

Indexed as

Arthroplasty, Replacement, KneeArtificial IntelligenceRadiographyAlgorithmsHumansKnee JointKnee Prosthesis

Identifiers

PMID40333699
PMCPMC12057988

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.