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Andriollo L, Picchi A, Sangaletti R, Perticarini L, Rossi SMP, Logroscino G, Benazzo F. The Role of Artificial Intelligence in Anterior Cruciate Ligament Injuries: Current Concepts and Future Perspectives. Healthcare (Basel) 2024; 12:300. [PMID: 38338185 PMCID: PMC10855330 DOI: 10.3390/healthcare12030300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
The remarkable progress in data aggregation and deep learning algorithms has positioned artificial intelligence (AI) and machine learning (ML) to revolutionize the field of medicine. AI is becoming more and more prevalent in the healthcare sector, and its impact on orthopedic surgery is already evident in several fields. This review aims to examine the literature that explores the comprehensive clinical relevance of AI-based tools utilized before, during, and after anterior cruciate ligament (ACL) reconstruction. The review focuses on current clinical applications and future prospects in preoperative management, encompassing risk prediction and diagnostics; intraoperative tools, specifically navigation, identifying complex anatomic landmarks during surgery; and postoperative applications in terms of postoperative care and rehabilitation. Additionally, AI tools in educational and training settings are presented. Orthopedic surgeons are showing a growing interest in AI, as evidenced by the applications discussed in this review, particularly those related to ACL injury. The exponential increase in studies on AI tools applicable to the management of ACL tears promises a significant future impact in its clinical application, with growing attention from orthopedic surgeons.
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Affiliation(s)
- Luca Andriollo
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
- Department of Orthopedics, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Aurelio Picchi
- Unit of Orthopedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (G.L.)
| | - Rudy Sangaletti
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
| | - Loris Perticarini
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
| | - Stefano Marco Paolo Rossi
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
| | - Giandomenico Logroscino
- Unit of Orthopedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (G.L.)
| | - Francesco Benazzo
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
- Biomedical Sciences Area, IUSS University School for Advanced Studies, 27100 Pavia, Italy
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Li J, Pan J, Xu Y, Wang Y, Zhang D, Wei Y. Optimal concentration of ropivacaine for peripheral nerve blocks in adult patients: a protocol for systematic review and meta-analysis. BMJ Open 2023; 13:e077876. [PMID: 38072500 PMCID: PMC10729281 DOI: 10.1136/bmjopen-2023-077876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Ropivacaine is the most widely used local anaesthetic for peripheral nerve blocks (PNBs). The effects of various concentrations of ropivacaine in PNB have been investigated and compared by many randomised controlled trials (RCTs). This protocol aims to identify the optimal concentration of ropivacaine for PNB in adult patients. METHODS AND ANALYSIS PubMed, EMBASE, the Cochrane library and Web of Science will be searched from their inception to 10 July 2023. RCTs that compare the analgesic effects of different concentrations of ropivacaine for PNB will be included. Retrospective studies, meta-analyses, reviews, case reports, letters, conference abstracts and paediatric studies will be excluded. The duration of analgesia will be named as the primary outcome. Secondary outcomes will include the onset time of motor and sensory blockade, postoperative pain scores, analgesic requirements over 24 hours and the incidence of adverse effects. The study selection, data extraction and quality assessment will be performed by two independent reviewers. Data processing and analysis will be performed by RevMan 5.4. The quality of the evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION Ethical approval is not applicable. The results of this study will be submitted to peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42023406362.
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Affiliation(s)
- Jing Li
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jiamei Pan
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Ying Xu
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Yi Wang
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Donghang Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yiyong Wei
- Department of Anesthesiology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzen, Guangdong, China
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ten Hoope W, Admiraal M, Hermanides J, Hermanns H, Hollmann MW, Lirk P, Kerkhoffs GMMW, Steens J, van Beek R. The Effectiveness of Adductor Canal Block Compared to Femoral Nerve Block on Readiness for Discharge in Patients Undergoing Outpatient Anterior Cruciate Ligament Reconstruction: A Multi-Center Randomized Clinical Trial. J Clin Med 2023; 12:6019. [PMID: 37762959 PMCID: PMC10531554 DOI: 10.3390/jcm12186019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/03/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
This study evaluated the effect of adductor canal block (ACB) versus femoral nerve block (FNB) on readiness for discharge in patients undergoing outpatient anterior cruciate ligament (ACL) reconstruction. We hypothesized that ACB would provide sufficient pain relief while maintaining motor strength and safety, thus allowing for earlier discharge. This was a randomized, multi-center, superiority trial. From March 2014 to July 2017, patients undergoing ACL reconstruction were enrolled. The primary outcome was the difference in readiness for discharge, defined as Post-Anesthetic Discharge Scoring System score ≥ 9. Twenty-six patients were allocated to FNB and twenty-seven to ACB. No difference in readiness for discharge was found (FNB median 1.8 (95% CI 1.0 to 3.5) vs. ACB 2.9 (1.5 to 4.7) hours, p = 0.3). Motor blocks and (near) falls were more frequently reported in patients with FNB vs. ACB (20 (76.9%) vs. 1 (3.7%), p < 0.001, and 7 (29.2%) vs. 1 (4.0%), p = 0.023. However, less opioids were consumed in the post-anesthesia care unit for FNB (median 3 [0, 21] vs. 15 [12, 42.5] oral morphine milligram equivalents, p = 0.004) for ACB. Between patients with FNB or ACB, no difference concerning readiness for discharge was found. Despite a slight reduction in opioid consumption immediately after surgery, FNB demonstrates a less favorable safety profile compared to ACB, with more motor blocks and (near) falls.
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Affiliation(s)
- Werner ten Hoope
- Department of Anesthesiology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Manouk Admiraal
- Department of Anesthesiology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Jeroen Hermanides
- Department of Anesthesiology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Henning Hermanns
- Department of Anesthesiology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Markus W. Hollmann
- Department of Anesthesiology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Philipp Lirk
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Gino M. M. W. Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Jeroen Steens
- Department of Orthopedics, Dijklander Ziekenhuis, Maelsonstraat 3, 1624 NP Hoorn, The Netherlands
| | - Rienk van Beek
- Department of Anesthesiology, Dijklander Ziekenhuis, Maelsonstraat 3, 1624 NP Hoorn, The Netherlands
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