Deep Learning Algorithms Improve the Detection of Subtle Lisfranc Malalignments on Weightbearing Radiographs

Ashkani-Esfahani, Soheil; Mojahed-Yazdi, Reza; Bhimani, Rohan; Kerkhoffs, Gino M. M. J.; Maas, Mario; DiGiovanni, Christopher W.; Lubberts, Bart; Guss, Daniel

doi:10.1177/10711007221093574

Cited by 9 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ashkani-Esfahani et al 4 internally validated 2 DCNN models for detecting Lisfranc instability from single-view (anteroposterior) and 3-view radiographs (anteroposterior, lateral, oblique), which performed excellently with AUCs ranging from 0.925 to 0.994.…”

Section: Resultsmentioning

confidence: 99%

Advancements in Artificial Intelligence for Foot and Ankle Surgery: A Systematic Review

Gupta

Kingston

O’Malley

et al. 2023

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

Background: There has been a rapid increase in research applying artificial intelligence (AI) to various subspecialties of orthopaedic surgery, including foot and ankle surgery. The purpose of this systematic review is to (1) characterize the topics and objectives of studies using AI in foot and ankle surgery, (2) evaluate the performance of their models, and (3) evaluate their validity (internal or external validation). Methods: A systematic literature review was conducted using PubMed/MEDLINE and Embase databases in December 2022. All studies that used AI or its subsets machine learning (ML) and deep learning (DL) in the setting of foot and ankle surgery relevant to orthopaedic surgeons were included. Studies were evaluated for their demographics, subject area, outcomes of interest, model(s) tested, model(s)’ performance, and validity (internal or external). Results: A total of 31 studies met inclusion criteria: 14 studies investigated AI for image interpretation, 13 studies investigated AI for clinical predictions, and 4 studies were grouped as “other.” Studies commonly explored AI for ankle fractures, calcaneus fractures, hallux valgus, Achilles tendon pathologies, plantar fasciitis, and sports injuries. For studies reporting the area under the receiver operating characteristic curve (AUC), AUCs ranged from 0.64 (poor) to 0.99 (excellent). Two studies (6.45%) reported external validation. Conclusion: Applications of AI in the field of foot and ankle surgery are expanding, particularly for image interpretation and clinical predictions. Current model performances range from poor to excellent, and most studies lack external validation, demonstrating a need for further research prior to deploying AI-based clinical applications. Level of Evidence: Level III, retrospective cohort study.

show abstract

Section: Resultsmentioning

confidence: 99%

Advancements in Artificial Intelligence for Foot and Ankle Surgery: A Systematic Review

Gupta

Kingston

O’Malley

et al. 2023

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

show abstract

“…Ashkani-Esfahani et al 2 internally validated 2 deep CNNs for the same purpose and achieved a near-perfect area under the curve of 0.99. AI has been used for image analysis throughout foot and ankle surgery, including for Achilles tendinopathy, 21 stress fracture, 22 Lisfranc fracture, 1 and calcaneal fracture. 5…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Quality and Usability of Artificial Intelligence–Generated Responses to Common Patient Questions in Foot and Ankle Surgery

Anastasio,

Mills,

Karavan

et al. 2023

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

Background: Artificial intelligence (AI) platforms, such as ChatGPT, have become increasingly popular outlets for the consumption and distribution of health care–related advice. Because of a lack of regulation and oversight, the reliability of health care–related responses has become a topic of controversy in the medical community. To date, no study has explored the quality of AI-derived information as it relates to common foot and ankle pathologies. This study aims to assess the quality and educational benefit of ChatGPT responses to common foot and ankle–related questions. Methods: ChatGPT was asked a series of 5 questions, including “What is the optimal treatment for ankle arthritis?” “How should I decide on ankle arthroplasty versus ankle arthrodesis?” “Do I need surgery for Jones fracture?” “How can I prevent Charcot arthropathy?” and “Do I need to see a doctor for my ankle sprain?” Five responses (1 per each question) were included after applying the exclusion criteria. The content was graded using DISCERN (a well-validated informational analysis tool) and AIRM (a self-designed tool for exercise evaluation). Results: Health care professionals graded the ChatGPT-generated responses as bottom tier 4.5% of the time, middle tier 27.3% of the time, and top tier 68.2% of the time. Conclusion: Although ChatGPT and other related AI platforms have become a popular means for medical information distribution, the educational value of the AI-generated responses related to foot and ankle pathologies was variable. With 4.5% of responses receiving a bottom-tier rating, 27.3% of responses receiving a middle-tier rating, and 68.2% of responses receiving a top-tier rating, health care professionals should be aware of the high viewership of variable-quality content easily accessible on ChatGPT. Level of Evidence: Level III, cross sectional study.

show abstract

“…Side-to-side asymmetry or a distance of >2 mm between the second metatarsal base and the medial cuneiform is highly specific (96%) in aiding in the diagnosis of a ligamentous injury 32 . Deep learning algorithms have reduced misdiagnosis of subtle injuries by a factor of 10 33 .…”

Section: Investigationsmentioning

confidence: 99%

Management of Lisfranc Injuries

et al. 2023

View full text Add to dashboard Cite

There is a spectrum of midtarsal injuries, ranging from mild midfoot sprains to complex Lisfranc fracture-dislocations.Use of appropriate imaging can reduce patient morbidity, by reducing the number of missed diagnoses and, conversely, avoiding overtreatment. Weight-bearing radiographs are of great value when investigating the so-called subtle Lisfranc injury.Regardless of the operative strategy, anatomical reduction and stable fixation is a prerequisite for a satisfactory outcome in the management of displaced injuries.Fixation device removal is less frequently reported after primary arthrodesis compared with open reduction and internal fixation based on 6 published meta-analyses. However, the indications for further surgery are often unclear, and the evidence of the included studies is of typically low quality. Further high-quality prospective randomized trials with robust cost-effectiveness analyses are required in this area.We have proposed an investigation and treatment algorithm based on the current literature and clinical experience of our trauma center.

show abstract

Deep Learning Algorithms Improve the Detection of Subtle Lisfranc Malalignments on Weightbearing Radiographs

Cited by 9 publications

References 35 publications

Advancements in Artificial Intelligence for Foot and Ankle Surgery: A Systematic Review

Advancements in Artificial Intelligence for Foot and Ankle Surgery: A Systematic Review

Evaluating the Quality and Usability of Artificial Intelligence–Generated Responses to Common Patient Questions in Foot and Ankle Surgery

Management of Lisfranc Injuries

Contact Info

Product

Resources

About