Despite the vast quantities of published artificial intelligence (AI) algorithms that target trauma and orthopaedic applications, very few progress to inform clinical practice. One key reason for this is the lack of a clear pathway from development to deployment. In order to assist with this process, we have developed the Clinical Practice Integration of Artificial Intelligence (CPI-AI) framework – a five-stage approach to the clinical practice adoption of AI in the setting of trauma and orthopaedics, based on the IDEAL principles (https://www.ideal-collaboration.net/). Adherence to the framework would provide a robust evidence-based mechanism for developing trust in AI applications, where the underlying algorithms are unlikely to be fully understood by clinical teams.

Cite this article: Bone Joint Res 2024;13(9):507–512.

Introduction

The FitBone lengthening nail (Orthofix UK) is an intramedullary device licensed for the lengthening of long bones in adults in the UK. It contains a motor powered by electricity transmitted via an induction coil placed underneath the skin. It was developed in Germany two decades ago but uptake in the UK has only started more recently. The aim of this study was to review the first cohort of FitBone lengthening nails in a unit with significant experience of other lengthening nails (including PRECICE and Stryde).

Objectives

To investigate psychosocial and biomedical outcomes following total hip replacement (THR) and to identify predictors of recovery from THR.

Introduction: In the United Kingdom, the wait for hip or knee joint replacement surgery can be particularly long. There are conflicting research accounts whether debilitating symptoms, such as pain and the effects on physical function and quality of life deteriorate or remain the same in individuals who are on the waiting list for hip or knee joint replacement. This study was conducted to investigate the severity of pain, level of physical function and quality of life amongst adults with osteoarthritis awaiting hip or knee joint replacement.

Methods: A longitudinal study was undertaken in the North West of England during 2003–2005. A total of 105 patients listed for primary hip or knee joint replacement were recruited, interviewed at baseline, and followed-up at three, six and nine months, or until their joint replacement. Measurement tools used were a visual analogue scale (VAS), Western Ontario McMaster’s University (WOMAC) Osteoarthritis Index and the Medical Outcomes Study Short Form Health Survey (SF-36).

Results: High levels of pain and poor physical function and quality of life were experienced by patients on the waiting list for joint replacement. At the three month follow-up (n=84) changes in VAS pain scores (0.6; 95% CIs mean difference 0.3,1.0); WOMAC pain scores (1.2 (95% CIs mean difference 0.7, 1.8) and WOMAC physical function scores (4.8; 95% CIs mean difference 2.8, 6.7) were significantly worse compared to baseline. However, there were minimal changes in quality of life as measured by the SF-36 while on the waiting list.

Discussion: The often long wait for joint replacement surgery and deterioration in pain and physical function has highlighted the need for active management by health professionals while patients are on the waiting list. There needs to be a clinical reassessment of patients by health professionals while on the waiting list for joint replacement.