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The Bone & Joint Journal
Vol. 106-B, Issue 11 | Pages 1348 - 1360
1 Nov 2024
Spek RWA Smith WJ Sverdlov M Broos S Zhao Y Liao Z Verjans JW Prijs J To M Åberg H Chiri W IJpma FFA Jadav B White J Bain GI Jutte PC van den Bekerom MPJ Jaarsma RL Doornberg JN

Aims

The purpose of this study was to develop a convolutional neural network (CNN) for fracture detection, classification, and identification of greater tuberosity displacement ≥ 1 cm, neck-shaft angle (NSA) ≤ 100°, shaft translation, and articular fracture involvement, on plain radiographs.

Methods

The CNN was trained and tested on radiographs sourced from 11 hospitals in Australia and externally validated on radiographs from the Netherlands. Each radiograph was paired with corresponding CT scans to serve as the reference standard based on dual independent evaluation by trained researchers and attending orthopaedic surgeons. Presence of a fracture, classification (non- to minimally displaced; two-part, multipart, and glenohumeral dislocation), and four characteristics were determined on 2D and 3D CT scans and subsequently allocated to each series of radiographs. Fracture characteristics included greater tuberosity displacement ≥ 1 cm, NSA ≤ 100°, shaft translation (0% to < 75%, 75% to 95%, > 95%), and the extent of articular involvement (0% to < 15%, 15% to 35%, or > 35%).


Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_14 | Pages 3 - 3
10 Oct 2023
Verma S Malaviya S Barker S
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Technological advancements in orthopaedic surgery have mainly focused on increasing precision during the operation however, there have been few developments in post-operative physiotherapy. We have developed a computer vision program using machine learning that can virtually measure the range of movement of a joint to track progress after surgery. This data can be used by physiotherapists to change patients’ exercise regimes with more objectively and help patients visualise the progress that they have made. In this study, we tested our program's reliability and validity to find a benchmark for future use on patients. We compared 150 shoulder joint angles, measured using a goniometer, and those calculated by our program called ArmTracking in a group of 10 participants (5 males and 5 females). Reliability was tested using adjusted R squared and validity was tested using 95% limits of agreement. Our clinically acceptable limit of agreement was ± 10° for ArmTracking to be used interchangeably with goniometry. ArmTracking showed excellent overall reliability of 97.1% when all shoulder movements were combined but there were lower scores for some movements like shoulder extension at 75.8%. There was moderate validity shown when all shoulder movements were combined at 9.6° overestimation and 18.3° underestimation. Computer vision programs have a great potential to be used in telerehabilitation to collect useful information as patients carry out prescribed exercises at home. However, they need to be trained well for precise joint detections to reduce the range of errors in readings