Introduction. Shoulder arthroplasty (SA) has been performed with different types of implants, each requiring different replacement systems. However, data on previously utilized implant types are not always available before revision surgery, which is paramount to determining the appropriate equipment and procedure. Therefore, this meta-analysis aimed to evaluate the accuracy of the AI models in classifying SA implant types. Methods. This systematic review was conducted in Pubmed, Embase, SCOPUS, and Web of Science from inception to December 2023, according to PRISMA guidelines. Peer-reviewed research evaluating the accuracy of AI-based tools on upper-limb X-rays for recognizing and categorizing SA implants was included. In addition to the overall meta-analysis, subgroup analysis was performed according to the type of AI model applied (CNN (Convolutional neural network), non-CNN, or Combination of both) and the similarity of utilized datasets between studies. Results. 13 articles were eligible for inclusion in this meta-analysis (including 138 different tests assessing models’ efficacy). Our meta-analysis demonstrated an overall sensitivity and specificity of 0.891 (95% CI:0.866-0.912) and 0.549 (95% CI:0.532,0.566) for classifying implants in SA, respectively. The results of our subgroup analyses were as follows: CNN-subgroup: a sensitivity of 0.898 (95% CI:0.873-0.919) and a specificity of 0.554 (95% CI:0.537,0.570), Non-CNN subgroup: a sensitivity of 0.809 (95% CI:0.665-0.900) and specificity of 0.522 (95% CI:0.440,0.603), combined subgroup: a sensitivity of 0.891 (95% CI:0.752-0.957) and a specificity of 0.547 (95% CI:0.463,0.629). Studies using the same dataset demonstrated an overall sensitivity and specificity of 0.881 (95% CI:0.856-0.903) and 0.542 (95% CI:0.53,0.554), respectively. Studies that used other datasets showed an overall sensitivity and specificity of 0.995 (95% CI:969,0.999) and 0.678 (95% CI:0.234, 0.936), respectively. Conclusion. AI-based classification of shoulder implant types can be considered a sensitive method. Our study showed the potential role of using CNN-based models and different datasets to enhance accuracy, which could be investigated in future studies

Using the transverse processes of fresh porcine lumbar spines as an experimental model we evaluated the heat generated by a rotating burr of a high-speed drill in cutting the bone. The temperature at the drilled site reached 174°C with a diamond burr and 77°C with a steel burr. With water irrigation at a flow rate of 540 ml/hr an effective reduction in the temperature was achieved whereas irrigation with water at 180 ml/hr was much less effective. There was a significant negative correlation between the thickness of the residual bone and the temperature measured at its undersurface adjacent to the drilling site (p < 0.001).

Our data suggest that tissues neighbouring the drilled bone, especially nerve roots, can be damaged by the heat generated from the tip of a high-speed drill. Nerve-root palsy, one of the most common complications of cervical spinal surgery, may be caused by thermal damage to nerve roots arising in this manner.