Application of artificial intelligence in trauma orthopedics: Limitation and prospects

The varieties and capabilities of artificial intelligence and machine learning in orthopedic surgery are extensively expanding.One promising method is neural networks,emphasizing big data and computer-based learning systems to develop a statistical fracture-detecting model.It derives patterns and rules from outstanding amounts of data to analyze the probabilities of different outcomes using new sets of similar data.The sensitivity and specificity of machine learning in detecting fractures vary from previous studies.AI may be most promising in the diagnosis of less-obvious fractures that are more commonly missed.Future studies are necessary to develop more accurate and effective detection models that can be used clinically.

Buddhist monk Lin Daoren,specialist of traumatology and orthopedics

Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by him is the first extant monography on traumatology and orthopedics in China.According to the preface of the book,he had profound medical knowledge especially about the theory,diagnosis and treatment for wounds and fractures.

Baishideng’s Reference Citation Analysis database announces the first Journal Article Influence Index of 104 core journals and a list of high-quality academic journals in orthopedics

After three rounds of rigorous evaluation of core journals in orthopedics conducted by the Reference Citation Analysis(RCA)editorial team of Baishideng Publishing Group(Baishideng),the RCA database of Baishideng officially released the 2022 Journal Article Influence Index(2022 JAII)of 104 core journals and a list of high-quality academic journals in orthopedics,for the first time on August 9,2022.The list of 104 core journals can be found at:https://www.referencecitationanalysis.com/SearchJournal.Among them,the highest 2022 JAII is 55.015 and the lowest is 3.076.This article introduces the 21 high-quality academic journals and describes the calculation method for the 2022 JAII,the evaluation process,and the inclusion principles for journals in the RCA.These steps are the underpinning of the RCA’s empirical journal academic evaluation service by which the digital platform addresses the needs of authors to select reliable journals for submission,readers to select high-quality literature for reading,and editors to track their own journal citation performance.As such,the RCA core journal list will serve as a useful Find-a-Journal tool.Any interested party is welcome to use this journal list and recommend it to their peers.

What is the purpose of launching World Journal of Orthopedics?

The first issue of World Journal of Orthopedics(WJO),whose preparatory work was initiated on March 11,2010,will be published on November 18,2010.The WJO Editorial Board has now been established and consists of 114 distinguished experts from 26 countries.Our purpose of launching WJO is to publish peer-reviewed,high-quality articles via an open-access online publishing model,thereby acting as a platform for communication between peers and the wider public,and maximizing the benefits to editorial board members,authors and readers.

New Year's greeting and overview of World Journal of Orthopedics in 2021

On behalf of the Editorial Office of World Journal of Orthopedics(WJO),we extend our sincere gratitude to our authors,subscribers,readers,Editorial Board members,and peer reviewers,thanking each and every one for their contributions to WJO in 2020 and with wishes for a Happy New Year.It was the support of all our Editorial Board members and peer reviewers that allowed the Baishideng Publishing Group Inc to successfully carry out the complete peer review,editing and publishing processes for WJO in 2020.We have analyzed the data of WJO's manuscript submissions and article publications in 2020,the invited manuscripts for 2021,manuscript peer review,composition of Editorial Board,and citation of WJO's articles,and present the findings here.We expect to be even more productive and to further raise the academic rank of WJO in 2021.

Impact of three dimensional printing in orthopedics

The primary objective of this article is to explore effects of latest development in the area of three dimensional(3D)printing&to assess its abilities,and further undertake helpful reporting.Here the focus is to assess ad vantages of 3D printing in orthopedics and analyze how 3D printed models help solve complex 3D orthopedics distortions.This study identified that 3D models manufactured by 3D printing models reduce medical parts de velopment cost and surgical planning time.Integrating 3D printing with orthopaedics helps in understanding the conditions of problems and achieving the operation succssfully.This technology can enable doctors/surgeons to design,produce,recreate and plan operations more accurately,carefully,and economicaly.3D models can assist specialists with a visual comprehension of the patient-particular pathology and life structures.Innovation in 3D printing initiated a scaffold for the virtual outline and execution of medical procedures.This research proposes the utilisation of 3D printers as an elective procedure for the fabrication of parts.It empowers surgeons/patients for better raining,education and research.In the future,there is a foreseeable expansion of additive manufacturing in orthopedics.

Development and prospects of digital orthopedics in Hubei province

Based on the development and application of new technology,as a new interdisciplinary subject,digital orthopedics becomes an important development direction of modern medicine in the past years.Using digital orthopedics technology,such as 3D digital printing technology,mixed reality technology,provides new impetus of orthopedic surgery and indicates its great potential of precision medicine and personalized therapy for orthopedic disorders.In 2017,Hubei Branch of China Digital Orthopaedic Society of SociétéInternationale de Chirurgie Orthopédique et de Traumatologie(SICOT)was founded.It is an important milestone and academic event for the development of digital orthopedics in Hubei.After that,Hubei's digital orthopedics professionals have made great progress in clinical,scientific research,conference and social activities.The development of 5G technologies in China will provide more opportunities and challenges for global digital orthopedics in the near future.

Normal Variants of the Lower Limbs in Pediatric Orthopedics

Normal variants of lower limb development such as in-toeing, out-toeing, flat feet, bow-legs and knock knees are a common cause for parental concern and also a common source of referral to pediatric clinics. A thorough history and clinical examination is usually all that is required to make the diagnosis of a normal variant. They also help to exclude pathological conditions that may present in a similar fashion. Radiological and other investigations are not routinely required in children with normal variants of the lower limb except to exclude pathological conditions. Shoe inserts, orthoses and physical therapy are not to be encouraged as they provide no benefit. In the majority of cases the natural history is one of spontaneous resolution of the deformity. Surgery may, however, be required in a small number of patients greater than eight years in whom severe in or out-toeing is present. Parental education and reassurance is an important part of the treatment and must be re-emphasized.

Study on the Effect of the Intervention on Traditional Chinese Medicine Negative Heel Shoes in Geriatric Orthopedics Patients

In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.

An Approach to Modern Schools of Orthopedics and Traumatology of TCM

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The application research progress of intelligent robot in orthopedics

This paper introduces the application of intelligent robot in orthopedic treatment and nursing research progress,and summarizes the advantages and disadvantages of intelligent robot,the prospect.The aim is to help medical staff understand the basic overview of intelligent robot,and learn cutting-edge knowledge,promote the deep integration of intelligent robot technology and orthopedics field,and provide reference for the future research direction of intelligent robot technology in orthopedics field.

Three-dimensional printing for the accurate orthopedics:clinical cases analysis

As an emerging technology to promote the combination of medicine and industry,the three-dimensional(3D)printing has developed rapidly in the fields of orthopedics,while its unique advantages in improving precise treatment still need to be further popularized.In this report,our team have exhibited several classic cases of integrating 3D printing into orthopedic clinical application,thereby further elaborating thoughts and opinions on the significance of 3D printing in the orthopedic clinical application,technical advantages,existing main problems and coping strategies.

Ultrasound in the diagnosis of clinical orthopedics:The orthopedic stethoscope

Ultrasonography has advantages over other imaging modalities in terms of availability and comfort,safety,and diagnostic potential.Operating costs are low compared with both computed tomography(CT)and magnetic resonance imaging(MRI).The portable equipment is accessible at locations distant from medical centers.Importantly,ultrasonography is performed while patients lie in a comfortable position,without pain or claustrophobia.Ultrasonography is a totally safe noninvasive imaging technique.In contrast to CT and X-rays,it does not emit ionizing radiation.Unlike MRI,it is safe for all patients,including those with cardiac pacemakers and metal implants,without any contraindications.Of the many indications for musculoskeletal ultrasonography,the evaluation of soft tissue pathology is particularly common.In addition,ultrasonography is useful for the detection of fluid collection,and for visualization of cartilage and bone surfaces.Color or power Doppler provides important physiological information,including that relating to the vascular system.The capability of ultrasonography in delineating structures according to their echotextures results in excellent pictorial representation.This imaging principle is based on physical changes in composition,as compared to imaging with MRI,which is based on changes in chemical composition.This article reviews the contribution of sonography to the evaluation of the musculoskeletal system.

Influence of different anesthesia methods on stress reaction and hemodynamics for elderly orthopedics patients during operations

Objective:To study the influence of general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia method on stress reaction and hemodynamics for elderly orthopedics patients during operations.Methods: A total of 90 cases of elder patients who received orthopedic operations were randomly divided to group A, B and C, with 30 cases per group. Three groups of patients were separately given by general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia for operations;The variations of adrenocorticotrophic hormone (ACTH), Cortisol (Cor),β-endorphin (β-EP), Angiotensin-Ⅱ(Ang-Ⅱ), heart rate (HR) and blood pressure (SBP, DBP) on patients in three groups before anesthesia (T0), during skin incision (T1), after skin incision (T2) and extubation after operation (T3) were compared and analyzed.Results:During T1, T2, ACTH, Cor,β-EP and Ang-Ⅱlevels in 3 groups of patients were significantly higher than those during T0;SBP and DBP were significantly lower than that during T0;HR during T2 was significantly lower than that during T0;During T3, every index in 3 groups were recovered to levels close to that during T0;During T1, T2, ACTH, Cor,β-EP, Ang-Ⅱlevels in group B and C were significantly lower than that in group A. And levels in C was lower than that in B;SBP and DBP in group B and C were significantly higher than A. No HR statistical significance appeared between each group.Conclusions: During clinical anesthesia, we should choose suitable anesthesia method combined with actual situations of patients. Combined spinal and epidural anesthesia had a slight influence on hemodynamics of elder orthopedics patients during operation, and it could effectively alleviate stress reaction during operation.

Layer-by-layer self-assembly and clinical application in orthopedics

Orthopedic implants for the treatment of bone defects from various causes have been challenged by insufficient osseointegration,bacterial infection,oxidative stress,immune rejection,and insufficient individualized treatment.These challenges not only impact treatment outcomes but also severely impact patients’daily lives.Layer-by-Layer(LbL)serves as a simple surface coating technique,in simple terms,to functionalize implants by sequentially adsorbing oppositely charged materials onto a substrate.In orthopaedics,LbL self-assembly technology solves some of the challenges by loading various drugs or biological agents on the implant surface and controlling their release precisely to the site of bone defects in a personalized way.This review will introduce the basic principle and the development of LbL in orthopaedics,review and analyze the chemical strategy of LbL in the preparation of bone implants to ensure the stability of the implant,and introduce the use of LbL bone implants in orthopaedics in recent years.The application of LbL includes the realization of programmed drug delivery and sustained release,thereby promoting osseointegration and the formation of new blood vessels,antibacterial,antioxidant,etc.This review focuses on the LbL technology,involving the technology selection for the preparation of bone implants,the chemical strategies of the stability guarantee of LbL implants,the pharmacological properties,loading and release mechanisms of loaded drugs,and the molecular mechanisms of osteogenesis and angiogenesis.The aim of this review is to provide an overview of current research advances,and a prospect in this field was also described.

A Review of the Application of Artificial Intelligence in Orthopedic Diseases

In recent years,Artificial Intelligence(AI)has revolutionized people’s lives.AI has long made breakthrough progress in the field of surgery.However,the research on the application of AI in orthopedics is still in the exploratory stage.The paper first introduces the background of AI and orthopedic diseases,addresses the shortcomings of traditional methods in the detection of fractures and orthopedic diseases,draws out the advantages of deep learning and machine learning in image detection,and reviews the latest results of deep learning and machine learning applied to orthopedic image detection in recent years,describing the contributions,strengths and weaknesses,and the direction of the future improvements that can be made in each study.Next,the paper also introduces the difficulties of traditional orthopedic surgery and the roles played by AI in preoperative,intraoperative,and postoperative orthopedic surgery,scientifically discussing the advantages and prospects of AI in orthopedic surgery.Finally,the article discusses the limitations of current research and technology in clinical applications,proposes solutions to the problems,and summarizes and outlines possible future research directions.The main objective of this review is to inform future research and development of AI in orthopedics.

Single-center experience with Knee+^(TM) augmented reality navigation system in primary total knee arthroplasty

BACKGROUND Computer-assisted systems obtained an increased interest in orthopaedic surgery over the last years,as they enhance precision compared to conventional hardware.The expansion of computer assistance is evolving with the employment of augmented reality.Yet,the accuracy of augmented reality navigation systems has not been determined.AIM To examine the accuracy of component alignment and restoration of the affected limb’s mechanical axis in primary total knee arthroplasty(TKA),utilizing an augmented reality navigation system and to assess whether such systems are conspicuously fruitful for an accomplished knee surgeon.METHODS From May 2021 to December 2021,30 patients,25 women and five men,under-went a primary unilateral TKA.Revision cases were excluded.A preoperative radiographic procedure was performed to evaluate the limb’s axial alignment.All patients were operated on by the same team,without a tourniquet,utilizing three distinct prostheses with the assistance of the Knee+™augmented reality navigation system in every operation.Postoperatively,the same radiographic exam protocol was executed to evaluate the implants’position,orientation and coronal plane alignment.We recorded measurements in 3 stages regarding femoral varus and flexion,tibial varus and posterior slope.Firstly,the expected values from the Augmented Reality system were documented.Then we calculated the same values after each cut and finally,the same measurements were recorded radiolo-gically after the operations.Concerning statistical analysis,Lin’s concordance correlation coefficient was estimated,while Wilcoxon Signed Rank Test was performed when needed.RESULTS A statistically significant difference was observed regarding mean expected values and radiographic mea-surements for femoral flexion measurements only(Z score=2.67,P value=0.01).Nonetheless,this difference was statistically significantly lower than 1 degree(Z score=-4.21,P value<0.01).In terms of discrepancies in the calculations of expected values and controlled measurements,a statistically significant difference between tibial varus values was detected(Z score=-2.33,P value=0.02),which was also statistically significantly lower than 1 degree(Z score=-4.99,P value<0.01).CONCLUSION The results indicate satisfactory postoperative coronal alignment without outliers across all three different implants utilized.Augmented reality navigation systems can bolster orthopaedic surgeons’accuracy in achieving precise axial alignment.However,further research is required to further evaluate their efficacy and potential.

Innovations in Orthopedics and Traumatology in China

According to the latest data released by the National Bureau of Statistics, the total population of the mainland of China is 1.33 billion in 2010, including 177 million people aged 60 years or older, accounting for 13.25% of the total population, which increased to 15.53% in 2014. With the degree of growing aging population in our country, patients with musculoskeletal diseases increased greatly, which are the most common cause of severe chronic pain and physical disability among older people. Meanwhile, with the fast development of economy and industrialization in China, the number of patients of traffic injury and construction injury increases rapidly. Taken together, the expenses in orthopedics and traumatology will inevitably increase, challenging the existed medical and health system, presenting significant financial and emotional burden on the society. To address this challenge and improve the patient＇s care, the innovation of advanced concepts, surgical skills, and novel instruments for accurate diagnostic and treatment methods in orthopedics and traumatology has become more and more vital and imperative in our country.

Academic productivity correlates with industry earnings in foot and ankle fellowship programs in the United States:A retrospective analysis

BACKGROUND The study investigates the connection between academic productivity and industry earnings in foot and ankle orthopedic surgery fellowships.Utilizing metrics like the H-index and Open Payments Database(OPD)data,it addresses a gap in understanding the relationship between scholarly achievements and financial outcomes,providing a basis for further exploration in this specialized medical field.AIM To elucidate the trends between academic productivity and industry earnings across foot and ankle orthopedic surgery fellowship programs in the United States.METHODS This study is a retrospective analysis of the relationship between academic productivity and industry earnings of foot and ankle orthopedic surgery fellowships at an individual faculty and fellowship level.Academic productivity was defined via H-index and recorded from the Scopus website.Industry earnings were recorded from the OPD.RESULTS Forty-eight foot and ankle orthopedic surgery fellowships(100%of fellowships)in the United States with a combined total of 165 physicians(95.9%of physicians)were included.Mean individual physician(n=165)total life-time earnings reported on the OPD website was United States Dollar(USD)451430.30±1851084.89(range:USD 25.16-21269249.85;median:USD 27839.80).Mean physician(n=165)H-index as reported on Scopus is 14.24±12.39(range:0-63;median:11).There was a significant but weak correlation between individual physician H-index and individual physician total life-time earnings(P<0.001;Spearman’s rho=0.334)and a significant and moderate positive correlation between combined fellowship H-index and total life-time earnings per fellowship(P=0.004,Spearman’s rho=0.409).CONCLUSION There is a significant and positive correlation between academic productivity and industry earnings at foot and ankle orthopedic surgery fellowships in the United States.This observation is true on an individual physician level as well as on a fellowship level.

Limb Lengthening and Reconstruction Society orthopedic surgeons in the United States:An analysis of geographical distribution,academic,leadership,and demographic characteristics

BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.