Page 6 - OrthoFeed issue3 - Final

Routine follow-up with

MRI! Why? Artificial intelligence
enabled decision aid
Researchers at Hospital for Special Surgery (HSS) have
proved that Magnetic resonance imaging (MRI) can identify There is growing interest in incorporating patient-reported
adverse local tissue reactions in patients who have received outcome measurements in the decision-making process. [1]
hip replacements or hip resurfacing arthroplasty. [1]
Decision aids (DAs) increase patient’s knowledge, the
These reactions are seen even in asymptomatic patients with accuracy of risk perceptions, and the proportion of patients
high-functioning hip scores. [2] making decisions that align with their values. [2]

Delayed detection of these adverse reactions can result in A team from the UT Health Austin Musculoskeletal Institute
unnecessary pain, more complicated revision operations and (MSKI) developed a patient decision aid in collaboration
challenging recovery. [2] with a digital health company. [3]

The study published in Clinical Orthopaedics and Related The decision aid uses artificial intelligence (AI) and
Research concludes that, the use of MRI should be included patient-reported outcome measures (PROMs) for enhanced
as part of routine annual follow-up protocol for hip shared decision-making (SDM) around (total knee
replacement patients. [1] replacement) TKR surgery. [3]

An AI-enabled decision aid significantly improves decision
quality, level of SDM, patient satisfaction, and physical
limitations without significantly impacting consultation
times, TKR rates, or treatment concordance in patients with
knee OA considering TKR. [1]

Figure- MRI showing soft tissue deposits in a patient with hip
arthroplasty implant and an adverse local tissue reaction [3]

What’s new?
Decision aids using a personalized, data-driven approach can
It is the first study to evaluate the presence and enhance shared decision making in the management of knee OA. [1]
risk of local tissue complications after hip
replacements made of different materials in
patients, including those who are asymptomatic.
Source-
Previous studies have been limited to
metal-on-metal implants in symptomatic patients. 1. Jayakumar P, Moore MG, Furlough KA, et al. Comparison of an Artificial
Intelligence–Enabled Patient Decision Aid vs Educational Material on
Decision Quality, Shared Decision-Making, Patient Experience, and
Functional Outcomes in Adults With Knee Osteoarthritis: A Randomized
Source-
Clinical Trial. JAMA Netw Open. 2021;4(2):e2037107.
1. https://orthospinenews.com/2021/07/08/hss-study-finds-that-mri-ident
ifies-adverse-tissue-reactions-are-common-in-asymptomatic-individual 2. Zbehlik, A. J., Riblet, N. B., Meinke, M. E., Pepin, R. L., Akkineni, R., & Bartels, S. J.
s-after-hip-resurfacing-arthroplasty/ (2016). Shared decision making in early knee osteoarthritis: A qualitative
study of older adults and healthcare providers. Osteoarthritis and Cartilage,
2. https://www.prnewswire.com/news-releases/hss-study-finds-that-mri-i 24, S234–S235.
dentifies-adverse-tissue-reactions-are-common-in-asymptomatic-indivi
duals-after-hip-resurfacing-arthroplasty-301328070.html 3. https://dellmed.utexas.edu/blog/artificial-intelligence-decision-aid-for-total-
knee-replacement
3. https://pubs.rsna.org/doi/10.1148/rg.344140010