| Objective: With the development of digital orthopedics,more and more artificial intelligence 3D planning software applications have emerged.At present,the AI-HIP 3D planning system developed by Beijing Changmugu Company has been applied to preoperative planning of total hip Joint replacement,and several clinical studies have been published.However,the clinical significance of AI-HIP application is currently uncertain.Therefore,this study evaluated the accuracy of total hip Joint replacement through literature retrieval,literature screening,literature inclusion,data extraction,and metaanalysis of AI-HIP three-dimensional template and two-dimensional template.Methods: The author will search English databases such as Pub Med,Cochrane,Embase,Web of Science,as well as Chinese databases such as CNKI,VIP,and Wanfang databases from the computer.The search was conducted from the establishment of the database until January 2023,and 11 clinical studies on the accuracy comparison of artificial intelligence3 D template and 2D template assisted planning for total hip arthroplasty were included.End Note X9 software was used for literature management.Two researchers independently screened the literature,extracted data,evaluated the risk of bias in the included literature,and conducted cross validation before conducting data analysis using Rev Man 5.4 and Stata SE 16 software.For continuous variables,mean difference(MD)combined effect quantity is used,risk ratio(RR)combined effect quantity is used for two categorical variable,and effect size(ES)is used for two categorical variable of single arm experiment.Results: A total of 11 clinical studies were included,including 5 cohort study,5 single arm studies and 1 randomized controlled trial.A total of 1189 patients were included.The results of meta-analysis of randomized controlled trials and cohort study show that when the planned acetabular cup prosthesis is completely consistent with the acetabular cup prosthesis used in surgery,the accuracy of AI-HIP three-dimensional planning acetabular cup prosthesis is better than that of two-dimensional template planning prosthesis(RR=1.46,95% CI [1.32,1.61],P<0.00001).When the planning of the femoral stem prosthesis is completely consistent with the femoral stem prosthesis used during surgery,the accuracy of AI-HIP three-dimensional planning of the femoral stem prosthesis is better than that of two-dimensional template planning of the femoral stem prosthesis(RR=1.41,95% CI [1.28,1.57],P<0.00001).When planning the number of prostheses(0± 1),the accuracy of AI-HIP three-dimensional planning of acetabular cup and femoral stem prostheses was also better than that of two-dimensional template planning prostheses(RR=1.22,95% CI [1.09,1.36],P=0.0004),(RR=1.30,95% CI [1.12,1.51],P=0.0004),all of which were statistically significant.The meta-analysis results of a single arm study showed that the accuracy of AI-HIP three-dimensional planning of acetabular cup prostheses was ES=0.77,95% CI [0.63,0.88],P<0.05,when the preoperative planning prostheses were completely consistent with the actual use of prostheses during surgery;The accuracy of 2D template planning for acetabular cup prostheses is ES=0.48,95% CI[0.40,0.55],P<0.05.The accuracy of AI-HIP three-dimensional planning for femoral stem prostheses is ES=0.73,95% CI [0.59,0.85],P<0.05,while the accuracy of twodimensional template planning for femoral stem prostheses is ES=0.46,95% CI [0.39,0.53],P<0.05,all of which are statistically significant.Conclusion: After this meta-analysis,we found that the application of the AI-Hip threedimensional template for planning acetabular cup components and femoral stem components had a higher accuracy rate than the two-dimensional template for planning acetabular cup components and femoral stem components.However,due to the moderate quality of the included literature and high heterogeneity in the results of individual studies,the grade of evidence and credibility provided may be biased. |
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