Mehmet Süleyman Abul, Ömer Faruk Sevim, Nazım Canberk Kılıç, Muzaffer Agir, İbrahim Tuncay
The AI-based analyses can accurately and consistently evaluate postoperative THA radiographs. There was one system that showed the best balance between sensitivity and specificity, indicating that AI-assisted interpretation may serve as a reliable adjunct to clinical follow-up for early complication prediction.
BACKGROUND: Artificial intelligence (AI) is increasingly used in total hip arthroplasty (THA), yet its role in postoperative imaging remains limited. This study evaluated the diagnostic performance of AI systems in interpreting postoperative radiographs following THA.
METHODS: A total of 1,045 patients who underwent primary THA between 2011 and 2015 were retrospectively analyzed. The first-day postoperative antero-posterior pelvic radiographs were assessed using AI systems to estimate the risk of dislocation and aseptic loosening. During a mean follow-up of 11.6 years (range, 10 to 14), 34 patients developed dislocation, 22 developed aseptic loosening, and 989 patients remained free of complications. Actual complications were confirmed through clinical and radiological records. Sensitivity, specificity, and area under the curve (AUC) values were calculated and compared.
RESULTS: There was one AI system that demonstrated the highest diagnostic accuracy (AUC 0.91 for dislocation and 0.90 for aseptic loosening), followed by the other systems (0.84 and 0.82) and (0.79 and 0.77), respectively. Repeated analyses produced identical outputs across sessions, confirming reproducibility.
CONCLUSION: The AI-based analyses can accurately and consistently evaluate postoperative THA radiographs. There was one system that showed the best balance between sensitivity and specificity, indicating that AI-assisted interpretation may serve as a reliable adjunct to clinical follow-up for early complication prediction.