A comprehensive predictive model for postoperative joint function in robot-assisted total hip arthroplasty patients: combining radiomics and clinical indicators

Jiewen Zhang; Yiwei Zhao; Yang Chen; Heng Li; Fangze Xing; Chengyan Liu; Xudong Duan; Huanshuai Guan; Ning Kong; Yiyang Li; Kunzheng Wang; Run Tian; Pei Yang

doi:10.1007/s11701-024-02102-6

A comprehensive predictive model for postoperative joint function in robot-assisted total hip arthroplasty patients: combining radiomics and clinical indicators

J Robot Surg. 2024 Sep 24;18(1):347. doi: 10.1007/s11701-024-02102-6.

Authors

Jiewen Zhang^#¹, Yiwei Zhao^#¹, Yang Chen^#¹, Heng Li¹, Fangze Xing¹, Chengyan Liu¹, Xudong Duan¹, Huanshuai Guan¹, Ning Kong¹, Yiyang Li¹, Kunzheng Wang¹, Run Tian¹, Pei Yang²

Affiliations

¹ Joint & Ankle Section, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
² Joint & Ankle Section, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China. yangpei@xjtu.edu.cn.

^# Contributed equally.

PMID: 39313734
DOI: 10.1007/s11701-024-02102-6

Abstract

Total hip arthroplasty (THA) effectively treats various end-stage hip conditions, offering pain relief and improved joint function. However, surgical outcomes are influenced by multifaceted factors. This research aims to create a predictive model, incorporating radiomic and clinical information, to forecast post-surgery joint function in robot-assisted THA (RA-THA) patients. The study set comprised 136 patients who underwent unilateral RA-THA, which were subsequently partitioned into a training set (n = 95) and a test set (n = 41) for analysis. Preoperative CT imaging was employed to derive 851 radiomic characteristics, selecting those with an intra-class correlation coefficient > 0.75 for analysis. Least absolute shrinkage and selection operator regression reduced redundancy to six significant radiomic features. Clinical data including preoperative Visual Analog Scale (VAS), Harris Hip Score (HHS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score were collected. Logistic regression identified significant predictors, and three models were developed. Receiver operating characteristic and decision curves evaluated the models. Preoperative VAS, HHS, WOMAC score, and radiomics feature scores were significant predictors. In the training set, the AUCs were 0.835 (clinical model), 0.757 (radiomic model), and 0.891 (combined model). In the test set, the AUCs were 0.777 (clinical model), 0.824 (radiomic model), and 0.881 (combined model). The constructed nomogram prediction model combines radiological features with relevant clinical data to accurately predict functional outcomes 3 years after RA-THA. This model has significant prediction accuracy and broad clinical application prospects and can provide a valuable reference for formulating personalized treatment plans and optimizing patient management strategies.

Keywords: Computed tomography; Nomogram; Radiomics; Robotic-assisted total hip arthroplasty.