As a Senior Staff Writer for Orthopedics Today, Ms. Casey Tingle recently reviewed the impact of artificial intelligence (AI) in the health care sector.  In her article she highlighted where AI may provide benefits to patients with musculoskeletal injuries.  Her work included input from McGowan Institute for Regenerative Medicine deputy director Stephen Badylak, DVM, PhD, MD, professor of surgery at the University of Pittsburgh, who said AI may be able to identify whether tissues that are healing from a traumatic injury will have a good or bad outcome based on certain biomarkers.

“For example, the more scar tissue and adhesions you get, the worse the clinical outcome is going to be,” Dr. Badylak said. “If we knew early on that certain things were starting to go down the wrong pathway, we could intervene either surgically or in other ways that could change the direction of wound healing,” he said.

Once the healing biomarkers are identified, Dr. Badylak noted AI, in the form of smart bandages, can be developed that, when used on wounds following a traditional repair procedure, can indicate in which direction the wound is healing and provide guidance on how surgeons can intervene, and when. Currently, Dr. Badylak and his colleagues are using AI to develop methods “that will decrease the time to functional healing of injured musculoskeletal tissue by 50%.”

“In other words, someone comes in with a traumatic injury, they have a fractured femur and they lost 50% of their quadriceps muscle. That is a pretty serious injury. Right now the expectation is we are going to do the best we can to salvage this and we are going to get to a point where we have scar tissue with a lot of morbidity and limited function,” Dr. Badylak told Orthopedics Today. “Well, the AI tells us that does not have to be the case. We can not only restore most of the functional tissue that was gone, but we could do it in half of the time if we only knew when to intervene and how to intervene both surgically and medically.”

Barriers of AI

Because not every hospital will have the resources to run and upkeep predictive models, Dr. Badylak said the models must be developed in an understandable and user-friendly way, especially in light of the current barriers to implementing AI as a standard of care. He said regardless of whether they are user-friendly, the more advanced AI designed for treatment of musculoskeletal injuries may be disadvantaged by regulatory barriers, as well as funding issues.

“The only way you are going to [obtain] third-party reimbursement is if you can show that, in the long run, this is more cost effective,” Dr. Badylak said. “That takes years to do because the cost benefits are going to be realized over years,” he said.

‘Keep an open mind’

Although Dr. Badylak said surgeons should keep an open mind regarding AI use in their practices, he also advises them to educate themselves and not believe everything they hear.

“If we are feeding the wrong information into a device that works on AI, then we are not going to get the information out of it that we want,” Dr. Badylak said. “In addition to keeping an open mind, we have to put forth the effort to understand how to take full advantage of what is being developed, otherwise we are going to either not make any advances or even have worse outcomes because we have provided the wrong information and expect a machine to fix it for us, and that does not happen.”

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