Variations in chondrocyte density and organization in cartilage histology sections are associated with osteoarthritis progression. Rapid, accurate quantification of these two features can facilitate the evaluation of cartilage health and advance the understanding of their significance. The goal of this work was to adapt deep‐learning‐based methods to detect articular chondrocytes and chondrocyte clones from safranin‐O‐stained cartilage to evaluate chondrocyte cellularity and organization. The U‐net and “you‐only‐look‐once” (YOLO) models were trained and validated for identifying chondrocytes and chondrocyte clones, respectively. Validated models were then used to quantify chondrocyte and clone density in talar cartilage from Yucatan minipigs sacrificed 1 week, 3, 6, and 12 months after fixation of an intra‐articular fracture of the hock joint. There was excellent/good agreement between expert researchers and the developed models in identifying chondrocytes/clones (U‐net: R2 = 0.93, y = 0.90x–0.69; median F1 score: 0.87/YOLO: R2 = 0.79, y = 0.95x; median F1 score: 0.67). Average chondrocyte density increased 1 week after fracture (from 774 to 856 cells/mm2), decreased substantially 3 months after fracture (610 cells/mm2), and slowly increased 6 and 12 months after fracture (638 and 683 cells/mm2, respectively). Average detected clone density 3, 6, and 12 months after fracture (11, 11, 9 clones/mm2) was higher than the 4–5 clones/mm2 detected in normal tissue or 1 week after fracture and show local increases in clone density that varied across the joint surface with time. The accurate evaluation of cartilage cellularity and organization provided by this deep learning approach will increase objectivity of cartilage injury and regeneration assessments.
Background: We aimed to develop automated data extraction pipelines with large language models (LLMs) to extract registry data from total hip arthroplasty (THA) operative notes and compare the performance with that of existing natural language processing (NLP) algorithms. Methods: We randomly sampled 1,000 primary THA cases from our institutional registry. Two human annotators manually reviewed each operative note for 3 data points: surgical approach, bearing surface, and fixation technique. All labeled THA notes were split into the development set (n = 239) and the testing set (n = 719). We developed a custom data extraction pipeline for each data point by combining an iteratively customized prompt with an LLM. The performance was compared with that of existing rules-based NLP algorithms. Results: The accuracy of LLMs was superior to that of NLP algorithms for all data points: surgical approach (96% compared with 94%), bearing surface (89% compared with 74%), and fixation technique (96% compared with 95%). Furthermore, the LLM accurately inferred the bearing surface for 80% of the notes that were ambiguous about the bearing surface. Conclusions: We developed LLM pipelines for extracting 3 registry-relevant data points from THA operative notes, demonstrating superior performance to existing NLP algorithms. Clinical Relevance: LLMs have the potential to impact clinical care, including the evaluation of electronic medical record free-text data. As registries serve as a cornerstone of orthopaedic evidence, this work demonstrates promise for LLMs to simplify, improve, and democratize the construction of registry databases from operative notes.
Artificial intelligence (AI) is increasingly shaping pediatric spine care, leveraging its rapid advancements in healthcare to improve efficiency, accuracy, and disease understanding. Moreover, machine learning and deep learning excel at detecting complex patterns. This holds promise in processing spinal deformity data, with the potential to surpass traditional statistical methods in predictive accuracy. Challenges persist, however, including unclear clinical implementation guidelines, limited model transparency, and ethical concerns surrounding data privacy and bias. Small sample sizes and the need for larger, diverse datasets further complicate integration. In order to realize AI’s transformative potential in pediatric spine care, these critical obstacles must be addressed for effective and ethical clinical adoption. This review examines the role of AI through applications such as image sorting, surgical outcome prediction, forecasting of spinal curve progression, and vertebral volumetric analysis using deep reasoning. It also explores possible intraoperative contributions from AI, including robotics and optimized screw trajectory planning, and the potential of large language models in clinical practice.