Fontalis, Andreas;
(2024)
The impact of enhanced technologies on patient-oriented outcomes, radiological outcomes and healthcare resource utilization in hip and knee arthroplasty.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Introduction: This thesis assesses the impact of technological advances in hip and knee arthroplasty, particularly focusing on robotic-arm assistance, advanced imaging techniques and the integration of artificial intelligence. It explores their influence on patient outcomes, inflammatory responses, radiological precision, and healthcare resource utilization. Methods: The thesis employs a mixed-methods approach, analyzing patient outcomes through both prospective cohort studies and randomized controlled trials. It evaluates the inflammatory response, patient-reported outcome measures (PROMs) and radiological outcomes. Additionally, the thesis evaluates healthcare resource utilization and explores the potential of AI in enhancing preoperative planning. Advanced imaging techniques for surgical planning, including 3D templating compared to traditional 2D methods, are also assessed. Results: The study revealed significant reductions in inflammatory markers in patients undergoing robotic-arm assisted total knee arthroplasty, indicating less invasive procedures could lead to quicker recovery. However, no marked differences were found in PROMs between conventional and robotic-arm assisted surgeries. Additionally, this research established that Long Leg Radiographs (LLRs) and Computerized Tomography (CT) scans are equally effective for preoperative planning, potentially minimizing unnecessary radiation exposure for patients. The introduction of the CT Limb Rotational Angle (CRA) presents a new standard for assessing limb alignment accurately. Furthermore, CT-guided preoperative planning for Total Hip Arthroplasty (THA) demonstrated enhanced precision in the restoration of native joint biomechanics. The integration of Artificial Intelligence (AI) led to the development of a pilot, patient-specific algorithm designed to predict impingement, tailored to individual phenotypes. Discussion: The findings of this dissertation highlight the potential of advanced surgical technologies to reduce procedural invasiveness and enhance postoperative outcomes. The equivalence of LLR and CT scans in preoperative planning signifies a significant shift, potentially reducing unnecessary radiation exposure and enhancing patient safety. The integration of AI into preoperative planning marks an innovative development but requires further investigation.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | The impact of enhanced technologies on patient-oriented outcomes, radiological outcomes and healthcare resource utilization in hip and knee arthroplasty |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10201432 |
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