The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic Review

Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common and serious complication following lower extremity arthroplasty, such as total hip and knee arthroplasty. Due to the increasing number of these surgeries, accurately predicting VTE risk is cr...

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Main Authors: Davood Dalil, MD, Sina Esmaeili, Ehsan Safaee, Sajad Asgari, Nooshin Kejani, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344125000597
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author Davood Dalil, MD
Sina Esmaeili
Ehsan Safaee
Sajad Asgari
Nooshin Kejani, MD
author_facet Davood Dalil, MD
Sina Esmaeili
Ehsan Safaee
Sajad Asgari
Nooshin Kejani, MD
author_sort Davood Dalil, MD
collection DOAJ
description Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common and serious complication following lower extremity arthroplasty, such as total hip and knee arthroplasty. Due to the increasing number of these surgeries, accurately predicting VTE risk is crucial. Traditional clinical prediction models often fall short due to their complexity and limited accuracy. Methods: This Preferred Reporting Items for Systematic Review and Meta-Analyses–guided systematic review summarized the application of artificial intelligence (AI) and machine learning models in predicting VTE after total joint arthroplasty. Databases including PubMed, Scopus, Web of Science, and Embase were searched for relevant studies published up to January 2024. Eligible studies focused on the predictive accuracy of AI algorithms for VTE post arthroplasty and were assessed for quality using the Newcastle-Ottawa Scale. Results: A total of 7 retrospective cohort studies, encompassing 579,454 patients, met the inclusion criteria. These studies primarily employed the extreme gradient boosting model, which generally demonstrated strong predictive performance with area under the curve values ranging from 0.71 to 0.982. Models like random forest and support vector machines also performed well. However, only 1 study included external validation, critical for assessing generalizability. Conclusions: AI and machine learning models, particularly extreme gradient boosting, exhibit significant potential in predicting VTE after lower extremity arthroplasty, outperforming traditional clinical prediction tools. Yet, the need for external validation and high-quality, generalizable datasets remains critical before these models can be widely implemented in clinical practice. The study underscores the role of AI in preoperative planning to enhance patient outcomes in orthopaedic surgery.
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spelling doaj-art-ee383e121b4c40d783afdff415bb12f52025-08-20T03:32:19ZengElsevierArthroplasty Today2352-34412025-06-013310167210.1016/j.artd.2025.101672The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic ReviewDavood Dalil, MD0Sina Esmaeili1Ehsan Safaee2Sajad Asgari3Nooshin Kejani, MD4Faculty of Medicine, Shahed University, Tehran, IranStudent Research Committee, Faculty of Medicine, Shahed University, Tehran, IranStudent Research Committee, Faculty of Medicine, Shahed University, Tehran, Iran; Corresponding author. Research Committee, Faculty of Medicine, Shahed University, Keshavarz Blvrd, Tehran, Iran 3319118651. Tel.: +98 215 522 8800.Student Research Committee, Faculty of Medicine, Shahed University, Tehran, IranDepartment of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, IranBackground: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common and serious complication following lower extremity arthroplasty, such as total hip and knee arthroplasty. Due to the increasing number of these surgeries, accurately predicting VTE risk is crucial. Traditional clinical prediction models often fall short due to their complexity and limited accuracy. Methods: This Preferred Reporting Items for Systematic Review and Meta-Analyses–guided systematic review summarized the application of artificial intelligence (AI) and machine learning models in predicting VTE after total joint arthroplasty. Databases including PubMed, Scopus, Web of Science, and Embase were searched for relevant studies published up to January 2024. Eligible studies focused on the predictive accuracy of AI algorithms for VTE post arthroplasty and were assessed for quality using the Newcastle-Ottawa Scale. Results: A total of 7 retrospective cohort studies, encompassing 579,454 patients, met the inclusion criteria. These studies primarily employed the extreme gradient boosting model, which generally demonstrated strong predictive performance with area under the curve values ranging from 0.71 to 0.982. Models like random forest and support vector machines also performed well. However, only 1 study included external validation, critical for assessing generalizability. Conclusions: AI and machine learning models, particularly extreme gradient boosting, exhibit significant potential in predicting VTE after lower extremity arthroplasty, outperforming traditional clinical prediction tools. Yet, the need for external validation and high-quality, generalizable datasets remains critical before these models can be widely implemented in clinical practice. The study underscores the role of AI in preoperative planning to enhance patient outcomes in orthopaedic surgery.http://www.sciencedirect.com/science/article/pii/S2352344125000597Artificial intelligenceMachine learningVenous thromboembolismTotal hip arthroplastyTotal knee arthroplastyDeep vein thrombosis
spellingShingle Davood Dalil, MD
Sina Esmaeili
Ehsan Safaee
Sajad Asgari
Nooshin Kejani, MD
The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic Review
Arthroplasty Today
Artificial intelligence
Machine learning
Venous thromboembolism
Total hip arthroplasty
Total knee arthroplasty
Deep vein thrombosis
title The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic Review
title_full The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic Review
title_fullStr The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic Review
title_full_unstemmed The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic Review
title_short The Prediction of Venous Thromboembolism Using Artificial Intelligence and Machine Learning in Lower Extremity Arthroplasty: A Systematic Review
title_sort prediction of venous thromboembolism using artificial intelligence and machine learning in lower extremity arthroplasty a systematic review
topic Artificial intelligence
Machine learning
Venous thromboembolism
Total hip arthroplasty
Total knee arthroplasty
Deep vein thrombosis
url http://www.sciencedirect.com/science/article/pii/S2352344125000597
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