Orthopedics

Comprehensive Summary

This paper developed and compared two machine learning models - the Explainable Boosting Machine (EBM) and Quantile Regression Forests (QRF) - to predict acetabular cup size for total hip arthroplasty (THA). The study utilized patient data from 30,587 THA procedures at a single medical institution (from March 2016 and January 2024). Both models were trained on nine easily accessible preoperative variables, such as height, sex, age, weight, race, anterior or posterior surgical approach, computer navigation, and robotic assistance. QRF demonstrated superior performance, correctly predicting 82.85% of cups within plus or minus 2 mm and 97.27% of cups within plus or minus 4 mm. Sex, height, age, weight, surgical approach, and BMI were deemed the most influential factors in the QRF model. Partial dependency plots were also generated from the EBM model, analysis of which showed that male sex, greater height and age, posterior surgical approach, and lower BMI were associated with a larger predicted cup size. The results address key limitations of previous models by providing high accuracy and prediction using convenient patient information.

Outcomes and Implications

This work demonstrates that machine learning can accurately predict implant sizes using only basic patient data, providing a method for hospitals to optimize inventory and reduce surgical costs. Currently, hospitals keep up to 17 cup sizes per case due to limited foresight into a patient’s specific size. However, model implementation could bring that number down to an average of five cup sizes per case. While the study’s single-center design and lack of external validation demonstrate room for improvement before clinical integration, the findings suggest a promising path towards machine learning-driven resource management during orthopedic surgery.

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© 2025 AIIM. Created by AIIM IT Team