ABSTRACT
Background: Artificial intelligence (AI) is increasingly being integrated into total hip arthroplasty (THA), particularly in preoperative planning, predictive modeling, and postoperative imaging analysis. However, current evidence remains heterogeneous regarding methodology, validation, and clinical applicability. Purpose: To systematically review the current applications, clinical utility, limitations, and future perspectives of AI in THA. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched for studies published between January 2015 and May 2026. Original studies evaluating AI-based applications in THA were included. Results: Thirteen studies were included in the qualitative synthesis. The principal AI application domains identified were: (1) preoperative planning and implant templating, (2) prediction of complications and functional outcomes, and (3) implant identification and postoperative imaging analysis. AI-assisted three-dimensional planning systems consistently demonstrated improved implant sizing accuracy and planning reproducibility compared with conventional templating techniques. Machine learning algorithms showed promising performance for prediction of postoperative complications, patient-reported outcomes, and periprosthetic joint infection. Deep learning-based imaging systems also demonstrated high accuracy for automated implant recognition using radiographic imaging. Conclusion: Current evidence suggests that AI-assisted technologies may improve planning accuracy, perioperative risk stratification, and workflow optimization in THA. Nevertheless, the available literature remains predominantly retrospective and heterogeneous, with limited external validation and insufficient prospective clinical evaluation.

ABSTRACT
Background: Total knee arthroplasty (TKA) is an established treatment for advanced knee disease, but functional recovery varies among patients. Identifying factors associated with postoperative function may help improve patient assessment and rehabilitation planning. Methods: This hospital-based observational study included 90 patients who underwent TKA from July 2024 to June 2026 at the Department of Orthopaedic Surgery, Uttara Adhunik Medical College, Dhaka, Bangladesh and selected private clinics within and outside Dhaka. Demographic and clinical characteristics, including age, sex, BMI, comorbidities, preoperative range of motion (ROM), deformity and functional status, were recorded. Postoperative functional outcome, pain improvement, ROM and walking ability were assessed. Data were analyzed using SPSS version 25, with p<0.05 considered statistically significant. Results: Good functional outcome was observed in 48 (53.3%) patients, moderate in 29 (32.2%) and poor in 13 (14.4%). Satisfactory pain improvement occurred in 67 (74.4%), while 43 (47.8%) achieved postoperative ROM >110°. Age was significantly associated with outcome (p=0.041), with good outcome in 66.7% of patients aged <60 years versus 44.4% aged ≥60 years. BMI (p=0.047), preoperative ROM (p=0.031) and comorbidity (p=0.006) were also significantly associated with functional outcome. Sex was not significantly associated (p=0.248). Conclusion: Functional recovery after TKA was generally favorable. Younger age, lower BMI, better preoperative ROM and absence of comorbidity were associated with better functional outcomes.

ABSTRACT
Background: Intertrochanteric fractures of the femur are common hip fractures, particularly among elderly patients with osteoporotic bones, and are associated with substantial morbidity and mortality due to prolonged immobilization and related complications. Therefore, this study aimed to compare the functional outcomes of intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS). Methods: This comparative observational study was conducted at the Department of Orthopaedic Surgery, Uttara Adhunik Medical College, Dhaka, Bangladesh, and selected private clinics within and outside Dhaka, from July 2024 to June 2026. Forty patients were included, with 20 treated by PFNA and 20 by DHS. Functional outcomes were assessed using HHS preoperatively and at 3 and 6 months, along with operative parameters and postoperative complications. Statistical significance was set at p<0.05. Results: Among 40 patients, PFNA showed shorter operative time (78.5 vs. 92.3 min; p=0.003), lower blood loss (105.0 vs. 148.5 mL; p<0.001), and higher HHS at 3 and 6 months (78.4 vs. 72.6, p=0.04; 86.7 vs. 81.9, p=0.03) than DHS. Excellent/good outcomes were 85.0% vs. 70.0% (p=0.45), while complications were 15.0% vs. 30.0% (p=0.45), respectively. Conclusion: PFNA provided satisfactory functional outcomes with shorter operative time, lower blood loss, and higher follow-up Harris Hip Scores compared with DHS.

ABSTRACT
Introduction: Tibial plateau fractures (TPFs) are severe articular fractures of the proximal tibia that threaten knee stability and mobility. Their increasing incidence, associated with the rise in road traffic, and their functional impact justify rigorous management and particular attention to their medico-legal implications. Materials and Methods: This was a 12-month prospective descriptive study conducted from March 17, 2014, to March 16, 2015, including 18 cases of TPFs treated in the Department of Orthopaedics and Traumatology at Ignace Deen University Hospital, out of 4,215 hospital admissions. Epidemiological, clinical, therapeutic, and outcome data were collected. The Duparc and Ficat classification was used, and outcomes were assessed according to the Merle d’Aubigné and Mazas functional criteria. Results: The frequency of TPFs was 0.42% of hospital admissions. The mean age was 35.5 years (range: 11–60 years), with a male predominance (sex ratio = 5). Road traffic accidents accounted for 66.66% of cases. Unicondylar fractures were the most frequent, accounting for 72.22% of cases. Surgical treatment was performed in 72.22% of patients. Functional outcomes were very good in 66.67% of cases and good in 27.78%. Six postoperative complications were observed, representing 33.33% of surgically treated patients. The mean length of hospital stay was one to two weeks in 72.22% of cases. Conclusion: TPFs are serious articular injuries for which early surgical management can achieve good functional outcomes. When these fractures occur following road traffic accidents or occupational accidents, they require a structured medico-legal approach, including a comprehensive initial medical certificate, assessment of temporary total incapacity for work (TTIW) and permanent partial impairment (PPI), and thorough documentation of complications.