With the growing complexity of total hip arthroplasty (THA) for high hip dislocation (HHD), artificial intelligence (AI)-assisted three-dimensional (3D) preoperative planning has emerged as a promising tool to enhance surgical accuracy. This study compared clinical outcomes of AI-assisted 3D versus conventional two-dimensional (2D) X-ray preoperative planning in such cases. A retrospective cohort of 92 patients with Crowe type II–IV HHD who underwent THA between May 2020 and January 2023 was analyzed. Patients received either AI-assisted 3D preoperative planning (n = 49) or 2D X-ray preoperative planning (n = 43). The primary outcome was the accuracy of implant size prediction. Secondary outcomes included operative time, blood loss, leg length discrepancy (LLD), implant positioning, functional scores (Harris Hip Score HHS, WOMAC, VAS), complications, and implant survival at 24 months. At 24 months, both groups demonstrated significant improvements in functional outcomes. Compared to the 2D X-ray group, the AI-3D group showed higher accuracy in implant size prediction (acetabular cup: 59.18% vs. 30.23%; femoral stem: 65.31% vs. 41.86%; both p 0.05). Implant survivorship was also comparable (100% vs. 97.7%; p = 0.283), with one revision noted in the 2D X-ray group. AI-assisted 3D preoperative planning improves prosthesis selection accuracy, implant positioning, and perioperative outcomes in Crowe type II–IV HHD THA, although 2-year functional and survival outcomes were comparable to 2D X-ray preoperative planning. Considering the higher cost, radiation exposure, and workflow complexity, its broader application warrants further investigation, particularly in identifying patients who may benefit most.
Lu et al. (2025) studied this question.