A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/Repair
Category: Basic Sciences/Biologics; Other Introduction/Purpose: The use of biologic adjuvants (orthobiologics) is becoming commonplace in orthopaedic surgery. Amongst other applications, biologics are often added to enhance fusion rates in spinal surgery and to promote bone healing in complex fractu...
| Váldodahkkit: | , , |
|---|---|
| Materiálatiipa: | Artihkal |
| Giella: | English |
| Almmustuhtton: |
SAGE Publishing
2023-12-01
|
| Ráidu: | Foot & Ankle Orthopaedics |
| Liŋkkat: | https://doi.org/10.1177/2473011423S00118 |
| _version_ | 1827400395496882176 |
|---|---|
| author | Albert T. Anastasio MD Bailey S. Zinger BS Thomas J. Anastasio PhD |
| author_facet | Albert T. Anastasio MD Bailey S. Zinger BS Thomas J. Anastasio PhD |
| author_sort | Albert T. Anastasio MD |
| collection | DOAJ |
| description | Category: Basic Sciences/Biologics; Other Introduction/Purpose: The use of biologic adjuvants (orthobiologics) is becoming commonplace in orthopaedic surgery. Amongst other applications, biologics are often added to enhance fusion rates in spinal surgery and to promote bone healing in complex fracture patterns. Generally, orthopaedic surgeons use only one biomolecular agent (ie allograft with embedded bone morphogenic protein-2) rather than several agents acting in concert. Bone fusion, however, is a highly multifactorial process and it likely could be more effectively enhanced using biologic factors in combination, acting synergistically. We used artificial neural networks to identify combinations of orthobiologic factors that potentially would be more effective than single agents. Methods: Available data on the outcomes associated with various orthopaedic biologic agents, electrical stimulation, and pulsed ultrasound were curated from the literature and assembled into a form suitable for machine learning. The best among many different types of neural networks was chosen for its ability to generalize over this dataset, and that network was used to make predictions concerning the expected efficacy of 2400 medically feasible combinations of 9 different agents and treatments. Results: The most effective combinations were high in the bone-morphogenic proteins (BMP) 2 and 7 (BMP2, 15mg; BMP7, 5mg), and in osteogenin (150ug). Some of the most effective combinations included bone marrow aspirate concentrate. In some others, electrical stimulation could substitute for osteogenin. BMP2 and BMP7 appear to have the strongest pairwise linkage of the factors analyzed in this study. Conclusion: Artificial neural networks are powerful forms of artificial intelligence that can be applied readily in the orthopeadic domain, but neural network predictions improve along with the amount of data available to train them. This study provides a starting point from which networks trained on future, expanded datasets can be developed. Yet even this initial model makes specific predictions concerning potentially effective combinatorial therapeutics that should be verified experimentally. Furthermore, our analysis provides an avenue for further research into the basic science of bone healing by demonstrating agents that appear to be linked in function. |
| first_indexed | 2024-03-08T20:02:27Z |
| format | Article |
| id | doaj.art-d30153623f084de0b7a88db817775502 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-03-08T20:02:27Z |
| publishDate | 2023-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-d30153623f084de0b7a88db8177755022023-12-23T16:05:20ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142023-12-01810.1177/2473011423S00118A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/RepairAlbert T. Anastasio MDBailey S. Zinger BSThomas J. Anastasio PhDCategory: Basic Sciences/Biologics; Other Introduction/Purpose: The use of biologic adjuvants (orthobiologics) is becoming commonplace in orthopaedic surgery. Amongst other applications, biologics are often added to enhance fusion rates in spinal surgery and to promote bone healing in complex fracture patterns. Generally, orthopaedic surgeons use only one biomolecular agent (ie allograft with embedded bone morphogenic protein-2) rather than several agents acting in concert. Bone fusion, however, is a highly multifactorial process and it likely could be more effectively enhanced using biologic factors in combination, acting synergistically. We used artificial neural networks to identify combinations of orthobiologic factors that potentially would be more effective than single agents. Methods: Available data on the outcomes associated with various orthopaedic biologic agents, electrical stimulation, and pulsed ultrasound were curated from the literature and assembled into a form suitable for machine learning. The best among many different types of neural networks was chosen for its ability to generalize over this dataset, and that network was used to make predictions concerning the expected efficacy of 2400 medically feasible combinations of 9 different agents and treatments. Results: The most effective combinations were high in the bone-morphogenic proteins (BMP) 2 and 7 (BMP2, 15mg; BMP7, 5mg), and in osteogenin (150ug). Some of the most effective combinations included bone marrow aspirate concentrate. In some others, electrical stimulation could substitute for osteogenin. BMP2 and BMP7 appear to have the strongest pairwise linkage of the factors analyzed in this study. Conclusion: Artificial neural networks are powerful forms of artificial intelligence that can be applied readily in the orthopeadic domain, but neural network predictions improve along with the amount of data available to train them. This study provides a starting point from which networks trained on future, expanded datasets can be developed. Yet even this initial model makes specific predictions concerning potentially effective combinatorial therapeutics that should be verified experimentally. Furthermore, our analysis provides an avenue for further research into the basic science of bone healing by demonstrating agents that appear to be linked in function.https://doi.org/10.1177/2473011423S00118 |
| spellingShingle | Albert T. Anastasio MD Bailey S. Zinger BS Thomas J. Anastasio PhD A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/Repair Foot & Ankle Orthopaedics |
| title | A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/Repair |
| title_full | A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/Repair |
| title_fullStr | A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/Repair |
| title_full_unstemmed | A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/Repair |
| title_short | A Novel Application of Neural Networks to Identify Potentially Effective Combinations of Biologic Factors for Enhancement of Bone Fusion/Repair |
| title_sort | novel application of neural networks to identify potentially effective combinations of biologic factors for enhancement of bone fusion repair |
| url | https://doi.org/10.1177/2473011423S00118 |
| work_keys_str_mv | AT alberttanastasiomd anovelapplicationofneuralnetworkstoidentifypotentiallyeffectivecombinationsofbiologicfactorsforenhancementofbonefusionrepair AT baileyszingerbs anovelapplicationofneuralnetworkstoidentifypotentiallyeffectivecombinationsofbiologicfactorsforenhancementofbonefusionrepair AT thomasjanastasiophd anovelapplicationofneuralnetworkstoidentifypotentiallyeffectivecombinationsofbiologicfactorsforenhancementofbonefusionrepair AT alberttanastasiomd novelapplicationofneuralnetworkstoidentifypotentiallyeffectivecombinationsofbiologicfactorsforenhancementofbonefusionrepair AT baileyszingerbs novelapplicationofneuralnetworkstoidentifypotentiallyeffectivecombinationsofbiologicfactorsforenhancementofbonefusionrepair AT thomasjanastasiophd novelapplicationofneuralnetworkstoidentifypotentiallyeffectivecombinationsofbiologicfactorsforenhancementofbonefusionrepair |