ABSTRACT
INTRODUCTION: Generative Artificial Intelligence is a technology that provides greater connectivity with people through conversational bots («chatbots¼). These bots can engage in dialogue using natural language indistinguishable from humans and are a potential source of information for patients.The aim of this study is to examine the performance of these bots in solving specific issues related to orthopedic surgery and traumatology using questions from the Spanish MIR exam between 2008 and 2023. MATERIAL AND METHODS: Three «chatbot¼ models (ChatGPT, Bard and Perplexity) were analyzed by answering 114 questions from the MIR. Their accuracy was compared, the readability of their responses was evaluated, and their dependence on logical reasoning and internal and external information was examined. The type of error was also evaluated in the failures. RESULTS: ChatGPT obtained 72.81% correct answers, followed by Perplexity (67.54%) and Bard (60.53%).Bard provides the most readable and comprehensive responses. The responses demonstrated logical reasoning and the use of internal information from the question prompts. In 16 questions (14%), all 3 applications failed simultaneously. Errors were identified, including logical and information failures. CONCLUSIONS: While conversational bots can be useful in resolving medical questions, caution is advised due to the possibility of errors. Currently, they should be considered as a developing tool, and human opinion should prevail over Generative Artificial Intelligence.
ABSTRACT
Hill-Sachs lesion is a defect of the posterosuperior aspect of the humeral head that occurs during an episode of instability. Under abduction and external rotation, this lesion may engage the anterior glenoid border, thus favoring instability. It may be the cause of many failed surgical stabilization procedures. We herein describe the arthroscopic remplissage technique, which consists of filling the lesion through capsulotenodesis of the infraspinatus tendon. This maneuver should be always be performed together with anterior capsulolabral repair. The results obtained by the authors and published in the literature are good, with a loss of mobility similar to the one resulting from the isolated arthroscopic Bankart technique. We recommend performing remplissage together with Bankart repair in patients with glenohumeral instability with significant Hill-Sachs lesions without a glenoid defect or with defects less than 25%.
Subject(s)
Arthroscopy , Joint Instability/surgery , Shoulder Joint , Arthroscopy/methods , HumansSubject(s)
Humans , Male , Female , Health Programs and Plans/organization & administration , Health Programs and Plans/trends , Program Evaluation/methods , Project Formulation , Project Reports/ethics , Project Reports/methods , Research/methods , Research/organization & administration , Research/standards , Evaluation of Research Programs and Tools , Research/education , Research/trends , Hypothesis-TestingABSTRACT
Objetivo. El objetivo de este trabajo es analizar el origen de los cambios plásticos del fenotipo en una estructura biológica, en nuestro caso la cadera. Como hipótesis de trabajo se presenta la posibilidad de que los cambios se puedan interpretar según el paradigma Lamarckiano, en contraposición al paradigma Darwiniano. La sección material y método del trabajo se menciona en la parte I. Se han añadido estudios de plantas y peces. Discusión. Los resultados muestran que el diseño de la cadera, como relación de bola y cuenco, no cambia. El fenotipo, en los elementos que costituyen los tejidos de la articulación de la cadera, muestra cambios plásticos significativos. Conclusión. Sugerimos: que los cambios de la plasticidad del fenotipo de la cadera son inmanentes al fenotipo, y no se interpretan según el paradigma Lamarckiano ni Darwiniano (AU)
Objective. The aim of this work is to analyse the origin of phenotypic plastic changes into a biologic structure, in this case the hip. As a hypothesis of the work, the possibility that changes could be explained following the Lamarckian paradigm, opposed to the Darwinian paradigm, is shown. The section material and methods of this work have been published in part I. Studies in plants and fish have been added. Discussion. Results showed that the ball-and-socket design of the hip joint remains unchanged. Phenotype in the elements that form the hip joint tissues showed significant plastic changes. Conclusion. Interpretation of our results suggest that changes in phenotype plasticity of the hip joint are immanent to phenotype and cannot be explained by following Lamarck's or Darwin's paradigm (AU)
Subject(s)
Phylogeny , Hip Joint/physiology , Hip Injuries/physiopathology , Plants/genetics , Fishes/physiology , Femur/physiopathology , Pelvis/physiopathology , Phenotype , Hip/physiopathology , Chondrocytes/physiologyABSTRACT
OBJECTIVE: The aim of this work is to analyse the origin of phenotypic plastic changes into a biologic structure, in this case the hip. As a hypothesis of the work, the possibility that changes could be explained following the Lamarckian paradigm, opposed to the Darwinian paradigm, is shown. The section material and methods of this work have been published in part I. Studies in plants and fish have been added. DISCUSSION: Results showed that the ball-and-socket design of the hip joint remains unchanged. Phenotype in the elements that form the hip joint tissues showed significant plastic changes. CONCLUSION: Interpretation of our results suggest that changes in phenotype plasticity of the hip joint are immanent to phenotype and cannot be explained by following Lamarck's or Darwin's paradigm.
Subject(s)
Adaptation, Physiological , Biological Evolution , Hip Joint/physiology , Phenotype , Phylogeny , Animals , Hip Joint/anatomy & histology , HumansABSTRACT
El término "cirugía en sitio erróneo" engloba aquella cirugía que es realizada en el lado erróneo, en una zona anatómica errónea, en el paciente erróneo o en la que se realiza un procedimiento diferente al planeado. Pese a estar claramente poco comunicada, es una complicación frecuente en la vida profesional de un cirujano, siendo la cirugía ortopédica la especialidad con mayor riesgo. La repercusión mediática aumenta la desconfianza en el sistema sanitario y las consecuencias legales para el cirujano son la norma. En la actualidad hay varios protocolos, entre ellos los propuestos para evitar esta complicación por la American Academy of Orthopaedic Surgeons (AAOS) y la Joint Comission on Accreditation of Healthcare Organizations (JCAHO), de fácil aplicación. Consisten básicamente en comprobar los datos del paciente, marcar la zona que se va a operar y realizar un tiempo muerto, una comprobación final, justo antes de iniciar la cirugía. Es fundamental su implantación en los centros de España, con la colaboración de los diferentes estamentos, para una prevención efectiva de este problema(AU)
The term "wrong site surgery" refers to surgery carried out on the wrong side, in the wrong anatomical area or in the wrong patient. It can also indicate that the surgical procedure employed was not the one intended. In spite of being a rather neglected topic, wrong site surgery is a fairly usual complication in a surgeon's professional life orthopaedic surgery being the speciality most at risk. Media reports on this subject undermine the general public's distrust of the health care system, surgeons more often than not having to face serious legal consequences. There are at present several easy-to-apply protocols, among them those proposed by the American Academy of Orthopaedic Surgeons (AAOS) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which can help preventing these unfortunate occurrences. They basically consist in checking the patient's details, marking the area to be operated and performing a final run-through just before starting the surgical procedure. It is of essence to introduce such a protocol in our own hospitals, with the support of all parties involved, in order to effectively address this problem(AU)
Subject(s)
Orthopedics/legislation & jurisprudence , Orthopedics , Orthopedic Procedures/ethics , Orthopedic Procedures/methods , Medical Errors/ethics , Medical Errors/methods , Professional Misconduct/ethics , Professional Misconduct/trends , Medical Errors/legislation & jurisprudence , Medical Errors/standards , Malpractice/legislation & jurisprudence , Clinical ProtocolsABSTRACT
Se presenta un caso de compresión del nervio cubital y de la arteria humeral en una paciente de 14 años de edad debido a la existencia de una apófisis supraepitroclear del húmero. La paciente relataba episodios repetidos de parestesias en cuarto y quinto dedos de la mano izquierda que aparecían durante la actividad. Asimismo, presentaba frialdad en la mano y antebrazo, con sensación de inflamación distal desde el codo a la mano. En el estudio radiológico se observó la existencia de un proceso supraepitroclear, evidenciando en la cirugía la existencia del ligamento de Struthers. Se procedió a la resección de la apófisis y a la comprobación de la indemnidad de las estructuras neurovasculares. A los 6 meses de la operación la paciente está asintomática, sin signos de recidiva. Se presenta este caso dada la infrecuente aparición de esta patología con afectación neurovascular (AU)
