Accelerating precision orthopaedic surgery using automated imaging and linked clinical data

A new NIHR Bristol Biomedical Research Centre (BRC) research project to improve surgical planning and precision using automated image analysis plans to use the South West Secure Data Environment (SDE) to link clinical imaging with electronic patient records.

The project is led by Mr Simon Abram. Linking imaging with records will enable development of innovative tools to help surgeons better understand how procedures will affect individual patients.

Orthopaedic operations such as knee and hip replacements, osteotomy and ligament reconstruction all have the potential to alter the way a joint moves. However, current methods make it difficult to predict how well a patient’s joint biomechanics will respond to surgery. This can lead to procedures that technically succeed but fail to deliver the optimal outcome for the patient’s functional needs.

The new project will bring together routinely collected imaging – including X‑rays, MRI and CT scans – with relevant clinical information from patient records. Researchers will use these linked datasets to train and refine machine‑learning models capable of automatically identifying anatomical landmarks, segmenting bones and joints. This will generate detailed 3D, and eventually 4D, representations of joint movement.

These “computer vision” tools have already shown promise in earlier pilots using publicly available datasets. However, scaling them for real clinical use requires access to much larger, high‑quality NHS datasets. The South West SDE provides the secure environment needed to build and test the data pipelines, linkage processes and algorithms underpinning this work.

This project is a crucial step towards automating parts of orthopaedic surgical planning that are currently highly manual and time‑consuming. In future, such technology could support personalised surgical decisions, improve implant positioning, reduce complications, and ultimately improve patient outcomes.

Simon Abram, Consultant Specialist Knee Surgeon and Senior Lecturer at University of Bristol, said:

“By enabling sophisticated analysis of linked imaging and clinical data, we hope to accelerate the adoption of advanced surgical planning tools into routine NHS practice. This will mean patients receive procedures tailored not just to their condition, but to their individual anatomy and biomechanics.”