Locally developed 'smart medicine' assists orthopedic doctors

Cai Wenjun
Doctors at Shanghai Sixth People's Hospital and tech wizards have created "smart medicine," a technology that has revolutionized the way doctors carry out hip and bone surgeries.
Cai Wenjun

Editor's note:

Smart medicine is the future of medicine. Information technology, artificial intelligence, and big data are becoming increasingly important in health care, which is becoming more human-centered and convenient. This series, which covers various aspects of the health field, is intended to demonstrate what high technology, smart systems, and inventions are capable of.

Shot by Jiang Xiaowei. Edited by Sun Chao.

Medicine is both a science and an art of healing. It denotes a surgical cut, suture and closure. Practice makes perfect.

Before becoming an accomplished surgeon, a rookie may need dozens, or probably even hundreds, of practices. A novice surgeon typically develops into an experienced one after five to 10 years of consistent practice.

But "smart medicine," which employs cutting-edge technologies to assist and guide doctors, is making surgery more precise, efficient and practical. Young surgeons are given the opportunity to do complex operations much more quickly and effectively.

"The future of medicine is smart," said Dr Zhang Changqing, head of the Shanghai Orthopedic Trauma Center and vice president of Shanghai Sixth People's Hospital. "In diagnosis, treatment and rehabilitation, digital technology and intelligent equipment are frequently being utilized."

"In orthopedics, robot-assisted surgery and surgical navigation make up the majority of smart medicine," Zhang said.

"Surgery typically depends on the doctor's judgment and experience. The finest aid for doctors now, however, is 3D imaging, computer calculation, and navigation. Orthopedic surgery is undergoing significant change thanks to smart medicine."

Locally developed 'smart medicine' assists orthopedic doctors
Jiang Xiaowei / SHINE

The digital navigation system developed for patients with dysplastic hips.

Intelligent medicine can spare patients who must undergo osteotomy for dysplastic hips from being exposed to dozens or even hundreds of X-rays to confirm and correct the angle and position of surgical sectioning.

Patients with dysplastic hips have an improperly positioned hip joint within the spherical acetabulum, which leads to frequent injuries while they walk. These people often have to undergo a repositioning procedure between the ages of 10 and 30. If not, they will need a replacement hip joint when the joint is entirely destroyed.

Locally developed 'smart medicine' assists orthopedic doctors
Jiang Xiaowei / SHINE

Dr Zhang Changqing (center) during a hip joint surgery

However, due to the deep operative location and the fact that some parts of the bone cannot be immediately viewed during the procedure, dysplastic hip surgery is one of the most challenging orthopedic procedures.

In order to ensure that the joint's mobility doesn't result in any harm, surgeons must remove specific portions of the acetabulum and reinstall the joint in the correct location.

"Due to the anatomical structure, a portion of the acetabulum is sliced on its backside, where the surgeons are unable to examine the area immediately. Therefore, we must rely on our experience and use an X-ray to confirm the cut angle and depth from time to time. During the procedure, patients are typically exposed to significant radiation," Zhang said.

"To get sufficient experience, a young physician should do at least 100 of these procedures. However, even for a skilled surgeon like myself, there is a 10 to 20 percent chance that the position of sectioning is not ideal. So we turned to smart medicine."

Zhang's team collaborated with regional industrial and computer experts to create a navigation system that digitalizes all patient information and data prior to surgery using a CT scan and inputs it into a computer system. The osteotome and hip joint each have their own installation of a signal-sending and receiving device.

Locally developed 'smart medicine' assists orthopedic doctors
Jiang Xiaowei / SHINE

The newly developed navigation system can guide and assist doctors during dysplastic hip surgery.

Dr Zhu Zhenzhong from the orthopedics department, who was involved in the development of the new system, said during surgery, doctors could see all the information on the screen along with the movement of the osteotome.

"The computer can guide and assist the surgeon to perform the cut at the right place and at the right depth without any mistakes."

"The method enables surgeons to do the procedure with considerably more accuracy, less trauma and shorter recovery time. No X-rays are needed for repeated confirmation and checks. Radiation can be avoided during surgery for patients and medical personnel."

He said that a clinical trial application has been made for the system, which has a full patent.

"While dysplastic hip surgery is the most challenging, the device can also be utilized for other orthopedic procedures that need digital navigation," he said.

Locally developed 'smart medicine' assists orthopedic doctors
Jiang Xiaowei / SHINE

Dr Zhu Zhenzhong, who was involved in the development of smart medicine, explains how it helps surgeons during surgery.

Innovation has played a significant role in medical practice. All smart medicine is a direct result of clinical demand and experience in treating clinical issues.

Dr Zhang Changqing said that "smart medicine is a supporting tool, not the purpose."

"By using a surgical robot as an assistant, surgeons can perform operations with more precision. The surgeon is still in charge of overseeing and managing the entire procedure. The surgical arm of a robot is more steady and can access angles that a human cannot. So we are fully utilizing their benefits to improve the operation."

His colleagues, along with experts, have created a knife to slice bone tissue samples into 2 and 50 micrometers for pathological testing. The price is much lower than that of an imported knife, and the quality of the sample is better.

"We have received multiple patents on the technology, which can be used on other hard tissues like bone and create better research conditions for departments like orthopedics, stomatology and hematology," he said.

Locally developed 'smart medicine' assists orthopedic doctors
Jiang Xiaowei / SHINE

A lab technician at Shanghai Sixth People's Hospital uses a self-developed knife to cut bone tissue as thin as 2 micrometers.

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