Recent Progress and Clinical Translation of Digital Medicine and 3D Printing Technology in Orthopedic Surgery

【Abstract】

OBJECTIVE: Discussing the latest progress and clinical translation of digital medicine and 3D printing technology in orthopedic surgery systematically based on the perspective of translational medicine. 

Methods: Introducing and prospecting the application of fast-developing digital medicine and 3D printing technology in the treatment of orthopaedic diseases and Digital Medicine Engineering Center of Shanghai Jiaotong University, the Department of Orthopaedics of the Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine. 

RESULT: The application of 3D printing digital endoprosthesis, joints, and personalized percutaneous guides in joint surgery achieves personalized precision in joint surgery. 3D printing titanium pelvic prosthesis met the biomechanical requirements, and provided biomechanical basis for the clinical application of 3D printing orthopedic endoprosthesis. Furthermore, the construction of artificial intelligence modeling and analysis technology of data from Chinese and the basic template library of experts relying on the the National Key R&D Program of China from the Ministry of Science and Technology: 1) automatic identification and segmentation of human geometric anatomical features based on neural network algorithms, 2) automatic extraction of human anatomical and mechanical features based on the quantitative CT technology and knowledge extraction algorithms; Establishing personalized and rapid design methods of 3D-printed medical devices based on the smart matching of deformation models and mechanical simulation technology: realizing the automated shape design of customized medical devices and rapid mechanical simulation calculations through the deformation matching of models, including the matching of shape and material properties; developing optimization technology based on digital twin and data mining-driven production intelligent: 1) building the "customization-design-simulation-production-delivery" all-in-one digital twin system 2) realizing intelligent optimization and dynamic collaboration under multi-task and multi-objective constraints; 3) developing a cloud-based virtual computing engine based on BaaS architecture and 4) improving multi-party safe data access and traceability strategy based on block chain technology. In addition, 3D printing plays a crucial role in bio-organoid, tumor drug screening, bio-printing, in vivo bio-fabrication, electronic prosthetics, orthotics, and external fixation supports. 

CONCLUSION: The clinical translation of digital medicine and 3D printing in the field of bone and joint surgery has entered a critical stage, which requires the integration and promotion of the whole industrial chain, including industry, academia, research, management and utilization.

KEYWORDS: Digital Medicine, 3D printing, Joint, Bio-printing, Rehabilitation Aids, bio-organoid, Tumor Drug Screening, Clinical Translation

【Bio】

Professor Wang Jinwu, MD, Chief Physician at the Ninth People's Hospital affiliated with the Shanghai Jiao Tong University School of Medicine. He is also a Professor at the School of Medicine of Shanghai Jiao Tong University, a part-time researcher at the School of Biomedical Engineering, Shanghai Jiao Tong University, and a doctoral and postdoctoral supervisor. He is an International Foreign Member of the Russian Academy of Sciences, and serves as the Chief Scientist for two national key research and development programs under the 13th and 14th Five-Year Plans of the Ministry of Science and Technology, as well as the Chief Scientist at the Translational Medicine Research Institute of Shanghai Jiao Tong University. He is also the fifth "Outstanding Achievement" People's Physician. Additionally, he serves as the Director of the Translational Medicine National Major Science and Technology Infrastructure (Shanghai), Director of the Innovative Medical Device Registration Research and Clinical Transformation Service Center, and Director of the Digital Medicine and Biological 3D Printing Laboratory. Furthermore, he is the Deputy Director of the Digital Medicine Clinical Transformation Engineering Research Center of the Ministry of Education, the Deputy Director of the Key Laboratory of Intelligent Control and Rehabilitation Technology of the Ministry of Civil Affairs, and the Deputy Director of the Digital Orthopedic Trauma and Joint Committee of the Chinese
Medical Association. He is an evaluation expert for the National Medical Products Administration (NMPA), an outstanding technical leader in Shanghai, and leads the key discipline of Bone and Joint Rehabilitation Medicine at the Shanghai Health Commission. He is also a leading figure in clinical rehabilitation medicine in Shanghai and the Chairman of the Shanghai Rehabilitation Engineering Society. Additionally, he serves as the Vice Chairman and Secretary-General of the Shanghai Rehabilitation Appliance and Elderly Welfare Industry Technology Innovation Strategic Alliance, the Deputy Director of the Digital Orthopedics Committee of the Chinese Medical Engineering Society, the Deputy Director of the Sports Medicine Professional Committee of the Chinese Research Hospital Association, the Deputy Director of the Biomaterials Advanced Manufacturing Branch of the Chinese Society for Biomaterials, and the Deputy Director of the 3D Printing Technology Branch of the Chinese Medical Biotechnology Association.
Professor Wang has long been committed to orthopedic surgery, digital medicine, biological 3D printing, and orthopedic rehabilitation. His biological 3D printing project has been featured in a special report by "Nature" magazine. He has undertaken nine national-level projects, including the 13th Five Year Plan Key Research and Development Program (Biological 3D Printing) and the 14th Five-Year Plan Key Research and Development Program (Digital Medicine and Micronano Biomaterials), as well as sub-projects of the Ministry of Science and Technology's "863" and "973" Programs. He has obtained the first medical device registration certificate issued by a research-oriented enterprise under the registered person system in China and led the formulation of multiple industry standards. His project "3D Printing Luna Bone" is one of the smallest joints in the human body to be 3D printed, and
this achievement has been patented and clinically applied. He has co-authored 15 monographs, edited or co-edited eight monographs, and translated or co-translated one monograph. As the first author or corresponding author, he has published more than 80 high-impact factor papers, including those in journals under the "Nature" and "Science" umbrellas. He has established a graduate course on cutting-edge medical engineering cross transformation research in digital medicine and 3D printing at Shanghai Jiao Tong University.
Professor Wang won the first prize for technological invention in Shanghai in 2022 with the project "Key Technologies and Equipment Development for the Digital Diagnosis and Treatment of Limb Bone and Joint Arthritis." He has also received first prizes for medical science and technology in Shanghai, first prizes for rehabilitation medicine science and technology in Shanghai, and first prizes for medical science and technology progress in China, as well as the Jiangsu Medical Science and Technology Award and the Jilin Provincial Science and Technology First Prize.