In few months back, Director Zhong of the First People’s Hospital of Huizhou City led the team to complete the “First AIKNESS + PSI Full Process Customized Total Replacement Surgery in Guangdong Province”.
Based on the characteristic of the patient’s disease and the result of AIKNEE medical imaging 3D reconstruction, Director Zhong will conduct a comprehensive assessment of the patient before the start of surgery, and use the 3D printing technology to customize the Patient Specific Instrumentation (PSI) for the patient. The Director hopes the combination application of AIKNEE + PSI will be able to benefit more patient and allow total knee replacement surgery to enter a new era of precision, individualization, and intelligence.
Director Zhong Haobo mention that the application of AIKNEE + PSI has the following important meanings:
- AIKNEE uses deep learning technology to carry out three-dimensional preoperative planning, individualized measurement of femoral posterior condyle angle, and tibial plateau posterior inclination angle. And accurately plans the size, placement, and angle of the prosthesis.
- Through the use of 3D printing technology printing PSI guide plate, the femoral side extramedullary positioning can not only accurately cut the bone nut also reduce the amount of intraoperative blood loss.
- Perform precise osteotomy on the tibial side according to the planned posterior angle.
- Compared with surgical robots, the PSI guide has a shorter learning curve, lower surgical threshold, lower overall cost, and higher social and economic benefits.
In this operation, the orthopedic artificial intelligence solution provided by Beijing Chang Mu Gu Medical Technology Co. Ltd. was used and the lesion model and guide plate were made using the MAGIC-HT-PRO printer.
Female, 71 years old, had no obvious cause of right knee pain 10 years ago. She could tolerate it at that time, and it was aggravated when walking, rest a while the pain will relieve; but she did not diagnose and treat it. In the past 10 years, this symptom repeated episodes and had visited the hospital for many times, tried out various conservative treatment such as acupuncture, physical therapy and etcetera. However, it did not improve significantly but the pain increased significantly, and it was heavier when walking, which seriously affected her daily life.
Preoperative X-ray of the patient (1）
Preoperative X-ray of the patient (2)
Based on the patient’s preoperative data, AIKNEE artificial intelligence-assisted three-dimensional reconstruction of the medical image of the knee replacement surgery is performed on the patient, and the doctor performs a comprehensive evaluation of the patient before the operation. As shown in the figure below:
Patient’s external rotation angle: 3.1°,
Backward angle: 3°
Included angle between the femoral mechanical axis and the anatomical axis: 5.1°
Included angle between the femoral mechanical axis and the tibial mechanical axis: 190.6°
In the three-dimensional reconstructed anatomical model, AI is used to identify the anatomical site, and according to the anatomical shape of the femur and tibia, the model of the intelligent designed PSI guide plate, the model of the prosthesis and the placement position; we can know that: The most suitable femoral prosthesis model for the patient is: ATTUNE-PS (4N), the platform gasket prosthesis model is: ATTUNE-PS-FB (4), and the tibial platform prosthesis model is: ATTUNE-FB (2). After serval times of communication with the Nagaki Valley team, it was finally determined that the femoral side guide plate increased the hollow space to avoid cartilage and adjusted the range of the sickle groove. Increase the support point inside the tibial tubercle on the tibial side and increase the hollow area for observing the fit.
After the planning, the lesion model and surgical guide will be made by IEMAI 3D printer MAGIC-HT-PRO.
With the assist of AIKNEE and PSI guides, the patient’s most suitable femoral side, platform gasket, and tibial platform prosthesis models are prepared before the operation.
Since the individual factors of the patient have been comprehensively considered before the operation, the surgical plan is personalized, and the operation is navigated with the aid of the system, the more difficult parts of the operation are completed by the guide system, and the operation is carried out smoothly and orderly. With the assistance of the customized knee surgery guide system, the amount of intraoperative blood loss is greatly reduced, and the operation is completed successfully.
After the operation, the patient’s line of force recovered. On the second day, compared with the patients who did not use the guide plate, the knee flexion and extension recovery were faster and better. The patient’s re-examination felt very good and very satisfied.
Team of Director Zhong
Director of Orthopedics Department, Huizhou First People’s Hospital
Chairman of the Joint Surgery Branch of Huizhou Medical Association
Member of Lower Extremity Committee of Sports Medicine Committee of Chinese Medical Association
Member of LATARJET National Shoulder Dislocation
Member of the Asia Pacific Knee-Arthroscope-Sport Medicine Society (APKASS)
Member of Joint Surgery Branch of Guangdong Medical Association
↓↓Introduction of Beijing Chang Mu Gu Medical Technology Co., Ltd.↓↓
Beijing Changmugu Medical Technology Co. Ltd. is a national high-tech enterprise focusing on orthopedic artificial intelligence solutions. It provides artificial intelligence-assisted diagnosis, individualized surgical planning, surgical navigation, post-operative evaluation and other full-process solutions for hospital orthopedics. The company has R&D teams with world-class backgrounds such as Harvard University, Stanford University, Tsinghua University, Peking University, Nankai University, etc. Changmugu is frequently favored by top domestic venture capitalists and has completed four rounds of financing (round A+). Investors include Lenovo Ventures, Zhongguancun Development Group, Lenovo Star, Fortune Capital, Wanhui Capital, and Ether Capital. Changmugu is committed to building China’s intelligent, world-leading orthopedic artificial intelligence and surgical navigation products, which will benefit many Chinese patients and make the world have no difficult operations.
↓↓Brand Introduction of IEMAI 3D↓↓
Imai Intelligent Technology Co. Ltd. is a high-tech enterprise in China focusing on 3D printing R&D and production. Its brand IEMAI 3D is a global industrial grade 3D printer brand, committed to provide users with the “All in one” 3D printing solution of multi material compatible issue. IEMAI 3D supports most of the thermoplastic materials in the 3D printing markets and assist the user to resolve the issue encounter during manufacturing, and all 3D printers and materials have achieved CE and ROHS certification. We attach great importance to brand building and have obtained trademarks certificates from China, United Sates and the European Union. We pursue core technology research and development, and have obtained software copyrights, invention patents, utility model patents, appearance design patents, and the title of national high-tech enterprise. At present, our 3D printing solutions have been applied to aerospace, automotive, petrochemical, medical, dental and electronics manufacturing.