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Development of the clinical decision support system developed based on the knowledge from the best medical experts

The foot-ankle forms a specific entity from the anatomical and clinical point of view, because of its biomechanical complexity and its central role in an essential human activity: walking.
Clinicians do not have available to them the appropriate support to analyze a pathology and to assess the potential success of a given therapy. Comprehensive but insufficiently structured clinical semiology leads to wide disparities among clinicians regarding establishment of diagnoses and, even more so, the definition of the most suitable treatment.

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Unique solution

Digital Orthopedics brings a unique solution to tackle these challenges thanks to its clinical decision support software for the foot and ankle.

The software includes an anamnesis module to be completed by the patient and a clinical module of structured semiology provided by the doctor during the medical consultation.

The software makes it possible to analyze this information and then to query the knowledge base and the expert system developed by Digital Orthopaedics using rule-based reasoning (algorithms).

Organize our accumulated knowledge with algorithms

These "guidelines" will allow, among other things, cost reduction, management of supplies and stocks, and for others, optimization of their clinical decisions.
As a first step, the tools are developed to model foot and ankle pathologies. In a second step, this technological know-how is extensible to all orthopedics and beyond.

The decision support is based on a tree structure of "XML like" knowledge, introduced as a semiological sign, which is the only system that allows computer algorithms to scan medical information for:

  • Clinical decision support.
  • Information storage to analyze and learn new knowledge through machine learning.

This tree structuring, and its exploitation makes it possible to adapt or complete the knowledge base in the field of its users to adapt the decision system to its users’ requirements.

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Use of realistic and dynamic simulation to determine the best treatment

We provide to healthcare professionals and medical device companies with a disruptive technology that transforms one-type-treatment-suits-all to a personalized therapeutic approach taking into account the patient’s unique anatomy and functional entity.

In current practice for foot surgery, surgeons take an almost purely “geometrical” approach. They start with the principle that a normal person has a “normal” geometry which results in painless motion and low stresses on the foot while a patient with foot pain has a “deviated” geometry that needs to be restored to provide relief.

There are many cases where restoring the geometry does not result in improvements or even worsens the original situation. So instead of relying on the geometry-based, generic approach, the breakthrough idea is to create personalized foot models for each patient starting from imaging and then determining, through via the use of realistic simulation the best possible treatment on the simulated 3D clone of that individual. This is a truly scientific approach that will ensure better outcomes.

To address this challenge, the Digital Orthopaedics’ platform has developed a subject-specific computational model of the human foot incorporating clinical reasoning and expertise in clinical decision-making in the field of foot and ankle surgery. This platform integrates Dassault-Systèmes software and clinically oriented data management providing orthopaedic surgeons efficient, outcome-driven and patient-specific diagnostics and treatment support tools to deliver effective patient-care.

Unique personalized surgical simulation workflow

Our services offer the opportunity to create new surgical guidelines built on effective data analytics and to demonstrate the value of predictive analytics in transforming orthopaedic surgery.

From the patient-specific diagnostic suggestions, gait data and segmented foot and ankle CT-scans, an automated process allows the modeling of the specific patient's entire lower limb system: a virtual representation of the patient's pathology including all clinical signs.

The combination of a multibody and a finite element modeling approach allows a deeper understanding of the cause-effect relationships between the clinical signs and the lower limb kinematics, the foot and the ground complex interaction, the internal foot quantifications, such as joint cartilage contact pressures and tissue stress levels.

Based on a library of virtual surgical interventions developed by the company a predictive risk analysis of different potentially good surgical treatments is performed and the patient's specific optimal surgical intervention is proposed.

Virtually plan, design, perform and adjust virtually surgery

Through the Digital Orthopaedics virtual surgical solution, orthopaedic surgeons can plan, design, perform and adjust their surgery virtually until they achieve the desired clinical outcome, and before entering the operating room.

The present solution offers surgeons a tool to reduce the surgical outcome variability by directly predicting clinical outcomes in relation to their actions.

The opportunity to create new surgical guidelines

This technology offers the opportunity to create new surgical guidelines built on effective data analytics and to demonstrate the value of predictive analytics in transforming orthopaedic surgery.