Digital innovations are taking medical interventions to new levels of precision and personalisation, but all new ideas do not provide real added value. We spoke to Luxembourg-born, internationally renowned orthopaedic surgeon and scientist Romain Seil about his work to develop and implement new digital tools in clinical practice while ensuring that patient needs remain at the very centre.
Digitalisation impacts virtually all aspects of medical practice. “It includes everything from patient information and remote consultations to the use of digital technologies such as augmented reality and robotics,” comments Romain Seil, who heads the Division of Neurosciences and Musculoskeletal Diseases at the Centre Hospitalier Luxembourg (CHL), Luxembourg’s first academic teaching hospital.
A specialist of knee surgery and sports traumatology and renowned for doing arthroscopic surgery at a very high clinical and scientific level, Professor Seil has been confronted with digitalisation for many years and remains passionate about pushing the boundaries further. “Today, I use augmented reality when doing knee arthroplasty surgery. I’m still evaluating the tool, but I can already see that it allows me to do less invasive operations but with a higher degree of precision and personalisation.”
In medical education, surgical simulation can be very useful to fill the gap between theoretical teaching and practice on actual patients.
In the context of an EU-funded project, he has also been working with Swiss company VirtaMed on the development of a simulator for arthroscopic surgery, in particular for meniscal repairs. “In medical education, surgical simulation can be very useful to fill the gap between theoretical teaching and practice on actual patients. It also helps doctors become proficient on very specific and difficult types of surgery.”
Professor Seil also talks about how new and more sophisticated diagnostic techniques are made feasible with tools such as Luxembourg’s brand new cone beam CT scan, which makes it possible to do imaging of the lower extremities with the patient in a standing position. “With the help of artificial intelligence, we will also be able to predict the course of arthritis in knees based on simple radiographs,” he predicts.
No digital tool can replace listening to and observing the patients and doing clinical examinations.
However, he still urges some caution. “You need to have a very open but critical mind when dealing with these types of new technologies: every innovation does not mean progress, and the theoretical advantages do not always translate into reality. The usefulness of each solution, and the surgeons’ level of acceptance, need to be confirmed in clinical practice. We also have to be very careful about keeping the patient at the centre of what we do. No digital tool can replace listening to and observing the patients and doing clinical examinations.”
Patient data analysis is another field that is strongly supported by digitalisation. In 2010, Professor Seil and some of his colleagues at the CHL initiated the creation of a quite unique database that today includes data on over 3,000 severely knee-injured patients. It provides valuable insights into the types of injuries treated as well as treatment evolution and outcome and has provided input to a number of scientific articles.
In order to digitally capture motion data, the Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS) has set up a gait laboratory together with the Luxembourg Institute of Health, the CHL and a grant from the national Losch Foundation. At the end of 2022, Luxembourg inaugurated the SportFabrik in Differdange: a biomechanical movement laboratory using top-range equipment to capture data in order to better understand sports movements and prevent injuries. “Our aim is to generate knowledge that can then be implemented into daily clinical practice and improve patient care. SportFabrik helps us build solid medical data.”
Our footprint in this field definitely exceeds the physical size of our country.
Over the past few years, Luxembourg’s reputation in the field of arthroscopy and sports traumatology has been confirmed in several major medical congresses in the Grand Duchy. The country also hosts the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), which is one of the world’s three key players in the field. “Our footprint in this field definitely exceeds the physical size of our country,” Professor Seil points out.
Photos: © Luxinnovation/Michel Brumat