artificial intelligence; digital twin; musculoskeletal; orthopaedic surgery; personalised medicine; rehabilitation; Humans; Wearable Electronic Devices; Artificial Intelligence; Machine Learning; Musculoskeletal Diseases; Computer Simulation; Surgery; Orthopedics and Sports Medicine
Abstract :
[en] Digital twin (DT) systems, which involve creating virtual replicas of physical objects or systems, have the potential to transform healthcare by offering personalised and predictive models that grant deeper insight into a patient's condition. This review explores current concepts in DT systems for musculoskeletal (MSK) applications through an overview of the key components, technologies, clinical uses, challenges, and future directions that define this rapidly growing field. DT systems leverage computational models such as multibody dynamics and finite element analysis to simulate the mechanical behaviour of MSK structures, while integration with wearable technologies allows real-time monitoring and feedback, facilitating preventive measures, and adaptive care strategies. Early applications of DT systems to MSK include optimising the monitoring of exercise and rehabilitation, analysing joint mechanics for personalised surgical techniques, and predicting post-operative outcomes. While still under development, these advancements promise to revolutionise MSK care by improving surgical planning, reducing complications, and personalising patient rehabilitation strategies. Integrating advanced machine learning algorithms can enhance the predictive abilities of DTs and provide a better understanding of disease processes through explainable artificial intelligence (AI). Despite their potential, DT systems face significant challenges. These include integrating multi-modal data, modelling ageing and damage, efficiently using computational resources and developing clinically accurate and impactful models. Addressing these challenges will require multidisciplinary collaboration. Furthermore, guaranteeing patient privacy and protection against bias is extremely important, as is navigating regulatory requirements for clinical adoption. DT systems present a significant opportunity to improve patient care, made possible by recent technological advancements in several fields, including wearable sensors, computational modelling of biological structures, and AI. As these technologies continue to mature and their integration is streamlined, DT systems may fast-track medical innovation, ushering in a new era of rapid improvement of treatment outcomes and broadening the scope of preventive medicine. Level of Evidence: Level V.
Disciplines :
Physical, chemical, mathematical & earth Sciences: Multidisciplinary, general & others
Author, co-author :
Diniz, Pedro ; Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg - Clinique d'Eich, Luxembourg, Luxembourg ; Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg ; Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg ; Department of Bioengineering, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
GRIMM, Bernd ; University of Luxembourg ; Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
Garcia, Frederic; Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
Fayad, Jennifer; Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg ; Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
LEY, Christophe ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Mathematics (DMATH)
Mouton, Caroline; Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg - Clinique d'Eich, Luxembourg, Luxembourg ; Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg
Oeding, Jacob F; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Hirschmann, Michael T; Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland, Bruderholz, Switzerland
Samuelsson, Kristian; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Seil, Romain; Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg - Clinique d'Eich, Luxembourg, Luxembourg ; Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg ; Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
External co-authors :
yes
Language :
English
Title :
Digital twin systems for musculoskeletal applications: A current concepts review.
The authors thank Camille Wojtylka and Arik Musagara from the LIROMS Human Motion Lab, Luxembourg, for their assistance in providing the running analysis images.
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