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Scientists and health professional are focusing on improving the medical sciences for the betterment of patients. The fourth industrial revolution, which is commonly known as Industry 4.0, is a significant advancement in the field of engineering. Industry 4.0 is opening a new opportunity for digital manufacturing with greater flexibility and operational performance. This development is also going to have a positive impact in the field of orthopaedics. The purpose of this paper is to present various advancements in orthopaedics by the implementation of Industry 4.0. To undertake this study, we have studied the available literature extensively on Industry 4.0, technologies of Industry 4.0 and their role in orthopaedics. Paper briefly explains about Industry 4.0, identifies and discusses the major technologies of Industry 4.0, which will support development in orthopaedics. Finally, from the available literature, the paper identifies twelve significant advancements of Industry 4.0 in orthopaedics. Industry 4.0 uses various types of digital manufacturing and information technologies to create orthopaedics implants, patient-specific tools, devices and innovative way of treatment. This revolution is to be useful to perform better spinal surgery, knee and hip replacement, and invasive surgeries.
Industry 4.0 is to provide intelligent orthopaedics with a combination of various advanced technologies. This industrial revolution easily handles the emergency and the proper management of healthcare service. It is applicable for social care service and integrated health. The advanced manufacturing and information technologies used in this revolution play an essential role in decision making during complex surgery. It makes innovative advancements in orthopaedics for better treatment and clinical outcomes. Industry 4.0 creates digitisation in the manufacturing process to meet customised demand. It enables digital support to orthopaedics doctors and surgeon by sharing the information and patient data.
In this revolution, the Internet of Things (IoT) enabled smart manufacturing helps provide significant development for the manufacturing of orthopaedics implants, tools and devices. It also helps for quality control in the ongoing manufacturing of medical or other products. It will create a smart healthcare industry to change the way of treatment and surgery.
Industry 4.0 uses additive manufacturing as an essential component for the manufacturing of customised orthopaedics implants and tools. It helps the surgeon to perform pre-surgical planning and practice before the actual surgery. 3D digital images are used in this technology helps to improve implant positioning precisely. These technologies provide a new shape to the orthopaedics field with the innovative treatment and surgical procedure.
Industry 4.0 improves the efficiency and quality in orthopaedics practice. It has a better ability to share the ideas and enhancement of creativity and brings together various software, sensors, smart machines and network connectivity to achieve a better result. Sensors are used to gain patient information and capable of checking blood pressure, sugar, glucose level and other related diseases. It correctly updates the orthopaedics devices as per the requirement of new diseases. The research and development is easily carryout by the predefined requirement.
With the help of digital technologies, it creates automation in orthopaedics for quality practices and solutions.
2. What is industry 4.0?
The concept of Industry 4.0 was first introduced in 2011 to enhance the competitiveness and efficiency in manufacturing industries. There is better connectivity in the system using different sensors, Internet of Things, Artificial Intelligence (AI) and other innovative technologies. In production lines, these technologies are used to provide appropriate information and decision during the complexity. This revolution enhances the smart factory and smart manufacturing system to manufacture any customised products.
Industry 4.0 creates interconnected advanced manufacturing and information system which can adequately communicate, analyse and provide useful information in the physical world. Previously three industrial revolutions have happened so far; these include Industry 1.0, Industry 2.0 and Industry 3.0. Fig. 1 shows the evolution of Industrial revolutions.
With the invention of the steam engine, Industry 1.0 introduced basic machines in the seventeen century. These machines helped human to use the manufacturing process. Industry 2.0 was introduced in the eighteenth century and provided a technological revolution with the introductions of mass production systems. Here electricity powered the machines, both basic and special purposes machines. Industry 3.0 occurred in nineteen century, which provided an automatic and digital revolution in the different fields. There was advance development in information and communication system. Now, Industry 4.0 has started, and we understand that this revolution will completely restructure the production and information processes to fulfil the customised requirements of the customer. Due to its customised capability, Industry 4.0 takes place extensive customization and thus suited to manufacture patient-specific bone implants, tools and devices and proper health monitoring system. It provides development in the existing products to create innovative changes in the market. It also creates innovative changes in the business and current digital trends. There are interconnectivity, automation and smart supply chain in the manufacturing industries. The technologies used in this revolution increases manufacturing efficiency and productivity.
There are self-monitoring and flexibility in the manufacturing system to perform the required customised task. In the orthopaedics field, there are various requirements which can quickly be undertaken by Industry 4.0 in lesser time and cost.
3. Research objectives of the paper
There is an improvement in research and development in orthopaedics field with the applications of digital technologies. Industry 4.0 utilises an integrated network of IoT and computer-controlled system to create smart factories. It connects people, doctors, patient, processes, system, data and service with IoT to utilise the information for better collaboration. It helps to plan, monitor, track, trace and creates real-time alert of the disease level. Thus, Industry 4.0 creates flexibility during the manufacturing of any individualized part as per the requirement of the patient. It provides intelligent service to the patients and health professional.
By using a cyber-physical system, it adopts a new business model in the field of orthopaedics. This industrial revolution may create an optimized operational and business process to improve patient satisfaction. There is a lesser wastage of materials and better capability to prevent ongoing error and delay. The four primary research objectives of the paper revolve around, how the introduction of industry 4.0 may bring change in the field of orthopaedics.
RO1: To study the requirements of Industry 4.0 in orthopaedics;
RO2: to identify major supportive technologies of Industry 4.0 for orthopaedics;
RO3: to study the significant benefits of Industry 4.0 in orthopaedics;
RO4: to identify advancements in orthopaedics with Industry 4.0.
4. Requirements of industry 4.0 in orthopaedics
Industry 4.0 to manufacture quality orthopaedics implants/parts/components as per the need of a patient. This industrial innovation uses electronic chips, wearable devices, smart medical devices and electronic health data to increase the overall performance of the healthcare. It uses innovative technologies like virtual reality/augmented reality for the training of orthopaedics doctors and surgeon. This helps to perform invasive and complex orthopaedics surgery without any risk. Artificial Intelligence can develop an understanding of the requirement of healthcare professional and patient. It allows detecting the disease or any other abnormalities at an earlier stage. This reduces the cost and time of the medical trial.
IoT is used to manage the medical devices automatically and provide better treatment process of the patient. Different digital technology has a high capacity to store and process data to impact the daily life of a human.
This easily connects human to machine and machine to machine. By a proper digital health monitoring system, this provides advances in medicine, better health care and longer life expectation. Industry 4.0 quickly sorts out various new ongoing problems in healthcare and its associated field. It provides customised service with better safety and efficiency.
This initiates to grow business by creating innovation in manufacturing and service sector. It enables to collaborate medical institutions with industry better.
5. Major supportive technologies of industry 4.0 for orthopaedics
Various technologies used in Industrial fourth revolution provide positive impacts in human health and environment as they also fulfil various requirements in orthopaedics. By the implementation of these digital technologies, there is an improvement in complex surgery. It improves the skill of the doctors in their specific field by providing proper learning, assisting research and development process.
It uses a robust computational algorithm for massive data set processing
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Undertakes an advanced scientific study of the statistical and algorithmic model using the computer system to perform specific tasks
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Applied for the drug discovery process at an early stage and assess its helpfulness in precise treatment in orthopaedics
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To play an essential role for billing, medical record and patient care
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Make the orthopaedics field smart by minimizing administrative and supply costs
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The significant applications of this technology would be the identification of disease, diagnosis, drug delivery, clinical trial, research and development and commercialization
Stored data is processed at remote servers using computer sources
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Customized applications of internet access to use the information stored in the cloud
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Hospital and clinician can store the medical data to help patients and researchers
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Deploys access and networked pieces of information and resources by offering on-demand computing using cloudases, this helps effective sharing of patient inform
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In emergency cation with the doctor/surgeon at different locations
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Easy connect of healthcare centres through the use of electronic documents and quickly providing support to physician enquiry, pharmacy order and patient management system
This provides development to physical processes using proper monitoring of network and computer technology and involves the integration of networking, computation and physical processes
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Doctors and researcher can better understand the problem and solve various challenges
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Health practitioners can now coordinate better among all medical devices to ensure the safety of their interaction
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Used for the research & development of highly reliable smart devices and tools
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Improves patient safety with the help of networked physical devices
These technologies are used to track patient health records and medical history. Diagnosis is made in a better manner, by viewing the patient’s health picture holistically. It helps develop a health information system and personalized orthopaedics treatment. Patient data are stored digitally, which helps to reduces errors in the treatment procedure. Computer sources are used to connect all documents electronically for proper patient management. Advanced robots are used to assist total knee arthroplasty.
Industry 4.0 uses IoT technology, by which all devices are connected to the internet which provides appropriate information. This information can help proper decision making by using artificial intelligence.
By the successful implementation of these technologies, orthopaedics practitioners can increase their confidence and make an innovative way of treatments to provide better satisfaction to the patients.
6. Significant benefits of industry 4.0 for orthopaedics
Industry 4.0 creates transparency in information, creates better technical assistance and decision making. Smart sensors are used to collect real-time data during medical processes. In the manufacturing of required orthopaedics parts, the traditional method of manufacturing will be replaced with cheaper, faster and with better quality automated systems.
In orthopaedics, Industry 4.0 is used to make successful treatments by the applications of real-time data. Thus, research, development and commercialization process get quicker, and the teaching and learning process becomes better.
Customization is the primary challenge taken by Industry 4.0. It creates an adequate physical environment with the help of connected and automated devices and is used to focus on the patient-specific health system, clinical setting and a better outcome. Industry 4.0 also helps to reduce waste and time in the manufacturing of any product. This reduces the critical risk to enhance the capability of doctors and the whole hospital management system.
It is used for safety, medical device regulation and privacy protection by the properly self-managing information system. Table 2 discusses the significant advancements of Industry 4.0 in orthopaedics.
Table 2Major advancements of Industry 4.0 in orthopaedics.
S No
Advancements
Description
References
1
Customised treatment
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This revolution is popular as it provides customization, by which individual requirements of patients can be assessed & fulfilled in lesser time
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In orthopaedics, there is an essential requirement of customised patient-specific implants which now are quickly manufactured by using AM/3D printing technology
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Perform customised patient treatment with advanced and digital technologies
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Improves treatment quality with the proper management of medical devices
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Used to address various symptoms, the discomfort of the legs and feet
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Customised treatment of foot deformities and other bone injuries
Communication practices that encourage and constrain shared decision making in health-care encounters: systematic review of conversation analytic research.
Influences on surgical antimicrobial prophylaxis decision making by surgical craft groups, anaesthetists, pharmacists and nurses in public and private hospitals.
Designing and printing of patient-specific implants is the primary challenge in the orthopaedics field and undertakes this challenge by the applications of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) and 3D printing technology
•
Scanning technologies are used to capture data of the patient and 3D printing easily print this data in lesser time and cost
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Provide an innovative solution with the help of medical devices and service
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These technologies are also applicable for custom fit prosthetic to create comfort to the patient
Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series.
Surgeons and preventive health: a mixed methods study of current practice, beliefs and attitudes influencing health promotion activities amongst public hospital surgeons.
Patient-reported outcome measures: selection of a valid questionnaire for routine symptom assessment in patients with advanced chronic kidney disease - a four-phase mixed methods study.
Industry 4.0 is expected to create major advancements in the field of orthopaedics. This revolution is to fulfil the demand for customised implants, tools and devices quickly as per the individual requirements. It provides real-time information and its proper management during an emergency. It is helpful for planning and decision making of a complicated case. It creates transparency among the doctors, surgeons and patients to avoid any confusion. It is used for the proper monitoring of health by managing all risk factors. These technologies are useful for design and manufacturing of patient-specific implants to create rapid development in the field of orthopaedics.
It suggests routine exercise and medication for the patient to stay fit.
Industry 4.0 uses different computational algorithms for prediction of diseases and surgical outcomes. This revolution uses AI technology to provide improvement in the imaging pathway and medical recordkeeping. It can be used to detect a fracture in the wrist, hand and ankle. Industry 4.0 will become an important revolution for total knee arthroplasty, unilateral knee arthroplasty and total hip arthroplasty.
This will create significant advancement to perform orthopaedics surgery in a better way. Sensor-based smart implants can provide real-time information to surgeons throughout the entire treatment process. These implants are to identify the ongoing problems and help perform a unique procedure. Physical orthopaedics devices would be digitally interconnected to exchange data by internet sources. It enhances communication in healthcare practice to manage, tracks and control medical supplies to perform the specific procedure. Industry 4.0 can be used to effectively track chronic diseases so that the patient receives proper treatment and timely care. Overall it seems to fulfil the difficult challenges of orthopaedics.
7.1 Significant contributions of the study
Industry 4.0 provides rapid changes in manufacturing reality. It is the combination of significant technological innovation which integrates and interlink with one another. The customized prosthetics are made as per the requirements of the patient. These revolutions mixed manufacturing and new industrial practice in the technological world. Hospital staff can access everything and information when they required. It handles all ongoing activities in healthcare to increase safety and quality of the patient life. This increase the efficiency and innovation of the whole health management process. It holds excellent promising applications to identify high-risk patients through appropriate screening. The significant contributions of this paper are as under:
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Industry 4.0 is the fourth industrial revolution used to meet the customised demand of the customer
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Focus on ‘on-demand manufacturing’ and the need for rapid change in the production processes of medical and orthopaedics products
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In orthopaedics, this revolution will create implants, tool, devices and another instrument as per patient match and also manage all ongoing activities during the treatment
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Industry 4.0 is implemented in orthopaedics to fulfil various innovative requirements like performance, efficiency, complex orthopaedics surgery without any error or any risk
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Major supportive technologies of Industry 4.0 for orthopaedics are Big data, Machine learning, Cloud computing, Advance robotics, Internet of Things, Cyber-Physical Systems, Artificial Intelligence, Video streaming, Cybersecurity, 3D printing, Wireless brain sensors and Nanomedicine
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The major benefits of Industry 4.0 in orthopaedics is the easy availability of real-time data, maximize patient outcome, orthopaedics research, improve treatment quality, connected information, automation, innovative teaching and learning process
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Industry 4.0 creates various advancements in orthopaedics like Customised treatment, Real-time information and its management, Digitisation/Intelligence in manufacturing, Planning and decision making, Transparency, Health monitoring, Risk management, Intricate designing of orthopaedics tools, Patient-specific implants, Increase performance of surgeon, Rapid development and Daily patient routine
•
In future, Industry 4.0 will bring major changes in orthopaedics by changing the way of information, treatment and surgical procedure more efficiently
8. Future scope
Industry 4.0 will provide vast development in orthopaedics by the applications of digital technologies. Smart machines used in this revolution can precisely capture and communicate real-time data for a better decision-making process. It rapidly brings new innovative orthopaedics tools which will reduce surgical risks. Patients can gain their knowledge, and upcoming devices will be helpful for the prevention of diseases at an early stage. Industry 4.0 will emerge in bioelectronics medicine which will be helpful for better treatment of illness. This can easily be performed robot assist surgery precisely in lesser time. In the upcoming years, Industry 4.0 will provide new opportunities and innovative treatment for patient care.
9. Conclusion
Industry 4.0 adopts new technologies to improve competitiveness in the manufacturing of the product. It offers significant potential to provide innovative changes in treatment and surgical procedure. With the advancement in automation and digitisation, it provides a flexible solution in the field of orthopaedics. These new technologies suggest proper exercise for the active motion of bones. It focuses on optimising the time of hospital management system. This revolution provides the development of predictive and personalized services. It has an excellent capability for better information system and diverse experience to the doctors. This efficiently manages the day to day quality process and performance of the orthopaedics surgeon. It quickly minimizes the risk and time-consuming activities during the bone fracture of the patient. This revolution appropriately manages the clinical and personal data of a patient, which helps to support the decision-making process. It provides awareness to the doctors, surgeon and monitors all activities during the whole treatment process. This brings significant development for personalized patient treatment by storing a tremendous amount of background patient data. It creates development for treatment, new drug and improves the quality of healthcare. This makes the production line more efficient by effective utilization for all the resources. In upcoming years, Industry 4.0 will open new possibilities in the field of orthopaedics by the implementation of advanced automation technologies and processes.
Declaration of competing interest
None.
References
Haleem A.
Javaid M.
Vaishya R.
Industry 4.0 and its applications in orthopaedics.
Communication practices that encourage and constrain shared decision making in health-care encounters: systematic review of conversation analytic research.
Influences on surgical antimicrobial prophylaxis decision making by surgical craft groups, anaesthetists, pharmacists and nurses in public and private hospitals.
Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series.
Surgeons and preventive health: a mixed methods study of current practice, beliefs and attitudes influencing health promotion activities amongst public hospital surgeons.
Patient-reported outcome measures: selection of a valid questionnaire for routine symptom assessment in patients with advanced chronic kidney disease - a four-phase mixed methods study.
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