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Tablets in Orthopaedics

In addition to the popularity of smart phones in medicine, tablet computers are quickly becoming popular clinical tools. The combined benefits of mobility, storage capacity, accessible interface, and wireless access make these devices ideal for orthopaedic surgeons, residents, and patients who expect reference information immediately available at their fingertips. The most recent version of the iPad includes a 9.7-inch touch screen and enough on-board memory to store potentially hundreds of hours of video, thousands of audio clips, and tens of thousands of PDF articles. Application (or “app”) developers have capitalized on the device’s computing speed and memory to create interactive, three-dimensional (3D) teaching tools that can be used by patients as well as providers. Combined with a screen size appropriate for reading, video viewing, and educational demonstrations, iPads are quickly become regular devices used within the hospital.

Like their smaller smart phone counterparts, tablet devices are enhanced by the availability of mobile apps to expand the functionality of these devices. Generally speaking, third-party applications can be classified into three broad categories: clinical education (journals and articles), surgical preparation (devices and techniques), and patient education (anatomy and pathology).

As a mobile library, the iPad can store thousands of resources such as books, videos, and journal articles. For physicians with an electronic collection of peer-reviewed literature, apps such as GoodReader and iAnnotate are available at minimal cost and offer significantly improved library management and annotation tools compared to Apple’s own iBooks app. iAnnotate also offers a full-text search feature.

Surgeons who do not maintain digital article libraries may be more interested in free apps offered by journals such as Acta Orthopaedica, Spine, Plastic and Reconstructive Surgery, and Journal of Trauma. In addition, Current Concepts in Joint Review (CCJR) has released a searchable app that includes more than 125 video lectures from the Spring 2011 CCJR Conference, all available at no cost. And the Orthopaedic Surgery Board Review Manual is published by Hospital Physician and offers free issues, each addressing a single orthopaedic topic.

Current books and journal apps for iPad include:

Recognizing the promotional and advertising potential of the iPad, several orthopaedic device manufacturers have released apps that demonstrate new orthopaedic implants and enable users to download technique guides along with other information. Some even include 3D animations depicting the procedure.

Current available device company apps include:

Health providers and commercial companies have begun to address patient education as well, resulting in a number of apps created to assist surgeons in teaching patients about their disease, demonstrating anatomy and pathology, even depicting how an operation will proceed. Some of the most popular apps include OrcaHealth’s SpineDecide, AgingSpine, KneeDecide, HandDecide, FootDecide, and ShoulderDecide. DrawMD Orthopedics is a free app that includes a number of anatomic templates for various body regions (such as the hip, knee, or shoulder), as well as an expansive collection of “stamps” that can be placed on the image to simulate pathologies (such as fracture or arthritis) as well as treatments (screws, plates, prosthetics).

The role of iPads in the medical setting is quickly expanding. At this time, the most useful apps address educational functions, but app developers are working on mobile picture archiving and communication software and mobile electronic medical records, and they are even exploring the use of the iPad in the operating room. Surgeons stand now at a technology crossroads, and the use of tablet computers in healthcare settings is likely to continue to expand and be refined.


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