Patients, clinicians and engineers ... inseparable

Jean Dubousset, born in 1936, is a pediatric orthopedic surgeon and Professor Emeritus at René Descartes University. He is a full member of the Académie Nationale de Médecine and the Académie de Chirurgie. He is also a member of the Scientific Advisory Board of the Fondation Cotrel de l'Institut de France and a member of the Scientific Advisory Board of the Laboratoire de Biomécanique ENSAM Paris Tech. Together with Y. Cotrel, he was awarded the World Surgery Prize for his work on 3D spinal correction, the Académie des Sciences prize for his work on malignant tumors in children, and the Maurice Muller prize for his work on the spine. Patients, clinicians and engineers... inseparable: As an orthopaedic surgeon and pure clinician, over 35 years' experience of working together with engineers in the fields of firstly computer science, then biomechanics and finally particle physics has shown me how essential this multi-disciplinary approach is to practical progress aimed at the most important element of the trio: the patient. Starting from pure clinical observation, for example of spinal deformities, and noting the discrepancies between clinical and radiological imaging associated with surgical failures, the three-dimensional nature of this spinal organ appeared to be a primordial element to be taken into account, measured and modelled in a personalized way, so as to be able to simulate corrective manoeuvres on computer models, before carrying them out on the living. This extended to the entire musculoskeletal system, where we had to include the essential role of the soft tissues, in particular the muscles, and of movement, i.e. both the central and peripheral nervous systems. Trying to understand before treating, but treating using the most reliable and efficient technologies, including robotics, being able to measure reliably and control the result, all this explains why the clinician has a duty to surround himself with all the skills of the engineering sciences, while remaining the privileged interlocutor, particularly in therapeutic indications and in the relationship of mutual trust with the patient, which is the basis of medical humanism.