ORTHO-X SurgiCoach : Orthopedic Workflow Companion for Diagnosis, Treatment Planning, Implant Selection, Outcome Assessment, and Case Documentation – powered by Google MedGemma
ORTHO-X SurgiCoach: MedGemma-Powered Orthopedic Workflow & Decision Support System
1. Problem Domain
Globally, orthopedic trauma care faces a critical bottleneck: a shortage of specialized surgeons and immense variability in fracture classification and treatment. In rural or low-resource settings, general practitioners often must make urgent orthopedic decisions without immediate specialist consultation. Misclassification of complex injuries (like a Schatzker Tibial Plateau fracture) leads to incorrect hardware selection, prolonged surgery times, and severe post-operative complications.
The Unmet Need: A tool that can translate raw medical imaging into standardized, globally recognized orthopedic classifications (AO/OTA) and ground its treatment recommendations entirely in vetted clinical guidelines, without hallucinating.
2. Effective Use of HAI-DEF Models
ORTHO-X solves this through a novel “Hand-Off Multimodal Architecture” using the Google Health AI Developer Foundations (HAI-DEF) ecosystem:
Vision Extraction: We use Gemini 3.1 Pro to analyze uploaded DICOMs/X-Rays. Instead of forcing it to diagnose, it acts as a radiologic extractor, parsing geometric displacement and bone morphology into strict JSON.
Clinical Reasoning (MedGemma): The JSON is fed into MedGemma (via Vertex AI). MedGemma acts as the clinical brain, applying its medical fine-tuning to evaluate the findings against the 2018 AO/OTA Fracture Compendium (using long-context RAG) to output a deterministic classification and flag urgent surgical red flags.
3. Impact Potential
By standardizing diagnosis through the AO/OTA Fracture Classification compendium, ORTHO-X reduces subjective human error.
Resource Optimization: If a hospital flags a “low-resource setting,” ORTHO-X dynamically adapts its treatment grounding to prioritize generic hardware (e.g., K-wires, standard tubular plates) over expensive proprietary implants.
Proactive Care: The Outcome Assessment module tracks post-op recovery metrics, shifting post-op care from reactive to proactive, reducing readmission rates.
4. Product Feasibility & Architecture
ORTHO-X is a production-ready React/Express stack.
Privacy First: It features an explicit PHI-scrubbing gate and uses Firebase Authentication to ensure only authorized clinicians can trigger Vertex AI inference.
Stateless Security: By routing the MedGemma API calls exclusively through a secure Express backend using Google Cloud ADC, client-side credential leakage is impossible.
Grounded Search: Treatment algorithms utilize Google Search Grounding strictly restricted via site: operators to the AO Foundation Surgery Reference, ensuring 100% accuracy.
5. Execution & Links
Open Code Repository (Apache 2.0 License): https://github.com/MAIVAN-ai/ORTHO-X-SurgiCoach/
ORTHO-X : From WhatsApp Fracture Intake to Publishable Orthopedic Case Intelligence
Check out the clickable PFN case flow demo:
ORTHO-X : Join the community connecting Surgeons and MedTech through Insights
ortho-x.maivan.ai
ORTHO-X offers instant access to high-quality, evidence-based knowledge and clinically validated AI models through a collection of orthopaedic AI assistants – aka ‘AI Agents’ – supporting both the surgeons’ education and training, as well as their clinical workflow from diagnosis, treatment and implant selection, to outcome assessment and case reporting.
By leveraging trusted content from top-quality sources and publishers like JBJS, Wiley, Springer Nature, the platform ensures evidence-based responses with proper citations.
ORTHO-X’s AI-enabled Features & Functionality:
The core elements and services of the ORTHO-X community platform include
- AI-enabled chat with surgical reference and leading textbooks
- AI-enabled surgical video knowledge extraction & conversation
- AI-enabled creation and publishing of case reports
- Access to clinically validated orthopaedic AI models
- AI-enabled PubMed-integrated research through The-Literature.com
- AI-enabled multi-lingual case documentation, sharing, presentation & discussion through ORIF-Osteosynthesis.org
- Access to myAO CaseFolio for enhanced case documentation & sharing
- AI-enabled conversation with industry knowledge & evidence for MedTech education, training & marketing
ORTHO-X is an open-source platform development under the Apache 2.0 license, led by ERMOS Foundation and the MAIVAN.ai surgeon & AI developer community.
We welcome your feedback and suggestions to ortho-x@maivan.ai and look forward to your active participation: join@maivan.ai
