Orthopaedics

Department of Orthopedics, Peking University Third Hospital

The Department of Orthopedics of Peking University Third Hospital (abbreviated as PKU Third Hospital) was founded in 1958. Under the leadership of 5 successive department chairs—Professors Yang Keqin, Zhang Zhihu, Dang Gengting, Liu Zhongjun, and Li Weishi—it has developed into a national key discipline with a leading academic position in China and a certain international influence. In 2007, it was awarded the title of “Innovative Team” by the Ministry of Education, and in 2019 it was approved to establish the Ministry of Education Engineering Research Center for Precision Medicine of Bone and Joints. In the 2021 ranking of China’s hospitals by five-year total scientific and technological value (ASTEM), released by the Chinese Academy of Medical Sciences, it ranked 3rd in orthopedic surgery.

Looking back at the development of the Department of Orthopedics of PKU Third Hospital, generations of orthopedic professionals have worked diligently and pursued innovation. At present, the Department of Orthopedics has 8 wards with a total of 272 beds, and its bed occupancy rate is above 95%. It has 75 specialized physicians, including 32 chief physicians, 16 deputy chief physicians, 17 doctoral supervisors, and 15 master’s supervisors; 5 have undertaken postdoctoral research, and more than 80% of the physicians hold doctoral degrees. In 2022, while actively carrying out epidemic prevention and control, the department performed more than 14000 operations throughout the year, handled 200,000 outpatient and emergency person-visits, achieved a case-mix index (CMI) of 2.20, and an average length of stay for the entire department of 5.67 days. In terms of medical efficiency, medical safety, and case complexity, it is at an internationally leading level.

In the late 1950s, the 1st department chair, Professor Yang Keqin, led the Department of Orthopedics in taking the lead in China in performing surgery for cervical spondylosis and lumbar disc herniation. In the early 1960s, it completed China’s 1st anterior cervical discectomy, bone grafting, and fusion under acupuncture anesthesia. By the 1970s, clinical diagnosis and treatment and related research on osteoarticular diseases and cervical spondylosis had continued to deepen. In 1972, it completed the 1st total vertebrectomy for a giant cell tumor of the lumbar spine, and in 1975 it published New China’s 1st monograph, Cervical Spondylosis.

In the 1980s, under the leadership of the 2nd department chair, Professor Zhang Zhihu, the department continued in-depth research in all areas of orthopedics and aligned itself with international standards. It began performing artificial joint replacement and conducted independent research and development of multiple artificial hip prostheses, becoming one of the few centers in China to take the lead in this work. In 1985, Professor Zhang Zhihu completed the 1st posterior double-door cervical laminoplasty in China. In 1986, Professor Cai Qinlin completed China’s 1st posterior single-door cervical laminoplasty. During the same period, the Department of Orthopedics of PKU Third Hospital was the 1st in China to systematically describe the clinical characteristics of foraminal and extraforaminal lumbar disc herniation, and took the lead in treating this condition with nucleus pulposus removal through an approach along the outer edge of the pars interarticularis.

In the 1990s, the Department of Orthopedics of PKU Third Hospital further accelerated the pace of discipline development. The 3rd department chair, Professor Dang Gengting, took the lead in dividing orthopedics into 6 specialty groups: cervical spine, lumbar spine, spine, joints, trauma, and craniovertebral junction. Related diagnosis, treatment, and research were carried out in depth, and the scale of the discipline expanded further. In 1992, the department used independently developed prostheses to perform unicompartmental knee arthroplasty and patellofemoral joint replacement. From 1999 to 2003, research on the pathogenesis of osteoarthritis and stem-cell therapy continuously received funding from the National Natural Science Foundation of China. The research achievements won the 2nd prize of the Chinese Medical Association Science and Technology Progress Award and the 3rd prize of the Beijing Science and Technology Progress Award, respectively.

Upon entering the 21st century, the discipline’s academic echelon and strength became even stronger. The 4th department chair, Professor Liu Zhongjun, led the department forward vigorously and established discipline-development goals through the construction of specialty groups, laying a solid foundation for clinical work and scientific research at the Department of Orthopedics of PKU Third Hospital. In 2018, the orthopedic team completed the transition between the old and new generations, and Professor Li Weishi became the 5th department chair. In response to new circumstances, Professor Li Weishi comprehensively advanced discipline development and, in accordance with the hospital’s need for high-quality development, reorganized the original 6 specialty groups into 3 subspecialties: spine, joints, and trauma. In 2021, a spinal deformity specialty group was established, which, together with the craniovertebral junction, cervical spine, lumbar spine, and spine groups, supports the comprehensive development of the spine subspecialty.

At present, the Department of Orthopedics of PKU Third Hospital is developing rapidly in the diagnosis, treatment, and research of spinal degeneration, spinal tumors, spinal deformities, spinal and extremity trauma, senile osteoarticular diseases, and articular cartilage and ligament injuries. In 2002, the project “Research on the Diagnosis and Treatment of Cervical Spondylosis” won the 2nd prize of the National Science and Technology Progress Award; in 2003, the project “Clinical Research on Cervical Spinal Cord Injury Without Fracture or Dislocation” won the 1st prize of the Ministry of Education Science and Technology Progress Award. Professor Chen Zhongqiang led the lumbar spine group in conducting in-depth research on the key diagnosis and surgical treatment of severe thoracolumbar kyphotic deformity and thoracic spinal stenosis, making major contributions and receiving the Beijing Municipal Commission of Science and Technology’s Top 10 Diseases Key Science and Technology Project award (Innovative Science and Technology Achievement Award) and the 2nd prize of the Beijing Science and Technology Award. In 2005, Professor Liu Xiaoguang pioneered the “cave-collapse method” for 360-degree circumferential decompression of the thoracic spinal cord. Professor Wang Chao led the craniovertebral junction group in completing more than 4000 atlantoaxial operations in total, making the Department of Orthopedics of PKU Third Hospital the world’s largest diagnosis and treatment center for atlantoaxial diseases. Professor Sun Yu’s cervical spine group has achieved numerous results in improving posterior cervical surgical techniques, long-term follow-up of cervical artificial disc replacement, and surgical treatment of severe cervical deformities. In 2014, Professor Liu Zhongjun completed the world’s 1st treatment of a spinal tumor using a 3D-printed, custom-made artificial axis; the 3D-printed products developed by the team obtained CFDA registration certification, promoting the rapid development of the clinical application of 3D-printed orthopedic products in China.

In recent years, Professor Li Weishi proposed the concept of a biomechanically adaptive interbody fusion cage, developed the world’s 1st 3D-printed lumbar interbody fusion cage with a trabecular-bone-like structure and biomechanical adaptability, and took the lead in applying it clinically. Professor Li Weishi also proposed the fitted relationship between sagittal spinopelvic parameters in the Chinese population and individualized treatment strategies, providing an important basis for reconstructing overall sagittal trunk balance in Chinese people. He proposed diagnostic criteria for osteoporosis in the Chinese population based on lumbar vertebral CT values, identified the important value of vertebral CT values in assessing the risk of fragility vertebral fractures, and was the 1st in the world to propose grading the severity of osteoporosis based on vertebral CT values. At the same time, he led a multidisciplinary team in taking the lead in developing the world’s 1st autonomous spinal lamina recognition-and-cutting robot system. In 2018, the project “Research, Development, and Promotion of a Domestic Unicompartmental Replacement System,” developed by Professor Tian Hua’s team, won the national 2nd prize at the 1st China Medical Transformation Innovation and Entrepreneurship Competition. Led by Professor Tian Hua, the team developed the Visual Treatment Solution visualization intelligent assistance system (VTS), which, as the 1st domestically produced visualization intelligent assistance system for joint replacement, was approved by the National Medical Products Administration for marketing, filling a gap in the industry. In March 2022, the Operation Specifications for Hip and Knee Joint Replacement (2022 Edition), organized under the leadership of Professor Tian Hua at the commission of the National Health Commission, was officially promulgated and implemented. The new classification of hip fractures proposed by Professor Zhou Fang and his research achievements have guiding significance for selecting internal fixation for different fracture types. To address the difficulty of surgical exposure in scapular fractures, Professor Tian Yun collaborated with Professor Wu Dankai of Jilin University and was the 1st in the world to propose the concept of exposing fractures of the anterior edge of the scapula through an axillary posterior-line approach. It was rapidly promoted nationwide, enabling more patients to receive better treatment outcomes. Professor Tian Yun innovatively used 3D-printed microporous titanium-alloy prostheses to treat large-segment bone defects of the extremities, and took the lead in China in carrying out groundbreaking work in 3D-printed repair and treatment of chronic osteomyelitis and in TCBridge certification for bone-defect treatment.

Over the past 5 years, the Department of Orthopedics of PKU Third Hospital has achieved significant results in research and development and talent development. It currently undertakes 73 national- and provincial/ministerial-level research projects, including key projects of the Ministry of Science and Technology and projects of the National Natural Science Foundation of China, and has completed 32 national- and provincial/ministerial-level projects. To date, it has published nearly 1000 scientific papers, including 399 SCI papers in international journals, and has translated or edited more than 10 orthopedic monographs.

In 2019, Professor Li Weishi led the team in obtaining approval to establish the Ministry of Education Engineering Research Center for Precision Medicine of Bone and Joints and served as the center’s director. Professor Li Weishi successively received the titles of Young and Middle-aged Leading Talent in Scientific and Technological Innovation from the Ministry of Science and Technology and Leading Talent in Scientific and Technological Innovation under the national “Ten Thousand Talents Plan.” Relying on the center’s platform, the orthopedic team of PKU Third Hospital has successively launched multiple research projects concerning “degenerative spinal diseases,” “spinal robots,” “intelligent artificial joint replacement,” and “repair of large-segment bone defects caused by osteomyelitis,” generating a series of research achievements, some of which have achieved excellent results in commercialization. The “Series of New Material Technologies for Orthopedic Repair and Replacement” from Professor Li Weishi’s team completed a technology transfer of 26.7 million yuan; the “3D-Printed Spine and Joint Products and Technologies” from Professor Liu Zhongjun’s team had a transfer amount of 10 million yuan; the “Series of Digital Technologies for Orthopedic Joint Surgery” developed in cooperation with Professor Tian Hua’s team completed a transfer of 10 million yuan; Professor Tian Yun’s team’s “A Bioadhesive, Its Preparation Method, and Applications” completed a transfer of 3.3 million yuan; and the “Relevant Patents for the Research and Development of Surgical Instruments for Cervical Spine Tumors” from Professor Wei Feng’s team had a transfer amount of 1.8 million yuan, bringing the total transfer amount to 51.8 million yuan. In talent development, the Department of Orthopedics of PKU Third Hospital adheres to thephilosophy of “Virtue and benevolence in medicine, seeking truth and expanding innovation,” educates and trains people, and since its establishment has trained 2243 visiting physicians, who are distributed across 32 provinces, municipalities, and autonomous regions nationwide. Among them, 536 became department directors, 45 became hospital presidents, and 1 became a university president, making a tremendous contribution to orthopedic development in many regions.

Keeping pace with the times, the Department of Orthopedics of PKU Third Hospital has continuously promoted the alignment of China’s orthopedic cause with international standards; its development has also been a process of moving toward the world. In 1980, Professors Yang Keqin and Zhang Zhihu invited a senior academic delegation of the American Orthopaedic Association (AOA) to visit China. This was the 1st visit and exchange in China by a foreign orthopedic expert group after the reform and opening up. In 1995, the 1st total knee replacement training course of PKU Third Hospital was successfully held, making it one of the earliest centers to promote standardized artificial joint replacement technology. In 2001, the international spine organization AO Spine established its 1st spinal surgery training center in China at PKU Third Hospital, marking orthopedics’ entry into a new stage in its process of aligning with international standards. In 2003, Professor Dang Gengting served as a council member of the Asia-Pacific Regional Council of AO Spine and as its chair for China. Thereafter, Professors Chen Zhongqiang, Liu Zhongjun, and Li Weishi successively held the positions of council member of the Asia-Pacific Regional Council of AO Spine and chair for China, greatly promoting the training of spinal surgeons and the improvement of clinical standards in China. Beginning in 2011, the Department of Orthopedics of PKU Third Hospital and the Department of Orthopedics of Massachusetts General Hospital of Harvard University jointly founded the “Peking University–Harvard International Spine Surgery Summit Forum,” which has successfully been held 10 times. As chair for China of the International Orthopaedic Trauma Association (IOTA), Professor Tian Yun has promoted the integration of Chinese trauma orthopedics with the international community, selected young doctors to study and exchange at internationally top-ranked hospitals, and promoted the international development of Chinese doctors.

People of the Department of Orthopedics of PKU Third Hospital have made active contributions to the development of orthopedics in China and to the work of related academic societies and associations. Professor Yang Keqin served as vice chair of the Orthopedics Branch of the Chinese Medical Association (1981-1990); Professor Dang Gengting served as chair of the Orthopedics Branch of the Chinese Medical Association (1992-2000); Professor Chen Zhongqiang served as vice chair of the Orthopedics Branch of the Chinese Medical Association (2010-2017); Professors Cai Qinlin and Liu Zhongjun both served as chairs of the Spinal and Spinal Cord Committee of the Chinese Association of Rehabilitation Medicine; and Professor Lou Siquan served as chair of the Cervical Spondylosis Committee of the Chinese Association of Rehabilitation Medicine. Professor Li Weishi serves as vice chair of the Committee for the Prevention and Control of Spinal Diseases of the Chinese Preventive Medicine Association. Many other orthopedic professors also hold important academic positions in different academic organizations, contributing the strength of the people of PKU Third Hospital’s Department of Orthopedics to the development of orthopedics in China.

Over 65 years, the predecessors of the Department of Orthopedics of PKU Third Hospital have worked through hardship and devoted themselves diligently to building outstanding achievements for the discipline. The new generation is carrying on the legacy, fulfilling its mission, and bringing the spirit of its predecessors forward. Upholding thephilosophy of “Virtue and benevolence in medicine, seeking truth and expanding innovation,” the people of the Department of Orthopedics of PKU Third Hospital are uniting their strength, pioneering, and striving forward. They will certainly work hard to achieve the goal of creating a world-class discipline and continue contributing to the development of orthopedics in China.