1. How to Treat: Arthrogryposis multiplex congenita
Wilmington Robotic Exoskeleton
Megan and Andrew Lavelle didn’t know their daughter, Emma, had a rare movement disorder until she was born. Her condition, arthrogryposis multiplex congenita, causes stiff, stuck-in-place joints and very little muscle tone. Emma’s hips were dislocated, her legs were bent upward, her wrists and shoulders were rotated incorrectly, and her feet were turned out. The only body part she could move was her thumb.
With months of therapy and a handful of surgeries, Emma gained a lot of movement. But she still couldn’t hold up her arms. “She would get really frustrated when she couldn’t play with things like blocks,” says Megan. “There’d be no way she could brush her hair or teeth.”
When Emma was two, her parents, who live in Wilmington, learned about a new device called the Wilmington Robotic Exoskeleton, or WREX. Developed by engineers from Nemours/Alfred I. duPont Hospital for Children, it gives mobility to people with movement disorders. WREX robots have metal or plastic arms with rubber bands at the joints to provide tension and lift. The robot’s arms sit alongside the patient’s and allow for easy movement in all directions. The machines can be customized for individual needs—mounted on a wheelchair for patients who can’t walk, built into a vest for those who can. DuPont engineer Tariq Rahman hatched the initial design using Erector Sets.
“I cried when they first put it on her,” says Megan. “The first thing Emma did was play with her blocks.”
Over the past two years, Emma, who’s now four and calls her robot Rexy, has used four different WREX prototypes. The Lavelles go back for fittings every few months. “I wouldn’t trade Rexy for the world,” says Megan. “When she started preschool, the kids called it Emma’s Magic Arms. And they’re right—that’s exactly what they are.”
Philadelphia hospital behind this medical breakthrough: Nemours/Alfred I. duPont Hospital for Children
2. How to Treat: Macular Degeneration
Vitrectomy at Wills Eye Institute
A clinical trial at Wills is testing the power of stem cells to restore vision in patients with macular degeneration, a leading cause of blindness. Wills Eye surgeon Carl D. Regillo is using a procedure called a vitrectomy, in which a tiny syringe is inserted directly into the retina, and lab-grown stem cells are injected at the site of deterioration. The hope is that the stem cells will regenerate or revive the dead tissue and pigment cells, improving sight. Regillo says this is the first time mature stem cells have been placed under the retina to actually regenerate tissue. “It’s sort of like a patch of missing grass on your lawn: We’re hoping it’ll take hold, reorganize and survive.”
Philadelphia hospital behind this medical breakthrough: Wills Eye Institute
3. How to Treat: Bad Knees
Quadriceps-sparing total knee replacement at Virtua
In a typical knee replacement surgery, doctors sever the quadriceps tendon, the largest in the body, to reach the knee joint; this causes a world of pain for the patient and slows down recovery. In 2003, Virtua’s Scott Schoifet began tinkering with a technique that let him simply loosen the tendon by cutting the kneecap in a precise pattern. Nearly a decade later, he has some 4,000 procedures under his belt. His patients are up and moving hours after being sewn up, and some are discharged same-day. Post-op pain can usually be managed with over-the-counter medications. “Almost everyone’s a good candidate for this,” he says. “For the patient, it’s a no-brainer.”
Philadelphia hospital behind this medical breakthrough: Virtua
4. How to Treat: Depression
New antidepressant Vilazodone at Penn Medicine
Antidepressants are literal lifesavers for those with major depression. But in up to 40 percent of sufferers, they have unwelcome sexual side effects, including reduced libido and failure to reach orgasm. Vilazodone, a new drug developed at Penn that’s just received FDA approval, slashes that percentage to less than five. It prevents serotonin reuptake, like traditional SSRIs, and also activates an impaired serotonin receptor. “In my study,” says lead researcher Karl Rickels, “we saw no more sexual side effects than with a placebo.” Patients feel better in as little as two weeks—and are more willing to stay on meds for the long haul.
Philadelphia hospital behind this medical breakthrough: Penn Medicine
5. How to Treat: Curvature of the Spine
A saliva test at Nemours/Alfred I. duPont
Who knew saliva could be so useful? Doctors here are using a spit test to predict if a child’s scoliosis curve will get worse—and by how much. ScoliScore, which is over 95 percent accurate, takes DNA from saliva and matches it against 53 markers for scoliosis, producing a risk score. Low risk requires only minimal treatment and periodic checkups; a high risk score lets doctors start treatment before the condition progresses. “In the past, we only knew what was going to happen after the fact,” says Suken A. Shah, director of the Spine and Scoliosis Center. “Now we can intervene earlier and help patients avoid costly, invasive treatments down the road.”
Philadelphia hospital behind this medical breakthrough: Nemours/Alfred I. duPont
6. How to Treat: Alzheimer's Disease
New tests at Penn Medicine
Traditionally, the only definitive diagnosis for Alzheimer’s was an autopsy. But Penn scientists have been working on a range of tests that can detect the disease even before symptoms appear. One assesses spinal fluid for “signature” chemical indicators; in another, positron emission topography (PET) employs a radioactive tracer to detect amyloid plaques in the brain. Arterial spin labeling uses a routine MRI scanner to noninvasively detect blood-flow patterns suggestive of Alzheimer’s. “We’ve made unbelievable progress in diagnosing,” says neurologist David Wolk. “Early detection will let us begin treatment before a lot of brain injury occurs.” Now he just has to wait for researchers to develop drugs that can modify or halt the disease.
Philadelphia hospital behind this medical breakthrough: Penn Medicine
7. How to Treat: Oxygen Deprivation at Birth
Hypothermic neuroprotection at St. Christopher’s Hospital for Children
Babies born with a compromised oxygen supply often suffer brain damage. Doctors here minimize that by cooling the newborns down—literally. “The process has to begin within six hours,” explains neonatologist Endla Anday. A cooling blanket or cap is used to lower body temperature by just two degrees, slowing everything down—the heart, the lungs, the creation of toxic matter in the brain. After 72 hours, the newborns are warmed back up. Anday says that the symptoms of babies with less severe cases of oxygen deprivation can be drastically improved. Count Sophia among them: Born in February 2011 with the umbilical cord around her neck, she was rushed to St. Chris’s. An MRI showed brain damage. But post-cooling, “She’s meeting all her goals,” her mom, Michele, reports, “walking, eating, drinking, playing. They said she could have cerebral palsy, could be blind or deaf. None of that has happened.”