“You can’t do that in orthopedics”

True innovation in orthopedics is questioned 100% of the time.

Initially, the “true” game changers are thought to be crazy.  They challenge the way we think. Challenge our conventional wisdom. Challenge our systems and the status quo.   

When people first see “true” innovation, they say…

“That’s too dangerous.”

“Surgeons will never use it.”

“It’s too complicated.”

“The regulators will never approve it.”

“Nobody will buy it.”

Let’s look a few real life examples from Orthopedic history.

“You can’t stretch and shape bones.”

In the 1950’s, Dr. Ilazarov (USSR) performed a corticotomy on long bone and pulls the two ends apart at a rate of 1mm per day. Today the Ilazarov technique is a standard tool in the orthopod’s hands.

“You can’t put a cystoscope into the knee and cut knee material.”

In 1962, Dr. Watanabe (Japan) did just that and created Arthroscopy, the most common orthopedic surgery today.

“You can’t inject bone cement into the spine.”

There is a modulus mis-match and the exothermic process kills bone.
Dr. Reiley (US) did in 1984 and created Kyphoplasty.

“You can’t reverse the ball and socket on a total shoulder implant.”

It’s not natural. Dr. Grammont (France) did in 1985 and ushered in reverse shoulders

“You can’t allow a robot to actually cut bone.”

The surgeon has do the cutting. Dr. Paul (US) invented Robodoc in 1985 for total hips. The rest is history. 

“You can’t put a large screw into the spine for fusion.”

It’s dangerous. Dr Bagby (US) did in 1987 and created spine cages.

“You can’t put synthetically-derived bone growth factors into a human.”

The molecule could go anywhere. It could cause cancer. Dr. Urist (US) thought it up and Danek backed the idea in 2003 and created the largest selling product in orthopedic history, Infuse.

“You can’t market remote control implants”

It’s dangerous to control an implant from outside the body at the hospital and especially not by patient’s family in a home setting. Ellipse Technologies ushered in MAGEC spine rods and PRECICE limb lengthening nails around 2010.

Looking towards the future… what else can’t we do?

“You can’t allow an AI system to make real-time medical decisions for surgeons.”

“You can’t print cartilage then implant it.”

“You can’t sell the implant at cost and make a profit with the data.”

“You can’t make an implant that almost as strong as metal but turns into bone.”

“You can’t use a patient’s genome to dictate the treatment plan.”

“You can’t do surgery remotely.”

… and so on.