The Mystery of True Innovation in Orthopedics
Go to an Orthopedics show. Anywhere. You will not find any real innovation.
You will see thousands of “new” products, but no Game-changers.
The “new” products proudly on display are simple new features. Design creep. A new coating here, a different material there, a new instrument here, a new implant style there. These “new” products are not Game-changers. They are incremental changes, and next year, these incremental changes will be copied by the other manufactures. This is slow iteration, not innovation. It’s sad.
Then every few years, WHAMMMO! Out of the blue, a true Game-changer will emerge. You know it when you see it. Wow! Where did that innovation come from? How did it happen?
These game-changers challenge the way that the industry thinks. They disrupt the industry and redefine what is possible, forever. Think back to moment you first saw arthroscopy, the Ilizarov apparatus, kyphoplasty, spine cages, or BMP.
So, where do the true “Game-changer” innovations come from?
Game-changing innovation does not originate from inside the walls of your Orthopedic company. There are five good reasons that prevent internal employees from ever creating true innovation.
CLINICAL EXPERIENCE – There is not enough of day-to-day experience in the OR. And there is a huge disconnect with clinical outcomes after the sales rep leaves the OR.
CROSS-POLLINATION – There is a lack of expertise in the technologies borrowed from other industries (optics, magnetics, drug elution, electrical engineering, software and wireless communications, AI). The core competences in orthopedic companies are mechanical engineering and biomaterials.
RESOURCES – Company resources always default to the big revenue legacy products that drive top line growth each quarter.
TALENT – The most talented people inside companies are committed to the big product launches, not to the skunk work programs. “D” as in development drives the new products with high visibility and short timeframes. “R” as in research is off in a corner somewhere with low visibility and aimless timelines.
FEAR OF FAILURE – Management and employees will always default to doing the safest things. Being innovative should never be the safe thing to do. Most companies reward NOT doing anything wrong; instead they should reward DOING.
Great new product ideas come from people who are deeply in touch with the clinical needs and additionally, from people who have an understanding of the what new technologies outside orthopedics are available. These people are outside of your company. Typically, the great ideas come from surgeons, nurses, PAs, sales reps, and inventors outside the orthopedic manufacturers. This is the key reason that the manufacturers pay huge consulting fees to surgeons. Surgeons usually bring the best new product ideas.
Let’s go back in history to see where some Game-changers came from.
Arthroscopy – In 1962, Dr Masaki Watanabe, a Japanese teaching surgeon, performed the first arthroscopic menisectomy using the arthroscopic instruments he developed. The patient was a 17-year-old boy who twisted his knee playing basketball. Watanabe débrided the flap tear of the medial meniscus. The patient went home the same day. In 6 weeks, he was back playing basketball. Dr Richard O’Connor brought arthroscopy to the western world in the 1970’s.
Ilizarov apparatus – In the late 1950’s Dr Gavriil Ilizarov, a Russian surgeon inventor in Siberia, used the materials available, including bicycle parts, to create the first external fixators then stumbled onto the technique to “stretch” bones, thus inventing distraction osteogenesis. Dr Paley writes about how the technology came to the west here.
Kyphoplasty – In 1997, Dr Mark Reiley, a surgeon inventor brought balloon angioplasty into spine to reshape bone.
Spine cages – Dr George Bagby invented the first cage and implanted them into the necks of horses. In the 1990’s Dr Steven Kuslich perfected cages for posterior lumbar fusions in people, opening a new era in spine stabilization.
Bone Growth Factors – Dr. Marshall Urist, a UCLA surgeon/researcher, discovered BMPs, but had no way of deriving a useful dose from cadavers. Genetics Institute (now Wyeth) created a synthetic version called rhBMP 2. In 2003, Sofamor Danek took a huge gamble and licensed rhBMP 2 from Genetics Institute (now Wyeth) and developed INFUSE. Today, INFUSE sales role to $3M/day in the grow factor, for fusion and bone repair.
In the future, look for Game-changers in the areas of orthobiologics, tissue regeneration, robotic surgery, artificial intelligence and smart implants.
Your Take Home Message
Game-changer innovation is possible for your company if you can set up a culture of harvesting ideas that come from OUTSIDE your four walls.
Empower your employees to look for ideas outside the company. Create a culture of idea sharing. Put in place a text number and email to instantly capture breakthrough ideas. Pay incentives to anyone who brings in a fresh new idea. Then, make sure that you have a process for evaluating ideas. Make it open and serious and regular. Executives should openly sponsor product innovation meetings that encourage all comers to present new ideas. And finally, management should reward innovators with new stock grants. This aligns everyone in your company to invest in the growth of innovation and the company.