Reverse and Frugal Innovations in Orthopaedics: Potential Applications in High-Resource Settings.

➢ Reverse innovation refers to the development of solutions in low- and middle-income countries with limited resources that are subsequently adopted in high-income countries. In orthopaedics, these solutions often emphasize simplicity, affordability, and durability while addressing common problems in musculoskeletal care.➢ Examples of breakthroughs from limited-resource environments include the Ilizarov circular fixator and distraction osteogenesis, the Jaipur Foot prosthesis, and locally manufactured negative-pressure wound therapy systems. These innovations demonstrate that working with limited resources can yield effective and affordable alternatives to expensive, complex technologies.➢ Processes such as focused factory systems and high-volume, standardized care models can provide affordable care while increasing access. Furthermore, the increase in clinical volume helps to build expertise, efficiency, and value through careful system redesign.➢ Certain reverse innovations relevant to musculoskeletal care that are developed in limited-resourced environments can potentially be adapted by high-income countries to improve value-based care, control costs, strengthen operations, and enhance access to care for a larger segment of society.➢ When adapting these innovations to high-resource environments, it is important to use a step-by-step approach. This includes initiating pilot programs, employing quality improvement methods, and closely monitoring safety, outcomes, and costs.