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

Abstract

➢ 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.

The authors' abstract, as published at the source. Journal of Bone and Joint Surgery, 2026 · DOI ↗