Health Policy: Ethics, Regulatory, and Financial Aspects of Innovation in Orthopedics

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The field of orthopedic surgery is laden with many examples of how progress in technology can greatly enhance patient care. The story of the modern total hip arthroplasty, one of the most successful surgical interventions of the century, is an example of how technology can evolve and provide significant benefits. There is a need for innovation and surgeons willing to challenge the status quo in order for the field of orthopedic surgery to continue to improve patient care. Thus, it is important for providers to understand the process of introducing new technology, ethical concerns with new technology, and the cost of developing and implementing new technology. In this article, we review current literature and highlight contemporary concerns with the introduction of new technologies in orthopedic care. Examples of successes and failures are abundant. The foot and ankle subspecialty in particular has a multitude of innovation and new technology that offer potential improvements to prior standards of care. New findings suggesting total ankle replacements as an alternative to ankle arthrodesis are an example of this progress. Continued research and innovation is crucial for improving orthopedic care, and the orthopedic community must learn from these experiences and remain vigilant of potential pitfalls by maintaining a balance between regulatory oversight with a climate suitable for ongoing medical exploration and innovation. Device companies, regulators, and health care systems and providers need to work synergistically with the common goal of improving patient care.

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