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Innovation in Hand Surgery: Who is in the Driver's Seat?
James H Sikes, MS
1, Michael S Lebhar, MD
2, Holman H Taylor, BS
1, Caroline H Slay, BS
1; Marc E Walker, MD, MBA
2(1)University of Mississippi Medical Center, Jackson, MS, (2)The University of Mississippi Medical Center, Department of Surgery; Division of Plastic Surgery, Jackson, MS
Introduction: Contributions to innovation in hand surgery may be attributed to the surgeons themselves, commercial entities, or perhaps a combination of both. While surgeons may have initially driven change in this field, as the 21st century approached, commercial entities with advanced technological capabilities have become a prominent participant in innovative approaches to hand surgery. It is not uncommon even now for collaboration between surgeons and industry partners to be stigmatized and might at times even create an obstructive animosity that can stifle innovation. The purpose of this review is to document the historical contributors to innovation in hand surgery and to explore how evolving trends suggest the end of stigmatizing collaboration between industry and healthcare providers.
Materials and Methods: A review of published articles discussing topics of innovation in hand surgery was completed using the online database PubMed. Records were filtered for study type, full-text availability, and English language and screened for eligibility for inclusion. A single journal, The Journal of Hand Surgery (American and European volumes), was analyzed. Studies were grouped based on publication year, source of innovation, and topic of innovation. The risk of bias for all included studies was assessed.
Results: A total of 1,022 records were identified, and 48 articles were included in the analysis. 90% of innovative research from 1978 to 1999 was attributable to surgeons alone. Industrial companies began promoting advancements in hand surgery in the early 2000s with 59% of articles identified from 2000 to 2010 tied to commercial contributions. Surgeon- and industry-driven innovative research followed similar trends from 2010 to present. 84.6% of original articles presented by surgeons related to surgical techniques while research with ties to industrial companies was more diverse: surgical technique (77.3%), biomaterials (27.3%), technological innovation (18.2%), post-operative rehabilitation (13.6%), and diagnosis (4.5%).
Conclusions: Surgeons advanced early innovation in hand surgery, and healthcare industry partners became more involved in hand surgery in the early 2000s. Importantly, from 2010 to present, industry and provider contributions to innovation in hand surgery paralleled each other, highlighting the evolution from an adversarial dynamic to one that is a synergistic partnership. This review has revealed that surgeons and their healthcare industry collaborators share a mutual relationship that can benefit the medical community and our patients. By embracing this collaborative partnership, providers and industry partners together may continue to drive innovation and enhance both patient care and the future of hand surgery.
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