{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:51:42Z","timestamp":1791226302937,"version":"4.1.0"},"reference-count":68,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>\n                    <jats:list list-type=\"plain\">\n                      <jats:list-item>\n                        <jats:p>\u27a2 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.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u27a2 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.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u27a2 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.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u27a2 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.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u27a2 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.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.2106\/jbjs.26.00002","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:00:59Z","timestamp":1791223259000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Reverse and Frugal Innovations in Orthopaedics: Potential Applications in High-Resource Settings"],"prefix":"10.2106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7263-6134","authenticated-orcid":false,"given":"Teja","family":"Yeramosu","sequence":"first","affiliation":[{"name":"Rothman Orthopaedic Institute at AdventHealth, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-1419","authenticated-orcid":false,"given":"Sanjeev","family":"Sabharwal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"1","key":"bib1-20261005","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/1744-8603-9-36","article-title":"Reverse innovation in global health systems: towards global innovation flow","volume":"9","author":"Syed","year":"2013","journal-title":"Global Health."},{"issue":"1","key":"bib2-20261005","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/08956308.2023.2142444","article-title":"Reverse innovation, frugal innovation, and jugaad","volume":"66","author":"McCausland","year":"2023","journal-title":"Res Technol Manag."},{"issue":"12","key":"bib4-20261005","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1007\/s12178-025-09985-4","article-title":"Frugal innovations in orthopaedics","volume":"18","author":"Kakulamarri","year":"2025","journal-title":"Curr Rev Musculoskelet Med."},{"issue":"1","key":"bib5-20261005","doi-asserted-by":"crossref","DOI":"10.1186\/s40669-016-0005-y","article-title":"What is frugal innovation? 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