Published 12/17/2025
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Heather Knox
Innovation in orthopaedic surgery is a process, not a single moment of genius. In an episode of the AAOS Now podcast, Amy Ladd, MD, chief of the Chase Hand & Upper Limb Center at Stanford University, discussed how this process unfolds in practice. She spoke with Robert M. Orfaly, MD, MBA, FAAOS, editor-in-chief of AAOS Now. Click here to access the podcast.
Drawing on more than three decades of experience in hand and upper-extremity surgery, Dr. Ladd shared how curiosity and careful observation can lead to both incremental improvements and larger innovations. Her career, marked by more than 30 patents, patent applications, and trademarks for technological innovations and advancements, offers a roadmap for orthopaedic surgeons interested in bringing their own ideas from inspiration to implementation.
Defining innovation
“Innovation may be an overused word because I think we’re all innovators,” Dr. Ladd said. “To me, it means creativity and something new that might change how we do and approach things.”
She likened innovation to the natural curiosity that drives surgeons to ask questions in the first place. “Our [Presidential Guest Speaker at the AAOS 2025 Annual Meeting] was Captain ‘Sully’ Sullenberger, and he opened with how he always has had intellectual curiosity,” she recalled. “As surgeons, we all want to make the world better and make people healthier — that’s where innovation begins.”
For Dr. Ladd, innovation is not always about building the next breakthrough device. It can be as simple as finding a better way to do something in the OR.
“Innovation, to me, is taking what’s around you and trying to make it better in creative ways,” she shared. “That could be devices, gadgets, or just a different way of thinking.”
Finding focus through curiosity
Despite her reputation as a focused innovator in thumb carpometacarpal arthritis, Dr. Ladd’s journey began as anything but linear.
“My interest in base-of-thumb arthritis evolved over time,” she explained. “I’ve been in practice 35 years — it was a very divergent, circuitous path to a focus.”
Early in her career, she dabbled before one area truly captured her attention. She recommended that trainees “go after lots of things initially and see what sticks. I’m definitely a dabbler. My interest in [carpometacarpal] arthritis took about 15 years [to develop].”
Her eventual research focus echoed her upbringing. “I grew up in a Kodak family,” she said. “My dad worked for Kodak. He sold X-rays. He desperately wanted me to be a radiologist, but I couldn’t stand that black box. Ironically, most of my research is around imaging and movement.”
Her current lab focus — to predict, prevent, and treat arthritis of the base of the thumb — emerged organically from curiosity rather than exposure during training.
For trainees and fellows, she emphasized two complementary stages of growth: “First is curiosity. Go for it. Second is, if you really want to do this for a career, be curious and then work on something for a while, fairly linearly, and see what other opportunities open up.”
Turning ideas into prototypes
Dr. Ladd distinguished between two scales of innovation: The “big idea” that might launch a company and the “quick win” that improves a procedure or tool. “Sometimes it’s just a matter of saying, ‘We need a better way to do this,’” she said.
For example, while treating scaphoid nonunions, Dr. Ladd noticed that tamping vascularized bone grafts risked damaging a small vessel, which prompted her to work with a student to develop a C-shaped tamp to relieve pressure.
“It’s a simple solution,” she explained. “It took nothing other than a little time and energy and partnering with someone who’s curious.”
Larger ideas require more formal steps. Dr. Ladd described her process for prototyping a deployant spring for distal radius fractures — an idea for which she has a patent but has not fully developed.
“I worked out the idea, what would counteract the mechanical forces, and that was just something I really thought about [and] I read about. I went to Michaels [the craft store] and the hardware store and played with all sorts of things. I looked at levers like car jacks, clips, a hair clip,” she shared.
When an idea shows promise, she advises documenting it early to jump-start the process of securing intellectual property rights. “You write it on anything, a napkin, a paper towel — but usually paper and ink works best,” she joked. “You sign it, you date it, and you need it notarized, and you need a witness. … Even if you put it in a drawer for five years, that really starts the process.”
She also recommended doing a patent search — something made much easier by online tools. “Google has a patent search,” she noted. “If your search doesn’t find anything [similar], then I would suggest talking to a patent attorney.”
She compared the process of searching for patents to checking the literature before writing a paper. This can help surgeons to avoid investing time and energy into something that has already been done.
Building innovation networks
Although creativity may begin alone, successful innovation rarely happens in isolation. Dr. Ladd emphasized the importance of building a network of curious, creative people with different skill sets and resources.
She credits interdisciplinary collaboration for one of her own projects. “I’m working on a trigger pad,” she shared. “I ran it by an engineer who helped me look for the patent, and the patent that’s out there is pretty close. My next stage is modifying it just enough.”
Dr. Ladd encouraged that even though academic institutions have a lot of available resources, these partnerships can extend beyond academia. “If you’re in private practice, you have to be a little bit more creative beyond your own network. The way to go is either institutional, which has its caveats, or industry, which also has its caveats.”
Institutions can offer support with patent searches or identification of companies that might be interested in an idea, but Dr. Ladd cautioned surgeons to understand the trade-offs. “The minute you involve a graduate student or a trainee, that liaison is formal and the university or institution is involved,” she said.
The key, she said, is transparency and timing. “You need to go to the people who oversee intellectual property and technical license transfer. It’s a good idea to do it early on, because you want to know where the landmines are.”
Innovation in orthopaedic surgery is less about chasing breakthroughs than nurturing curiosity. By fostering a mindset that encourages questioning, experimenting, and sharing discoveries, orthopaedic surgeons can continue to advance the specialty and shape the next generation of musculoskeletal care.
“I think everyone has that creative drive, and it’s just a question of nurturing it and jumping in,” Dr. Ladd remarked in closing.
Heather Knox is the associate editor of AAOS Now. She can be reached at hknox@aaos.org.