Writing about medical innovation was a challenging experience. Innovation is defined as: ”change that creates a new dimension of performance” . According to Michael Porter , ”innovation includes both improvements in technology and better methods or ways of doing things”. The researchers should understand that innovation in medicine can be stepwise, or it can be transformative. In addition, a common misconception must be corrected: being innovative does not mean inventing.
Until now, many scientists think that innovation is innate ability and our aim as scientific community is to support it by providing a great environment include funding, time and infrastructure. Elias Zerhouni [3, 6] thinks that innovation is specific to humans. For that to happen, people must work together, share their knowledge and pool their expertises. The great revelation given the innovations was, “why not?”, Zerhouni said that his residence completed as soon arrived at the department of radiology at Johns Hopkins, he proposed a great idea to extract biological information of the human body using medical images. His professor Stanley Siegelman said: ” I’m not sure of this idea, but why not?”
Roberta Ness  thinks that we can teach innovation to challenge the biggest problems. She thinks that innovation represents a way to move from a normal science to a discovery. The graduate course ”innovative thinking” developed by Dr. Ness and Dr. Jack Smith provides new ideas to find an innovative solution for some problems in practice. According to Ness, the strategies would be useful to anyone struggling to find new ideas and better approaches. She mentioned that the key of successful innovation generation is based on: learn to observe, ask the right question, use analogy to see the challenge in new ways, juggle induction and deduction, change your point of view, broaden your perspective, dissect the problem, reverse your thinking, recombine and rearrange, rely on the power of groups, shift the frame, and move away from the limits. The aim of the course is to remove the feel of the fear of failure and to raise the ability to identify the fundamental frames to our thinking. Dr. Ness thinks that ”creativity gap” due to the absence of strategies to educate student to be innovative. Training of thinking led researchers to demonstrate a greater attitude for solving complicated problems.
The question of sustainable innovation is the implementation on the large scale.
”Scaling up” has been used to describe an increase in the coverage of medical interventions that have been tested in experimental projects in order to support policy and programme development at a large or national scale. What we present is not a theory, ”scaling up” may succeed or fail which depend on many factors includes the strategies employed for having broader impact, the environment, and the resource organization or resource team. Success in achieving improvements in orthopaedic will also depend on efforts undertaken.
Different aspects of the ”scaling up” are substantially discussed in several fields of medicine. In orthopaedic, there are a limited number of researchers which devoted their efforts to this issue. In this work, Mediouni  discuss the ”scaling up” and mentioned that it depends on the following conditions:
- Orthopaedic community must perceive a need and motivate to implement it. Does the innovation respond to a priority and who are exactly the advocates of this innovation?
- We must make sure that timing and circumstances are right.
- Maximize the opportunities and minimize the constraints for better implementation.
- Build a strong team, network of supporters include individuals and institutions and find an appropriate collaboration. It is important to ensure that managerial expertise and skills in advocacy are well integrated.
 Goldsmith M, Baldoni J, McArthur S (2010) The AMA Handbook of Leadership. New York, NY: American Management Association.
 Porter ME. The Competitive Advantage of Nations. New York, NY: Free Press; 1990
 Elias Zerhouni. Nature Biotechnology 29, 188 (2011)
 Mediouni M, Vaughan N, Shetty SH, Arora M, Volosnikov A, et al. (2016) How Challenging is the ‘Scaling Up’ of Orthopaedic Simulation?. Peertechz Journal of Orthopedics and Rheumatology 1: 12-14.
 Stanley S. Siegelman. Elias A. Zerhouni, MD, Radiologist: New Director of the National Institutes of Health. Radiology. 309-312, 2002.
About the author:
Mohamed Mediouni is a prominent figure in orthopaedics surgery. The researcher desires to provide orthopaedic community a platform that contains templates for performing surgical simulations. This 3D collection will be accessible online, will provide all models of bones and surgical tools. He is the Editorial Board Members of a number of reputed International Journals. He has been awarded with Antoni-Trias-Biomet in the year 2013-2014.