Over the past several decades, the field of orthopaedics has been transformed by new devices, surgical techniques, and treatment modalities. Many of these advancements began with an idea often originating from an orthopaedic surgeon. The subspecialties of total joint arthroplasty and spine surgery have many examples of strong collaborations between surgeons and industry. The development of new total joint replacements as well as techniques for spinal fusion and disc replacements that have occurred over the past twenty years have often been the result of implants that were developed by a single surgeon and then were sold to companies. Major advances in these areas have also occurred when companies have worked with surgeon design teams, sometimes as consultants, to optimize an idea, design, instrumentation, or technique, as well as to refine these ideas in an iterative manner to improve the overall clinical results.