Background: Technological innovation in orthopaedics is key to advancing patient care. As emerging technologies near maturity, clinicians must be able to objectively assess where and when these technologies can be implemented. Patent databases are an underappreciated resource for quantifying innovation, especially within orthopaedic surgery. This study used a patent database to assess patent activity and relative growth of technologies in musculoskeletal medicine and orthopaedics over a period of 46 years. Methods: A total of 121,471 patent records were indexed from Lens.org, a patent database. These patents were grouped into subspecialty clusters and technology clusters using patent codes. Five-year (2014 to 2018), 10-year (2009 to 2018), and 30-year (1989 to 2018) compound annual growth rates were calculated and compared for each cluster. Results: Annual patent activity increased from one patent in 1973 to 4,866 patents in 2018. Of the eight subspecialty clusters, the largest number of patents were related to Inflammation (n = 63,128; 40.57%). The Elbow, Shoulder, and Knee clusters experienced increased annual patent activity since 2000. Of the 12 technological clusters, the largest number of patents were related to Drugs (n = 55,324; 39.75%). The Custom/patient-specific instrumentation, Computer Modeling, Robotics, and Navigation clusters saw growth in the average annual patent activity since 2000. Discussion: Innovation, as measured by patent activity in musculoskeletal medicine and orthopaedics, has seen notable growth since 1973. The Robotics cluster seems poised to experience exponential growth in industry investment and technological developments over the next 5 to 10 years. The Diagnostics, Computer Modeling, Navigation, and Design and Manufacturing clusters demonstrate potential for exponential growth in industry investment and technological developments within the next 10 to 20 years. Copyright 2023 by the American Academy of Orthopaedic Surgeons.
