創新是產業發展的推動力，也是企業重點關注的發展目標。創新的源頭多樣，
但近年來，討論的焦點主要集中在外部貢獻者，尤其是使用者所帶來的影響，促
使產業產生新的思維，推動產業革新。這種由使用者主導的創新往往能帶來開創
性的進步，挑戰既有的設計模式和發展路徑。本研究深入探討了一個特定的使用
者創新案例，區別於一般使用者的定義，特別聚焦於「專業使用者」在創新過程
中扮演的關鍵角色，而這一群體在創新來源理論中至今鮮少受到關注。科學社群
中的專業使用者擁有專業化和實踐性知識，這可能與製造商或開發者的觀點不同，
使他們能夠創造出具有重要科學價值的創新，同時更好地滿足終端實際使用者的
需求。
在實證方面，本研究專注於醫材設備的專業使用者-醫師，他們具有巨大的
創新潛力，進行了以骨科治療為中心的質性研究，探討了兩個成功的醫材創新案
例。本研究採用了內部外部方法論，並凸顯了由醫師主導創新的重要性，這不僅
取決於醫師的專業醫學知識，還取決於醫師與患者之間的社會互動和反饋。本研
究確定了兩個關鍵的使用者群體——醫師和患者——他們之間的持續互動在推
動醫材創新方面起著至關重要的作用。而本研究的重要貢獻在於加深對醫材設備
專業使用者的理解，強調了從醫病互動過程中產生的創新，深化科學專業知識與
個人需求交織的創新催化過程。

Innovation drives industrial progress and is a core focus of business efforts. While
innovation can emerge from various sources, recent discussions have primarily focused
on external contributors, particularly users, spurring industries to adopt fresh
perspectives and advance innovation. User-driven innovation often leads to
groundbreaking advancements, challenging established design patterns and pathways.
This study examines a specific user innovation case, emphasizing the pivotal role of
"professional users" in the innovation process, a group often overlooked in innovation
theories. Professional users within scientific communities possess specialized
knowledge, enabling them to create innovations with significant scientific value while
better addressing end users' needs.
This study centers on professional users of medical devices - doctors, who hold
considerable innovation potential. Qualitative research focused on orthopedic treatment
explored two successful medical device innovation cases. Using an insider-outsider
methodology, the study underscores the importance of physician-led innovation, which
relies not only on medical expertise but also on social interaction and feedback between
doctors and patients. It identifies two key user groups - doctors and patients - whose
ongoing interaction drives medical device innovation. The study deepens understanding
of professional users of medical devices, highlighting innovation catalyzed by the
interaction between medical professionals and individual needs, thereby enriching the
integration of scientific expertise with personal requirements.

Abrahamsen, B., van Staa, T., Ariely, R., Olson, M., & Cooper, C. 2009. Excess
mortality following hip fracture: A systematic epidemiological review.
Osteoporosis international, 20(10): 1633-1650.
Afuah, A. 2020. Innovation management-strategies, implementation, and profits. New
York, NY: Oxford University Press.
Ahuja, G., & Katila, R. 2001. Technological acquisitions and the innovation
performance of acquiring firms: A longitudinal study. Strategic Management
Journal, 22(3): 197-220.
Aronson, J. K. 2008. Something new every day: Defining innovation and
innovativeness in drug therapy. The Journal of Ambulatory Care Management,
31(1): 65-68.
Baldwin, C., Hienerth, C., & von Hippel, E. 2006. How user innovations become
commercial products: A theoretical investigation and case study. Research
Policy, 35(9): 1291-1313.
Baldwin, C., & von Hippel, E. 2011. Modeling a paradigm shift: From producer
innovation to user and open collaborative innovation. Organization Science,
22(6): 1399-1417.
Bartunek, J., Foster-Fishman, P., & Keys, C. 1996. Using collaborative advocacy to
foster intergroup cooperation: A joint insider-outsider investigation. Human
Relations, 49(6): 701-733.
Bartunek, J. M., & Louis, M. R. 1996. Insider/Outsider team research. Thousand Oaks:
Sage.
Berthon, P. R., Pitt, L. F., McCarthy, I., & Kates, S. M. 2007. When customers get clever:
Managerial approaches to dealing with creative consumers. Business Horizons,
33
50(1): 39-47.
Best, M. J., Buller, L. T., & Eismont, F. J. 2015. National trends in ambulatory surgery
for intervertebral disc disorders and spinal stenosis: A 12-year analysis of the
national surveys of ambulatory surgery. Spine, 40(21): 1703-1711.
Bhandari, M., & Swiontkowski, M. 2017. Management of acute hip fracture. New
England Journal of Medicine, 377(21): 2053-2062.
Bogers, M., Afuah, A., & Bastian, B. 2010. Users as innovators: A review, critique, and
future research directions. Journal of Management, 36(4): 857-875.
Boos, N., Weissbach, S., Rohrbach, H., Weiler, C., Spratt, K. F., & Nerlich, A. G. 2002.
Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo
Award in basic science. Spine, 27(23): 2631-2644.
Chang, W.-T., Kuo, Y.-J., Huang, Y.-Y., Tsai, M.-J., & Chen, Y.-P. 2019. Poor activities
of daily living function reflect poor quality of life after hip fracture surgery for
geriatric patients. Social Health and Behavior, 2(2): 41-46.
Chatterji, A. K., & Fabrizio, K. 2012. How do product users influence corporate
invention? Organization science, 23(4): 971-987.
Chatterji, A. K., & Fabrizio, K. R. 2014. Using users: When does external knowledge
enhance corporate product innovation? Strategic Management Journal, 35(10):
1427-1445.
Chatterji, A. K., Fabrizio, K. R., Mitchell, W., & Schulman, K. A. 2008. Physicianindustry
cooperation in the medical device industry. Health Affairs, 27(6): 1532-
1543.
Chen, I. J., Chiang, C. Y., Li, Y. H., Chang, C. H., Hu, C. C., Chen, D. W., . . . Hsieh, P.
H. 2015. Nationwide cohort study of hip fractures: Time trends in the incidence
rates and projections up to 2035. Osteoporosis International, 26(2): 681-688.
Chen, Y., Vanhaverbeke, W., & Du, J. 2016. The interaction between internal R & D
34
and different types of external knowledge sourcing: An empirical study of C
hinese innovative firms. R&D Management, 46(S3): 1006-1023.
Chesbrough, H. 2003. Open innovation: The new imperative for creating and profiting,
from technology. Boston, MA: Harvard Business School Press.
Chie, W. C., Yang, R. S., Liu, J. P., & Tsai, K. S. 2004. High incidence rate of hip
fracture in Taiwan: Estimated from a nationwide health insurance database.
Osteoporosis International, 15(12): 998-1002.
Ciani, O., Armeni, P., Boscolo, P. R., Cavazza, M., Jommi, C., & Tarricone, R. 2016.
De innovatione: The concept of innovation for medical technologies and its
implications for healthcare policy-making. Health Policy and Technology, 5(1):
47-64.
Cornwall, R., Gilbert, M. S., Koval, K. J., Strauss, E., & Siu, A. L. 2004. Functional
outcomes and mortality vary among different types of hip fractures: A function
of patient characteristics. Clinical Orthopaedics and Related Research, 425: 64-
71.
Dahlander, L., Gann, D. M., & Wallin, M. W. 2021. How open is innovation? A
retrospective and ideas forward. Research Policy, 50(4): 104218.
De Zubielqui, G. C., Jones, J., & Lester, L. 2016. Knowledge inflows from market-and
science-based actors, absorptive capacity, innovation and performance—A
study of SMEs. International Journal of Innovation Management, 20(06):
1650055.
Eisenhardt, K. M. 1989. Building theories from case study research. Academy of
Management Review, 14(4): 532-550.
Enos, J. L. 1962. Petroleum progress and profits: A history of process innovation.
Cambridge, MA: The MIT Press.
Escobar, O., Schiavone, F., Khvatova, T., & Maalaoui, A. 2021. Lead user innovation
35
and entrepreneurship: Analyzing the current state of research. Journal of Small
Business Management, 61: 1-18.
Evered, R., & Louis, M. R. 1981. Alternative perspectives in the organizational sciences:
"Inquiry from the inside" and "Inquiry from the outside". The Academy of
Management Review, 6(3): 385-395.
Flessa, S., & Huebner, C. 2021. Innovations in health care – A conceptual framework.
International Journal of Environmental Research and Public Health,
18(19):10026.
Franke, N., & Shah, S. 2001. How communities support innovative activities: An
exploration of assistance and sharing among innovative users of sporting
equipment. Sloan working paper #4164, Massachusetts Institute of
Technology/Sloan School of Management, Cambridge, MA.
Franke, N., & Shah, S. 2003. How communities support innovative activities: An
exploration of assistance and sharing among end-users. Research Policy, 32(1):
157-178.
Freeman, C., Robertson, A. B., Whittaker, P. J., Curnow, R. C., Fuller, J. K., Hanna,
S., . . . Rufo, G. 1968. Chemical process plant: Innovation and the world market.
National Institute Economic Review, 45: 29-57.
Grant, R. M. 1996. Prospering in dynamically-competitive environments:
Organizational capability as knowledge integration. Organization Science, 7(4):
375-387.
Hacking, I. 1992. Science in action: How to follow scientists and engineers through
society. Cambridge, MA: Harvard University Press.
Heck, V. J., Klug, K., Prasse, T., Oikonomidis, S., Klug, A., Himpe, B., . . . Scheyerer,
M. J. 2023. Projections from surgical use models in Germany suggest a rising
number of spinal fusions in patients 75 Years and older will challenge healthcare
36
systems worldwide. Clinical Orthopaedics and Related Research, 481(8):1610-
1619.
Herstatt, C., & von Hippel, E. 1992. From experience: Developing new product
concepts via the lead user method: A case study in a “low-tech” field. Journal
of Product Innovation Management, 9(3): 213-221.
Hienerth, C., & Lettl, C. 2011. Exploring how peer communities enable lead user
innovations to become standard equipment in the industry: Community pull
effects. Journal of Product Innovation Management, 28(s1): 175-195.
Hippel, E. v., & Katz, R. 2002. Shifting innovation to users via toolkits. Management
Science, 48(7): 821-833.
Höyssä, M., & Sampsa, H. 2009. The fog of innovation: Innovativeness and deviance
in developing new clinical testing equipment. Research Policy, 38: 984-993.
Huang, H., & Xu, C. 1999. Institutions, innovations, and growth. American Economic
Review, 89(2): 438-443.
Hughes, T. P. 1986. The seamless web: Technology, science, etcetera, etcetera. Social
Studies of Science, 16(2): 281-292.
Jensen, M., Johnson, B., Lorenz, E., & Lundvall, B.-Å. 2007. Forms of knowledge and
modes of innovation. Research Policy, 36: 680-693.
Jeppesen, L., & Frederiksen, L. 2006. Why do users contribute to firm-hosted user
communities? The case of computer-controlled music instruments.
Organization Science, 17: 45-63.
Kanter, R. M. 2009. When a thousand flowers bloom: Structural, collective, and social
conditions for innovation in organizations. In P. S. Myers (Ed.), Knowledge
management and organisational design: 93-132. Oxford, England: Butterworth–
Heinemann
Katila, R., Thatchenkery, S., Christensen, M., & Zenios, S. 2017. Is there a doctor in
37
the house? Expert product users, organizational roles, and innovation. Academy
of Management Journal, 60(6): 2415-2437.
Kim, S. J., Park, H. S., & Lee, D. W. 2020. Complications after internal screw fixation
of nondisplaced femoral neck fractures in elderly patients: A systematic review.
Acta Orthopaedica et Traumatologica Turcica, 54(3): 337-343.
Koh, G. C., Tai, B. C., Ang, L. W., Heng, D., Yuan, J. M., & Koh, W. P. 2013. All-cause
and cause-specific mortality after hip fracture among Chinese women and men:
The Singapore Chinese health study. Osteoporosis International, 24(7): 1981-
1989.
Kos, N., Gradisnik, L., & Velnar, T. 2019. A brief review of the degenerative
intervertebral disc disease. Medical Archives, 73(6): 421-424.
Lakhani, K. R., & von Hippel, E. 2003. How open source software works: “free” userto-
user assistance. Research Policy, 32(6): 923-943.
Laursen, K., & Salter, A. 2006. Open for innovation: The role of openness in explaining
innovation performance among U.K. manufacturing firms. Strategic
Management Journal, 27: 131-150.
Lettl, C., Herstatt, C., & Gemuenden, H. 2006. Users' contributions to radical
innovation: Evidence from four cases in the field of medical equipment
technology. R&D Management, 36: 251-272.
Lilien, G., Morrison, P., Searls, K., Sonnack, M., & Hippel, E. 2002. Performance
assessment of the lead user idea-generation process for new product
development.. Management Science, 48(8): 1042-1059.
Lin, K. B., Yang, N. P., Lee, Y. H., Chan, C. L., Wu, C. H., Chen, H. C., & Chang, N.
T. 2018. The incidence and factors of hip fractures and subsequent morbidity in
Taiwan: An 11-year population-based cohort study. PLoS One, 13(2): e0192388
Lundvall, B.- Å. , 2016. Innovation as an interactive process: From user-producer
38
interaction to the national system of innovation. In The learning economy and
the economics of hope: 61-84. London, England: Anthem Press
Lüthje, C. 2004. Characteristics of innovating users in a consumer goods field: An
empirical study of sport-related product consumers. Technovation, 24(9): 683-
695.
Lüthje, C., Herstatt, C., & von Hippel, E. 2005. User-innovators and “local”
information: The case of mountain biking. Research Policy, 34(6): 951-965.
Mayo, A., Myers, C., & Sutcliffe, K. 2021. Organizational science and health care.
Academy of Management Annals, 15(2): 537-576.
Mitchell, V., Ross, T., May, A., Sims, R., & Parker, C. 2016. Empirical investigation of
the impact of using co-design methods when generating proposals for
sustainable travel solutions. CoDesign, 12(4): 205-220.
Morrison, P. D., Roberts, J. H., & von Hippel, E. 2000. Determinants of user innovation
and innovation sharing in a local market. Management Science, 46(12): 1513-
1527.
Piller, F., & Walcher, D. 2006. Toolkits for idea competitions: A novel method to
integrate users in new product development. R&D Management, 36: 307-318.
Prabhu, M. C., Jacob, K. C., Patel, M. R., Pawlowski, H., Vanjani, N. N., & Singh, K.
2022. History and evolution of the minimally invasive transforaminal lumbar
interbody fusion. Neurospine, 19(3): 479-491.
Ranga, R., & Rousseau, D. M. 2006. The challenges are organizational not just clinical.
Journal of Organizational Behavior, 27(7): 811-827.
Ravindra, V. M., Senglaub, S. S., Rattani, A., Dewan, M. C., Härtl, R., Bisson, E., . . .
Shrime, M. G. 2018. Degenerative lumbar spine disease: Estimating global
incidence and worldwide volume. Global Spine Journal, 8(8): 784-794.
Riggs, W., & von Hippel, E. 1994. Incentives to innovate and the sources of innovation:
39
The case of scientific instruments. Research Policy, 23(4): 459-469.
Russell, S., & Williams, R. 2002. Social shaping of technology: Frameworks, findings
and implications for policy. In K. H. Sørensen & R. Williams (Eds.), Shaping
technology, guiding policy: Concepts, spaces and tools: 37-120. Cheltenham,
England: Edward Elgar Publishing
Sawhney, M., Verona, G., & Prandelli, E. 2005. Collaborating to create: The Internet as
a platform for customer engagement in product innovation. Journal of
Interactive Marketing, 19(4): 4-17.
Shah, S. K., & Tripsas, M. 2007. The accidental entrepreneur: The emergent and
collective process of user entrepreneurship. Strategic Entrepreneurship Journal,
1(1/2): 123-140.
Shaw, B. 2007. The role of the interaction between the user and the manufacturer in
medical equipment innovation. R&D Management, 15: 283-292.
Slaughter, S. 1993. Innovation and learning during implementation: A comparison of
user and manufacturer innovations. Research Policy, 22(1): 81-95.
Stockstrom, C., Hinsch, M., & Lüthje, C. 2014. User innovation in techniques: A case
study analysis in the field of medical devices. Creativity and Innovation
Management, 23: 484-494.
Tarpada, S. P., Morris, M. T., & Burton, D. A. 2017. Spinal fusion surgery: A historical
perspective. Journal of Orthopaedics, 14(1): 134-136.
Teraguchi, M., Yoshimura, N., Hashizume, H., Muraki, S., Yamada, H., Minamide,
A., . . . Yoshida, M. 2014. Prevalence and distribution of intervertebral disc
degeneration over the entire spine in a population-based cohort: The Wakayama
Spine Study. Osteoarthritis Cartilage, 22(1): 104-110.
Thomas, M. D., Blacksmith, J., & Reno, J. 2000. Utilizing insider-outsider research
teams in qualitative research. Qualitative Health Research, 10(6): 819-828.
40
Tohidi, H., & Jabbari, M. M. 2012a. The important of innovation and its crucial role in
growth, survival and success of organizations. Procedia Technology, 1: 535-538.
Tohidi, H., & Jabbari, M. M. 2012b. Innovation as a success key for organizations.
Procedia Technology, 1: 560-564.
Trott, P., & Hartmann, D. A. P. 2009. Why'open innovation'is old wine in new bottles.
International Journal of Innovation Management, 13(04): 715-736.
Un, C. A., Cuervo‐Cazurra, A., & Asakawa, K. 2010. R&D collaborations and product
innovation. Journal of Product Innovation Management, 27(5): 673-689.
Ven, A. H. V. d., Polley, D. E., Garud, R., & Venkataraman, S. 1999. The innovation
journey. New York, NY: Oxford University Press.
von Hippel, E. 1976. The dominant role of users in the scientific instrument innovation
process. Research Policy, 5(3): 212-239.
von Hippel, E. 1978. A customer-active paradigm for industrial product idea generation.
Research Policy, 7(3): 240-266.
von Hippel, E. 1986. Lead users: A source of novel product concepts. Management
Science, 32(7): 791-805.
von Hippel, E. 1988. The sources of innovation. New York, NY: Oxford University
Press.
von Hippel, E. 1994. "Sticky information" and the locus of problem solving:
Implications for innovation. Management Science, 40(4): 429-439.
von Hippel, E. (2006). Democratizing innovation. Cambridge, MA: The MIT Press.
von Krogh, G., & von Hippel, E. 2003. Special issue on open source software
development. Research Policy, 32(7): 1149-1157.
von Krogh, G., & von Hippel, E. 2006. The promise of research on open source
software. Management Science, 52(7): 975-983.
Wu, Y., Leu, T. H., Chuang, T. Y., Ho, W. P., Chen, Y. P., & Lin, C. Y. 2019. Screw
41
trajectory affects screw cut-out risk after fixation for nondisplaced femoral neck
fracture in elderly patients. Journal of Orthopaedic Surgery, 27(2):
2309499019840252.
Xin, J., Wang, Y., Zheng, Z., Wang, S., Na, S., & Zhang, S. 2022. Treatment of
intervertebral disc degeneration. Orthopaedic Surgery, 14(7): 1271-1280.
Yin, R. K.. 2014. Case study research design and methods (5th ed.). Thousand Oaks,
CA: Sage.
Zobel, A.-K. 2017. Benefiting from open innovation: A multidimensional model of
absorptive capacity. Journal of Product Innovation Management, 34(3): 269-
288.