Academic research is essential to bring disruptive innovation on medical devices market because the risk-taking is too high for companies and their investors. Performing clinical trials is essential to technical files but no one wants to accept responsibility for implanted off-label devices. The paper explains the academic process for innovation. We see that academic research depends, at the end, on the motivation of companies to develop a product. The key to innovation stands in the early collaboration between the surgeons, the research teams and the companies in a project. Innovation is a good idea supported by the expertise of the right people at the right moment. In orthopaedics, we need, more than ever, to stay focused on the patient benefits.