Patient: I have a fusion of both hips with double lacquer necrosis, what is the best material to use for surgery, and how much does it cost? First, should we operate? In fact, there is only one indication for joint replacement surgery, that is, the pain and deformity is already unbearable, life is not normal, medication or other treatment is not effective, with all due respect, you are probably already at this stage, just “tolerate” it. Second, how to do surgery? (1) You are a young patient with polyarticular disease, generally either rheumatoid or strong column, belonging to the autoimmune disease, not only the skeletal system, other organs of the body may have problems, life expectancy is lower than normal people, can not be seen in accordance with the eyes of ordinary people, for social issues and quality of life considerations, should be relatively early surgery. If there is a problem with an important organ, even if you want to do joint replacement surgery, you will not have a chance. 2) Should we do the hip surgery or the knee surgery first? This is a question that needs to be discussed. I believe that hip surgery should be done first based on three considerations: First, the hip is a large weight-bearing joint, which is more painful and has a greater impact on life, so it should be addressed first. Second, if we don’t do the hip first, it will be difficult to balance the force line of the lower limb if we do the knee; third, after correcting the deformity of the hip joint and restoring the normal force line, the knee joint will no longer bear the abnormal weight, and it may heal itself without surgery. 3) What material to use? This question is the least important. The most important thing is the quality of the surgeon’s surgery, which is decisive. Under the premise of ensuring the quality of surgery, I recommend the material of “ceramic to polyethylene”, which is more secure, the high side of polyethylene anti-dislocation has a certain “insurance” effect. “Ceramic to ceramic” is more durable, but I don’t recommend it because of the possibility of shattering on impact, abnormal ringing, and most of all, controversy. “Metal vs. metal” is also controversial. (4) The knee joint problem I guess is not necessarily necrosis, this can be discussed later. Third, the cost issue. The price of the prosthesis is about 40,000-50,000, the medical cost is about 10,000-20,000, and the whole thing is about 60,000, but using “metal to polyethylene” only costs about 40,000.