What should I do if I am elderly, hypertensive, diabetic, cardiovascular or cerebrovascular disease and have high risk of joint surgery? In clinical practice, I often encounter a situation where an elderly man in his 70s or 80s has had joint pain for many years and needs surgical treatment. However, the patient is accompanied by many years of hypertension, diabetes, heart disease, cerebral infarction, myocardial infarction, arrhythmia, slow blocking lung, pulmonary heart disease, chronic cardiac insufficiency and other cardiovascular and cerebrovascular diseases. The risk of surgery for such a patient is definitely high. When the doctor informs the patient’s family in detail about the various surgical risks, the patient and family members are psychologically burdened and the doctor is under a lot of pressure. In response to such a phenomenon, I have done some deep thinking. Nowadays, our joint surgery technology has matured, the operation time has been greatly shortened, and the bleeding volume is basically controllable. So where do the risks of surgery for such patients mainly come from? The main risk is anesthesia and the risk of pre-existing disease induced by perioperative stress. With this in mind, we have developed a new anesthesia technique for joint replacement in conjunction with the Department of Anesthesiology, namely compound nerve block. This type of anesthesia is actually “anesthesia without intoxication”, the patient is awake, but without pain, and if the patient is afraid, the patient is put to sleep. At the end of the operation, the patient can be woken up and returned to the ward directly without going to the anesthesia wake-up room. From the results of the implementation, this new technique has great advantages. First of all, the patient is not under general anesthesia and deep anesthesia, there is no tracheal intubation and use of ventilator, the risk of anesthesia itself has been greatly reduced, there is no postoperative unstable blood pressure, no postoperative unconsciousness, and no occurrence of gibberish. Moreover, because it is a nerve block, the patient’s postoperative pain is greatly reduced and the joint function is recovered satisfactorily. Of course, this new technique is difficult to operate and is currently only carried out in the First Affiliated Hospital of Anhui Medical University. For the knee joint replacement, we have combined with the Department of Anesthesiology to carry out the lumbar plexus nerve combined with sciatic nerve block, which is a combination of nerve stimulator with precise puncture and block under the guidance of micro B-ultrasound. Artificial joint technology has developed rapidly over the years, but there are still many aspects that we need to continuously think about and improve. The more we improve, the less patients will suffer.