Arthritis is the number one disabling disease in the world. As of 2015, it is estimated that there are more than 100 million arthritis patients in mainland China, and the number is increasing with the aging of the society. Some of these patients will eventually progress to advanced stages of the disease, producing severe pain, joint deformities and functional impairments that affect the patient’s life. At such times, surgery is a very effective treatment that can significantly relieve pain, correct deformities and improve function, allowing patients to return to normal work and life. In the case of the hip and knee joints, which are the most commonly affected by arthritis, total hip replacement and total knee replacement surgery are so effective and cost-effective that they have been named the “most successful surgical procedure of the 21st century. However, the disadvantage of conventional joint replacement surgery is that the wounds are relatively large, and because the surgery involves incision and stripping of a large number of muscles and soft tissues, the patient will suffer from wound pain, loss of muscle strength and limpness for several months after surgery, and it will take several months to return to normal life and work after surgery. In recent years, with the development of concepts, techniques and surgical tools, these deficiencies have been greatly improved. First, improvements in analgesia have greatly reduced postoperative pain, especially with the use of intraoperative mixed drug periwound injections (also known as cocktail therapy) or nerve root blocks, which allow patients to feel essentially no pain for 1 or 2 days after surgery. These analgesic treatments are done intraoperatively without increasing patient trauma and pain, without interfering with postoperative recovery, and are easy and safe. Combined with other post-operative intravenous and oral analgesics, they can help patients tolerate post-operative joint pain well and perform rehabilitation exercises. Secondly, treatment is tailored to the type of arthritis and site of damage, rather than total joint replacement. This is mainly seen in the treatment of knee osteoarthritis, for example, for osteoarthritis that damages the anterior medial aspect of the knee, only the medially damaged cartilage may be replaced, leaving the rest of the undamaged cartilage of the knee intact, or the joint may not be replaced, but rather the joint pain may be relieved by osteotomy. This allows for the most appropriate treatment by strictly differentiating the patient and minimizing surgical trauma. Even more gratifying is the fact that recent advances in minimally invasive techniques have made joint surgery much less invasive. For example, in total hip arthroplasty, the use of the direct anterior approach and the direct superior approach for minimally invasive surgery has matured, reducing the surgical incision to less than half of the original conventional incision. These advances have led to better surgical outcomes for advanced arthritis, making the surgical experience more comfortable for the patient and making joint surgery less “scary”.