For many people, artificial joint replacement surgery is no longer an unfamiliar term, but a real problem that they need to face, but they are very afraid of it, here I will call it “artificial joint replacement surgery phobia”. The human body is a magical machine with its own power, the power is our muscles, muscle contraction drives the bones to produce activity, the hub and fulcrum of bone activity is the joint, the importance of the joint can be seen. The hip and knee joints are the two largest and most complex joints in the human body, and problems with any of the four joints in the hip and knee can bring endless pain and trouble to a patient’s life. The most common one is osteoarthritis, and others are rheumatoid arthritis, ankylosing spondylitis, aseptic necrosis of the femoral head, developmental acetabular dysplasia, slipped femoral epiphysis, femoral acetabular impingement, and so on. Some of these diseases have a slow onset and can extend over several years and decades, while others have a rapid onset and development, but they usually have a process of occurrence, development, aggravation and deterioration. However, many of the joints that require and deserve artificial joint replacement are not fully functional. However, many patients who need and deserve artificial joint replacement surgery are afraid or unwilling to take surgical measures because of various concerns; or they clench their teeth and struggle to maintain with various painkillers and think about dealing with the adverse effects of painkillers; or they seek “prescriptions” and “secret recipes”. “secret recipes”, fall for deception, and hurt their lives and money; or give up on themselves, and their lives are in the dark. According to our experience with many patients, the reasons for “artificial joint replacement phobia” are generally the following. ”Unexplained fear” is a very common situation, where you are just afraid, but you can’t say what you are afraid of. Humans have an innate fear of the unknown, especially when this surgery is going to be performed on them. Science has advanced to the point where no one has a full understanding of our surroundings. Most people don’t know how televisions, washing machines, or cars work, or what happens to the food we eat, but none of this seems to affect our ability to watch television, do laundry, drive in a car, or even eat. On the other hand, artificial joint replacement surgery has been developed for more than 50 years and has been hailed as the most successful surgery of the 20th century. Today, several million cases are performed each year around the world, and hundreds of thousands of such surgeries are performed in our country each year. So it is a very mature surgery and there is really no need to be afraid. ”This is a situation that causes doctors a lot of headaches and laughter, and their patient explanations are often not worth the words of the “next door neighbor”. This “next door neighbor” can be anyone around the patient, but is this “next door neighbor” the joint surgeon? Will he be held accountable for his words? Does he have a better way to relieve your pain? ”The word “heard” is the same as “the next door neighbor said” or “they said”. On the other hand, if artificial joint replacement surgery is really not effective, then I am afraid that the majority of people will not know about this method, and there will not be so many hospitals and doctors to do this surgery, and the state and government will not provide any medical insurance coverage for the patients. ”Fear of the surgical procedure” is more common among the elderly. In fact, older people prefer a stable and familiar environment, but the whole procedure requires a “traverse” through a completely different environment and people, which is a big challenge for many older people. At this time, it is recommended that patients and their families should find doctors and hospitals that they trust and are familiar with, and communicate more with the doctors to gradually alleviate the elderly’s doubts; and to let the elderly see that the result of the “crossing” is the relief of pain, improvement of function and quality of life. For doctors, it is sometimes necessary to allow patients to communicate with post-surgical patients or to visit the ward to familiarize themselves with the process in advance. ”Fear of surgical pain” is a major concern for many patients because traditionally it seems that surgery and pain are a natural twin and that surgery is inevitably accompanied by great pain. Because of this, the medical community has raised pain to an unprecedented level in the past decade, and pain has been considered the “fifth vital sign” in addition to body temperature, respiration, heart rate, and blood pressure, resulting in many analgesic concepts and methods. Perioperative analgesia has also received a great deal of attention, and there are many ways to provide perioperative analgesia for artificial joint surgery to ensure pain-free weight-bearing activity early in the postoperative period. ”In the early 1990s, when modern artificial joint replacements were first introduced in China, patients were often kept in bed for 3 months for fear of post-operative joint dislocation. This practice was abandoned a long time ago, and on the contrary, the emphasis is now on getting out of bed as early as possible, as long as the patient’s physical condition permits, and under the premise of good analgesia, the patient can get out of bed 1-2 days after surgery and perform functional rehabilitation. Of course, some elderly patients with severe osteoporosis or those undergoing revision surgery may require longer periods of bed rest. ”You can’t walk after surgery” is a misconception that clearly lacks common sense. The purpose of surgery is to relieve pain and restore function, not to create problems. Of course, there are risks associated with any surgery, and the same is true for artificial joint replacement surgery, such as infection, post-operative dislocation, lower extremity vein thrombosis, etc. This is inherent in the science itself, just as walking inevitably leads to falls, and drinking water sometimes leads to choking and coughing, which no one can completely eliminate. Overall, the complication rate of artificial joint replacement surgery is comparable to that of a car accident, and most complications can be properly managed and eventually recovered. ”The phrase “artificial joints only last 15 years” can be daunting to many young patients, but in fact, it is a statement taken out of context. This is the general result of the current international follow-up of large cases, and a closer understanding shows that about 85% of patients have been using artificial joints for more than 20 years, and they are using prostheses manufactured 20 years ago. There is a lack of such long-term follow-up data in China, but we have a late-stage advantage, and there is no doubt that the current prostheses used are far superior to those made 10, 15, or 20 years ago. The current surgical techniques are also very different from those of 15 or 20 years ago, with more emphasis on soft tissue protection, avoiding unnecessary damage, and advocating “less invasive” surgery. Cost is a real problem, but the good news is that the national health insurance has been investing more and more in the field of joint replacement over the past few years, and depending on the region and the type of health insurance the patient has, the health insurance will generally pay 20-50% of the total price of the prosthesis. For patients with really limited financial means, it is necessary for doctors to help them choose some low-end products with a good track record. Some prostheses are cheap because they have been sold for a long time and their cost has been very low, and such prostheses, which often have a good historical record, would otherwise have been eliminated long ago. The causes of “artificial joint replacement surgery phobia” are many and varied, and each patient will have his or her own story, so it is difficult to list them all. Hip and knee arthroplasty has been hailed as the most successful surgery of the 20th century because it has actually solved the pain of a large number of patients, restored them to a good quality of life, and had excellent long-term results. In the last decade or so, the field of artificial joints has seen great additional advances in many areas such as biomechanics, implant material morphology and surface treatment, and frictional payoff configurations of weight-bearing surfaces. At this stage, the focus of consideration in this field is to give the prosthesis sufficient longevity, with the goal of reaching 50 years or more, in order to make it a once-in-a-lifetime procedure for the patient. For many patients with end-stage arthropathy, the arthropathy itself is not malignant and does not cause your life to be in danger, but it can severely affect your quality of life, which is a “cancer that never dies”. So when you are faced with the choice of surgery or not, remember that artificial joint replacement surgery can improve the function of your joints and therefore your quality of life. When you delay surgery for any reason, you also need to account for the opportunity cost of the disease itself, the cost of conservative treatment, the loss of work capacity, the loss of quality of life, and the physical and emotional cost of your family suffering along with you.