That day, the plane landed at the New York airport. I was just walking out of the customs hall. Suddenly, I was attracted by a giant billboard advertising the “Hospital for Special Surgery (HSS)” for total anterior hip replacement. A red-clad motocross rider was leaping in the sky blue mid-air. The tagline was bold: “101 days after hip replacement”. This made my jaw drop as an arthro surgeon – could this be true? You know, in China this is a fantasy. One day a year ago, Director Zhang Hong called me to his office and told me to put aside my work for a while and go to the United States to study for six months to master the surgical technique of total hip anterior approach arthroplasty. At that time, I thought, “For many years, total hip replacement has been a posterior-lateral approach, and the surgical technique is very mature. The incision in the posterior approach is only 10 centimeters, and we can be discharged within a week after surgery. Did we need to reopen the gong so much? Six months later, when I stepped on the plane from New York airport to my home country, I saw the advertisement of total anterior hip replacement at the American Hospital for Special Surgery again, and my thoughts turned 180°. Through six months of hard study, I understood all the “hidden organs” of the anterior approach incision for total hip replacement, and I already had the bottom of my heart. As an 80-year-old, although I am still an attending doctor, I have the responsibility to carry out the scouting of total hip replacement in 304 joint surgery. This not only heralded a shift from the knee field to the hip field upon my return to China, but also set a milestone in my career of aspiring to be a great joint surgeon, starting from mile 0. I found that in the United States, the anterior approach was also just entering a phase of rapid development. Statistics from the American Academy of Surgeons (AAOS) in 2014 showed that 75% of young orthopaedic surgeons are interested in anterior approach total hip replacement and want to try applying this approach. Currently, at least 20% of U.S. orthopaedic surgeons are using this approach. And that number is expected to reach 25-30% by the end of 2015. I asked a few young orthopedic surgeons my age privately, “Why is the “anterior approach” to the hip so popular in the United States?” Their answer was surprising: patients are asking us to do it! I also asked some senior American orthopedic surgeons why they wanted to change the approach that they had been doing for more than a decade or even decades, and they unanimously replied, “It’s what the patients want! Ah! American patients can actually choose their own surgical approach? How could they give their own green light to the anterior approach? Well, it turns out that American doctors and patients have equal access to all kinds of medical academic and scientific information. Patients in the United States have access to all information about their disease through various means. For every patient facing a total hip replacement, videos of all procedures are available on medical video sites. This includes impressive post-operative recovery videos, plus the socio-medical economics of a significantly shorter hospital stay, such as a three-day discharge from bed the next day. Patients know all the details of the procedure and the “benefits” they can expect. Therefore, in the United States, the huge advertising campaign promoting total anterior hip replacement has the advantage of a broad “mass appeal”. This has contributed to the rapid promotion of anterior hip replacement surgery, which is really driven by the patients themselves. I think in China, it is the lack of equal access to medical information for patients and doctors that has prevented Chinese patients from being the real drivers of total hip “anterior approach” replacements. We hope that Chinese patients will choose the “anterior approach” as clearly as American patients do, so that they can truly express their own demands and promote the relatively slow progress of total hip replacement in China. The process of total hip replacement is relatively slow in China. In 2013, after a meeting in Switzerland, Director Zhang Hong went to study total hip anterior approach replacement with Professor Leunig, the son-in-law of Professor Ganz, the master of orthopedics, and thus made up his mind to develop anterior approach in our joint surgery department. Director Zhang Hong told me that many doctors in Europe and the United States use the direct anterior approach to perform total hip replacement, which is particularly beneficial to patients because of the small intraoperative damage and quick postoperative recovery, so we should also overcome this beneficial surgical approach. For us orthopaedic surgeons, we need to overcome the original sequential approach mindset and re-establish a new learning curve, which is equivalent to a skilled bicycle rider abandoning his bicycle to learn how to ride a tricycle. It was in this state of “crossing the river by feeling the stones” that we performed the first surgery. The anterior approach took significantly longer and the rhythm of the surgery was not smooth, but we did take the first step. During my six months abroad, I visited several hospitals and tens of surgeries. Although they applied different surgical aids, the difficulty of this surgery was how to better reveal the proximal femur and facilitate the preparation of the medullary cavity of the femur. Since only the surgeon and the assistant could see the lateral femoral release during the surgery due to the patient’s position during the surgery, I need to thank Prof. Spangehl of MAYO CLINIC who not only let me stand in the position of the first assistant during the hands-on training session when the new fellow arrived, but also drew me a schematic diagram on paper with a marker after the surgery. After six months of training abroad, I have mastered the basic techniques of anterior approach surgery. And during this time I was also able to feel that this surgery can really be done one day after surgery, like the advertised 101 days after surgery to fly over on a motorcycle, and even outpatient surgery without hospitalization, and can go home after waking up from anesthesia after surgery.