What is the difference between domestic and imported joints? How to choose? Prof. Guan Zhenpeng: Domestic joints are imitated imported joints in the early stage, the material is basically the same, the only difference is the production process. Meanwhile, the imported joints may have been updated to the fourth generation, while the domestic joints are still in the third generation, which will affect the delicacy of the joints. As for the service life, domestic joints are a little less than imported joints. However, imported joints are more expensive than domestic joints, so the choice between the two still needs to be based on one’s financial situation. I started to do joint replacement surgery independently in 2002, and have done nearly 4,000 cases so far, with both domestic and imported joints. From what I have observed so far, there is not much difference between the use of domestic and imported joints within 10-15 years, and there may be a significant difference after 15 years, but it is impossible to predict at this time. Does osteoporosis affect the service life of artificial joints? Prof. Guan Zhenpeng: This is a controversial issue. On the one hand, osteoporosis is commonly referred to as bones becoming “bad and brittle”. After joint replacement surgery, osteoporosis patients have a very poor grip on the artificial joint, just like a stick in a pile of sand, which can easily fall down. Therefore, osteoporosis patients are prone to loosening of the prosthesis, which in turn affects the service life of the artificial joint. However, on the other hand, nowadays, most of the knee replacements in China are fixed with bone cement. Osteoporosis leads to “fragile” bones, and when the bone cement fixes the artificial joint, it also sticks the “fragile” bones, i.e. the bones and the prosthesis grow together. This reduces the impact of osteoporosis on the loosening of the artificial joint. Osteoporosis is often caused by diseases or medications, such as rheumatoid arthritis or hormone use. In addition, joint pain that prevents walking can also cause bone loss. After artificial knee replacement, patients are able to walk for exercise and sunbathing, so that the bone quality can be improved instead.