With the increase of life expectancy, the aging of China’s population is becoming more and more advanced. Shanghai is particularly prominent, with the population over 60 years of age accounting for 27.1% of the city’s total population by the end of 2013, making it a truly super-aging city. The patient population facing orthopaedics is therefore significantly different from that of 10 or 20 years ago, with an increasing number of elderly orthopaedic patients and an increasing proportion of elderly and even super-elderly patients. A distinctive feature of these patients is that they have many complicated co-morbidities, such as diabetes, hypertension, heart disease, etc. It is also very common for multiple medical diseases to occur together, some patients have had stents and bypass surgery on their hearts, some patients have kidney failure and need constant hemodialysis, and some patients have had kidney or even heart transplants. The three patients above are typical representatives of this group. So, is advanced age and super advanced age really a no-go area for surgery? The answer is of course no. Advanced and super advanced age are not direct contraindications to surgery, but the surgical management of these patients must be different from that of younger patients. First, before surgery, medical co-morbidities such as hypertension, hyperglycemia, etc. need to be reasonably managed and controlled and must be adjusted to tolerate the surgery; and the patient’s surgical risk needs to be reasonably assessed and effectively communicated with the patient’s family and even the family to make them understand the need for surgery and its possible risks and benefits. Secondly, a reasonable surgical plan needs to be formulated and a suitable surgical team needs to be assembled to complete the surgery with the least possible trauma, short time and less anesthesia reaction in order to minimize the disturbance of the organism by the surgery. Once again, post-surgical management is also extremely important, and a strong monitoring unit as well as internal medicine and rehabilitation teams are effective guarantees for a good recovery.