Total joint replacement has been one of most successful medical innervations developed in the 20th century. In October 2007, the Lancet published an article entitled, “The operation of the century, total hip replacement”. The results of total hip and knee replacement have been studied extensively and pain relief, return of function, and patient satisfaction have been in excess of 90%. Currently, over 200,000 hip replacements and 450,000 knee replacements are performed in the United States. These numbers are expected to grow over the next 20 years with an expected increase in hip replacement of 174% and that of knee replacement, 673%. At the 18th annual meeting of the American Association of Hip and Knee Surgeons in Dallas, a paper was presented outlining the potential short fall of surgeons available to perform this increased number of joint replacements. The work force of orthopedic surgeons performing hip and knee replacement is expected to decrease by 34% between 2008 and 2016. These remaining surgeons, working at current capacity, will leave a 46% deficit in the number of hip replacements and 72% decrease in the number of knee replacements that will need to be done. Clearly, this is a looming crisis as baby boomers reach retirement age and there will be an insufficient number of surgeons to deal with the surging number of potential joint replacements.