Several authors have evaluated different techniques to determine the effectiveness of new technologies. In an article published in The Journal of Bone and Joint Surgery in 2006. Kevin Bozic, M.D., and coauthors, outline the potential benefits and cost effectiveness of new technologies involving bearing surfaces for total hips. They evaluated the increased cost on ceramic-on-ceramic bearing as well as metal-on-metal bearings and determined how great a decrease in failure would be necessary to make the increased cost of these bearings justified. They concluded that the incremental cost of metal-on-metal and ceramic-on-ceramic bearing would be justified in patients 63 years of age and younger, due to the potential decrease in failure over the 20 year life expectancy of that patient. Data such as these help surgeons, patients and hospitals evaluate the appropriateness of new technology and determine if it makes sense for specific patients with a variety of different disease processes. In this era of increased scrutiny of health care costs it is important to determine if new technologies make sense for everyone and how much testing and verification is needed prior to use of new technologies.