Over 700,000 hip and knee replacements are performed each year in the United States. As the population ages this number will increase significantly. There is concern that newer implants are being approved with insufficient testing resulting in increased failure rates. A recent study published in the Journal of Bone and Joint surgery indicates that not a single new artificial hip or knee introduced over the past 5 years was any better than the older ones and many were worse. For example it is estimated that replacing metal-on-metal hips will not only result in additional surgeries for patients, but will cost companies, insurers and taxpayers billions of dollars.