We talk a lot on WhatsTheRealCost.org about doing comparison shopping for health care. While not every situation lends itself to that, joint replacement offers good opportunities for comparing not only the joint itself but the doctor and facility doing the work. There are nearly a million joint replacement surgeries performed each year. This New York Times article makes a compelling case for checking into key issues before you make the decision, and offers solid consumer advice for how to go about it. Here’s the case for doing your homework: • A study published in 2007 found that 7 percent of hips implanted in Medicare patients had to be replaced within seven and a half years. Those patients must endure additional recoveries, often painful, and increased medical expenses. • The failure rate should be lower. Sweden has a failure rate estimated to be a third of that in the United States. • Countries that keep registries of how the different joints manufactured perform over time have significantly lower rates of replacement. The US is not one of them. Here are pertinent issues to research: • How many joint replacement has the doctor performed? Those who perform more than 50 a year have fewer complications. • How much will your condition benefit from joint replacement? Not all pain is equal. Pain from arthritis can see significant relief, but if most of the pain is from inflamed tissue, joint replacement is not the first or best option. • Even though the US hasn’t kept registries of joint performance, other countries have, like Sweden and Australia. You and/or your surgeon can consult those to see which have “higher than expected” rates of replacement. You wouldn’t buy a car without checking expert and consumer reviews. You’re the one living with that new hip or knee, and paying for it. This is one of those medical situations when there’s both time and reason to do the homework. Luckily, as this article describes, there are some ways to do that.