In a recent study sixty-eight patients that were scheduled for a total hip replacement or total knee replacement were asked to complete a questionnaire with their expectations in terms of pain relief and function after surgery. The surgeons were also asked to take the same questionnaire for each patient. The results showed that few patients (>20%) had lower expectations than the surgeons. But most patients (>50%) had greater expectations after the procedure than their respective surgeons. These patients and surgeons both had similar expectations in terms of pain relief and the ability to stand etc. However, these patients had greater expectations for more challenging activities like sports and maintaing difficult positions such as sitting down, kneeling, squatting etc. It’s important that patients have managed expectations of activity limitations before and after surgery. New options like Platelet Rich Plasma (PRP) & Bone Marrow Concentrate (BMC) hold promise for patients hoping to avoid a joint replacement while maintaining an active lifestyle.