To the Editor.
—As a practicing orthopedic surgeon with fellowship training in total joint reconstruction, I read with interest the Clinical Crossroads article1 pertaining to total hip replacement. I deal with this scenario daily and concur completely with Dr Pottenger who was the peer reviewer for the case. The decision to proceed with surgery rests solely with the patient and is strictly a quality-of-life issue. To recommend surgery to this patient is basically "treating the x-ray" rather than listening to the patient. Pain eventually will lead her to have the surgery, but she is not ready for it at this time. We need to step back and think of the ramifications of the physician's perception that he or she always knows what is best for the patient. Complications can and do happen despite our best intentions.