The first Joint Replacement Centre was set up in Hong Kong in December 2010 at Buddhist Hospital. Aim is to better manage growing demand, more efficient utilization of resources and ensure service quality and safety. It’s targeted to perform extra 500 arthroplasty surgery in Kowloon Central Cluster per year. During the first 5 years, we managed to reduce the surgery waiting time from 50 months to about 10 months. More Joint Replacement Centers are being set up in other clusters. However, as more people are aware of the benefits of joint replacement surgery, in term of pain control and functional improvement, and the population continues to aged, there is a three-fold increase in the waiting list in Hospital Authority from 7065 in 2011 to 21481 in 2018. Therefore, the challenge has become HA-wide.