Readers of the popular press may have noted that orthopaedic surgery has been in the news recently with regard to premature failure of artificial joint components. Medical practitioners would be unwise to think that they are immune to this type of publicity.Medicine in general, and surgery in particular, is a fashion industry. Patients want the latest devices; instrument companies want surgeons to use the latest devices; pharmaceutical companies want practitioners to use the latest drugs; and overseas trends are held in high regard.Much information gleaned by patients from the Internet is believed to be the last word rather than subtle marketing on behalf of industry. The medical supply industry is rather like the auto industry, devices and drugs have a product life of 3 or 4 years before they are superseded by a new or upgraded model, and in many cases these changes result in products that are not as effective as the ones they replace. This is particularly the case in orthopaedic surgery.In the medical world, the area of deep vein thrombosis (DVT) prophylaxis is another fashion-driven industry. Most articles on the topic are written by groups compromised by industry funding, and guidelines for the same problem are vary enormously between countries, although this year for the first time there is agreement on prophylaxis between the American Academy of Orthopaedic Surgeons and the American College of Chest Physicians—two groups who for years disagreed.Although it might seem unfashionable, medical practitioners should stick to proven technologies rather than satisfy the whims of patients who have information from the Internet, or salespeople anxious to achieve sales targets for new devices or drugs. Geoffrey Horne Professor and Orthopaedic Surgeon Wellington Regional Hospital Wellington