The Institute of Medicine defines disparity as the difference in health care utilization or outcome not including patient preference.(1) This definition of health disparity holds true in most cases but not all. Total joint replacement (TJR) in the management of knee and hip osteoarthritis (OA) might represent an exception to the rule. TJR, and more specifically knee and hip elective TJR, is considered to be one of the most successful treatments in the history of surgery. Today more than 700 000 TJRs are performed each year in the United States. (Am J Public Health. Published online ahead of print February 14, 2013: e1-e2. doi:10.2105/AJPH.2012.301077).