Insurance companies are refusing more of these operations down now due to rising costs from Obamacare so there isn't as much a demand anymore or right now for artificial parts. For example I was scheduled to have my left knee replaced next spring and then it went to Dec 8th and as of last Thursday its now this coming Tuesday and when we checked the Surgeons office told us that many elders are being refused this operation now in thanks to Obamacare so many cancellations are happening worldwide