RT Journal Article SR Electronic T1 Are We Finally Ready for Total Joint Replacement of the Spine? An Extension of Charnley’s Vision JF International Journal of Spine Surgery JO Int J Spine Surg FD International Society for the Advancement of Spine Surgery SP 24 OP 31 DO 10.14444/8538 VO 18 IS 1 A1 Humphreys, S. Craig A1 Hodges, Scott D. A1 Sielatycki, J. Alex A1 Sivaganesan, Ahilan A1 Block, Jon E. YR 2024 UL https://www.ijssurgery.com/content/18/1/24.abstract AB Professor Sir John Charnley has been rightfully hailed as a visionary innovator for conceiving, designing, and validating the Operation of the Century—the total hip arthroplasty. His groundbreaking achievement forever changed the orthopedic management of chronically painful and dysfunctional arthritic joints. However, the well-accepted surgical approach of completely removing the diseased joint and replacing it with a durable and anatomically based implant never translated to the treatment of the degenerated spine. Instead, decompression coupled with fusion evolved into the workhorse intervention. In this commentary, the authors explore the reasons why arthrodesis has remained the mainstay over arthroplasty in the field of spine surgery as well as discuss the potential shift in the paradigm when it comes to treating degenerative lumbar disease.