Technological advances such as computer navigation systems and robotics, includingsupport systems for minimally invasive surgery, have the potential to revolutionise howorthopaedic surgery is carried out. However uptake has so far been limited. Increasedawareness of user requirements in adoption decision-making will be useful. In this regard,the opinion of the individual surgeon regarding his or her willingness to engage in a noveltechnology has rarely been garnished. This paper analyses the opinions of orthopaedicconsultants from the UK and USA about technological advances in hip and kneearthroplasty, factors contributing to successful short-term and long-term surgicaloutcome, and patient preferences. The survey, using a web-based questionnaire, wascarried out in 2006–2007 and followed up in 2010. The results of this research give agreater insight into why surgical technologies that have the potential to improve patientoutcome are not more speedily adopted in the health service.