Dr. van der Merwe reflects on an uncommon path from family medicine in rural Saskatchewan to arthroplasty, describing how his primary-care background sharpened communication with referrers and broadened patient management. He discusses major shifts in hip and knee replacement—from evolving liner designs and resurfacing debates to migration toward medial congruent knees—and notes Canada’s openness to innovation despite structural limits. He also reviews his research on periprosthetic fracture classification, sciatic nerve palsy, and postoperative text-messaging systems, underscoring their clinical relevance. He closes with advice to trainees: follow genuine interest, stay evidence-driven, and remain engaged with emerging technologies to elevate patient care.