Surgery is a set of skills which is taught over the course of many years, essentially as an apprenticeship. One typically learns those skills from other surgeons. Like learning to fly a plane, it’s best learned from an expert, and can take years to master. Consequently there are few surgical innovators. All new surgical techniques take time to develop and even more years to gain wide acceptance. As an Orthopedic Surgeon who was first a bioengineer, Dr. Gautsch developed the Southern Approach over the course of 15+ years. Now that it has proven beneficial for a large number of patients, other surgeons are starting to learn it. Since 2017 we have performed thousands, documented the results, and subsequently taught a number of visiting surgeons, who also want to offer this improvement to their patients. Several times a year Dr. Gautsch travels to various parts of the country to discuss and demonstrate the technique, and also participates with Orthopedic manufacturers and other engineers in the design of new knee replacement instruments and computer navigation applications. He also occasionally travels to surgical labs across the country, including most recently to Northern California where he taught Stanford University surgeons. Although much better for the patient, the technique is more technically demanding than the traditional approach, both for the surgeon to learn and to get good at. It also requires very specialized equipment. Dr. Gautsch designed and equipped the Indian Lake Surgery Center in Hendersonville specifically for these outpatient joint replacement procedures. Over the next several years the Southern Approach will undoubtedly become the technique of choice for patients and their surgeons around the country.