One of the locals went to Costa Rica this year for hip replacement. It aparently went well.
I'm definitely planning degenerative disk surgery in the States. Even in the States I'm getting different opinions from different MDs. You wouldn't want to NOT have the option of different opinions. Also, post OP Physical Therapy is limited. I know one person that had very good results, with there PT coming to the Island for sessions.
Be careful with your decisions, the results are long term.