> If you use your example and search for "hip replacement", or any "what are the signs" variation, you get all of the content free SEO spam farms specifically c

> If you use your example and search for "hip replacement", or any "what are the signs" variation, you get all of the content free SEO spam farms specifically catered to returning useless garbage to medical queries, but no informational academic/government/ngo health sites. I did do the hip replacement search and got no spam and all medical organizations. I just tried "what are the signs I need a..." and chose the first completion of "pacemaker". That also had very high quality results from government health orgs, medical associations, Mayo and Cleveland clinics, healthgrades (looks ok), and a nice list pulled from Vein, Heart and Vascular Institute. Do you have a specific search that has bad results?