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Our findings indicate a correlation of the c.1569 T-allele in XYLT-II with an earlier manifestation of OA and that the serum XT activity is a potential biochemical marker for staging and monitoring the progression of AC damage in OA. Comparison of XT-I activity in mutant enzymes in vivo and in vitro revealed that heterozygous mutations are not involved in OA.

58 out of 69 patients after open operation for osteochondritis dissecans (OD) of the upper ankle joint were reexamined retrospectively. In 44 cases the medial talar edge was concerned, in 15 the lateral one. Pain in activity resisting conservative treatment led to the operations. 31 excisions, 16 drillings, 10 autogenous bone graftings (2 external) and 2 diagnostic arthrotomies had been carried out. Medial malleolar osteotomy had to be performed in 22 cases, mainly concerning excisions and graftings to maintain sufficient survey of the lesion. Follow-up examination took place an average 67 months postoperatively. The results were obtained through a new scoring system with special regard to subjective and clinical criteria. 13 excellent, 29 good, 10 fair and 7 bad results were obtained. Results depended mainly on operative approach, location of the lesion and in lateral OD time of operation. Medial malleolar osteotomy frequently led to local osteoarthritis and less favourable clinical findings. No significant difference could be realized for size of the lesion and the applied operative technique. Stage and age at time of operation did not clearly influence the outcome. The indication for operation must be made dependant on individual complaints. Even in the era of arthroscopy medial malleolar osteotomy sometimes is necessary, but goes along with higher morbidity and worse prognosis. Operations have to be carried out according to stage and followed by proper rehabilitation to render proper assessment. Lateral lesions result from sprains and should be operated early.

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In a retrospective study, 22 patients treated surgically for solitary or multiple myeloma between 1980 and 1993 were analysed. The main complaint was pain. A fracture was observed in 7 cases and motor-sensory impaired neurology due to spinal compression in 3. Apart from incisional biopsies, tumour resections, reductions (with and without stabilization by osteosynthesis) and endoprotheses were performed either at the extremities or on the spine. In addition, radiation and chemotherapy were included in the therapeutical concept. Early mobilization was achieved in all cases, and the 5-year survival rate (Kaplan-Meier method) was 48%. The results presented in this study demonstrate that a variety of surgical interventions can be of importance in the treatment of myeloma of the bone, ranging from biopsy or even curative resections in selected cases to endoprosthetic replacement. Thus, good functional results can be achieved and maintained over often long survival times.