The triple pelvic osteotomy according to Tönnis and Kalchschmidt has shown in the present study a high and constant potential with regard to reduction/absence of disorders as well as a statistically highly significant amelioration of clinical scores and relevant radiological angles. In our experience, this surgical method can be regarded as the joint-preserving method of choice in the cardinal indication of adolescent and adult acetabular dysplasia.

The results show that Indomethacin-Short-Term-Therapy as well as Single-Dose-Radiatio with 6 Gy can reliably prevent the occurrence of severe PAO. Both therapeutic concepts therefore can be employed as prophylaxis in primary endoprosthetic operations. The choice between the two procedures will then mainly be determined by given logistic conditions in the clinic, specific contraindications of the patient and financial considerations.

Complications after total knee arthroplasty were evaluated prospectively after a total of 321 procedures. 53 (16.5 %) patients showed postoperative courses deviating from the routine. Of these 5.0 % developed clinically relevant deep vein thromboses, the rate of deep infections was 1.6 %, 3.7 % of the patients suffered from persisting or recurrent joint effusions, arthrofibrosis was observed in 4.4 % of the patients and 1.9 % were affected by wound complications. In most patients deep infections were treated by removal of the implants and reimplantation after clearing of the infection. The primary treatment of arthrofibrosis consisted of manipulation under general or regional anaesthesia. Patients with recurrent joint effusions received punctions, which had to be repeated in some cases. In one patient an intraarticular drainage had to be inserted. The conservative or surgical therapy of wound complications depended on the patient's situation. In patients with thrombosis distal to the trifurcation of the popliteal vein anticoagulation with heparin was continued. In contrast, in patients with femoral or popliteal venous thrombosis the anticoagulation was changed to cumarine derivates.

Concerning the so-called minimal invasive procedures currently available for the treatment of lumbar disc prolapse (percutaneous endoscopic discectomy, APLD, laser decompression, chemonucleolysis), the intradiscal application of Chymopapain represents the method with the longest period of clinical use and experience. Long-term studies have shown good clinical results. When considering of the indication and the few contraindications - particularly allergic diathesis - chemonucleolysis provides a low-risk, efficient, minimally invasive therapy that closes the therapeutic window between conservative and open surgical treatment.

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