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The results of this radiographic analysis give support to the principle of using metaphyseal anchoring, calcar guided short-stems. The low incidence of bony alterations after a follow-up of 2 years indicates a physiological load distribution. After mild initial subsidence a stable osteointegration can be achieved over time.

The efficacy of "athermic" lasers (HeNe lambda = 632.8 nm and IR diode lambda = 904 nm) in the treatment of tendinopathies was investigated in a randomized double-blind study. On 10 consecutive days, 64 patients (32 therapy, 32 placebo) were treated for 15 minutes each with a switched-on or switched-off laser under otherwise identical conditions. The extent of movement in involved joints (neutral 0 method) and rating on a pain scale for resting pain, movement pain, and pressure pain before treatment, after treatment, and 2 weeks after conclusion of therapy, as well as infrared thermography, served to check therapy. After the end of therapy, a significant reduction (P = less than 0.001) of 50% was shown for resting pain as well as reductions of 30% for movement and 30% for pressure pain. This result was identical in the therapy group and in the placebo group. There was also no indication of a different result of therapy between the therapy and placebo groups with regard to the thermographic control and the extent of movement. The breakdown of the data in terms of age, sex, and duration of disease did not provide any indications of different results for placebo or therapy. It was striking that the patients who reported sensations during or after the treatment (irrespective of whether pleasant or unpleasant) had a greater reduction of pain than the patients without sensations. This laser therapy thus did not show any effect above and beyond that in the untreated group in our double-blind clinical study.

Thirty-one patients with herniated cervical discs were treated with PLDD from 1991 to 1993. In 1990, a few of these patients were treated with the Nd:YAG laser with no complications. Since 1991 we have used the holmium:YAG laser; 28 of the 31 patients experienced pain relief in a 6-week follow-up. PLDD for the cervical discs is a viable therapy.