Introduction: In 1962 Harrington published his method of spinal instrumentation in scoliosis treatment. 256 patients have been treated with this instrumentation at the Hospital for Orthopaedic Surgery Stolzalpe in the years of 1968 –1992.

Material & Methods: A retrospective study was performed on 74 patients (48 female, 26 male) with a mean follow up time of 22,5 years. A clinical examination, x-ray, spirometry was performed as well as the Oswestry Score and the Visual Analogue Scale test (VAS) to determine the patients confidence and possibilities in activities of daily living (ADL), profession and sports. Also the ROM of the spine, degeneration of the adjacent levels and loss of correction were a subject of interest.

Results: All patients were satisfied or very satisfied and there were no severe restrictions in their ADL. 92 % are busy in the normal working process, 61 % do sports without complaints. The mean Oswestry Score was 9 pts (1–12,5) and the average VAS was 1,1 of 10 (0–4), with major problems in sitting and standing. Spirometry was restricted in 33%, movement was limited in side bending in nearly all patients.

Conclusion: Although with Harrington’s method no segmental correction was possible and long time casting and orthetic aids were necessary, we found very confident patients without major restrictions in daily life. Similar long term results with modern methods and instruments have to be proven.

Problem: There are known numberous surgical treatments for problems of arthrotic ankle-joints. Recently there is comeing up more and different kind of arthroplasty. The overall aim is to create good axis, stable situation and full weight-bearing situation without pain for a long time.

Our technique is a single anterior surgical aproach and internal fixation with 2 cannulated percutaneous titanium screws.

This procedure allowes both in young active persons and in cases after failed surgery a good and recomendable solution with early weight-bearing and durable results without following surgery.

Method and Results: We present our follow up results of 40 Patients in paired samples tests and VAS at minimum 24 month.

Difficult revisionsurgery and degenerative cases are shown in pictures. Cases of Revision after Arthroplasty are done.

Facit: In our hands this procedure is the standard procedure. We can reach the aim of good, safe and longterm standing results. The biomechanical positioning is mandatory. The overuse of following joints is not clinicly relevant and reduceable by wearing adapted shoes.

Even in cases of revisionsurgery after arthroplasty the modification with “malleolus lateralis-Interposition” is a good possbility to reach functionally good results without loosing height at safe softtissue.