[Why long-term results?]

Lifelong histories are characteristic of orthopaedics. Long-term planning and guidance are essential features of orthopaedic thinking. The indications for operation are based on prognosis, which in turn we only know from long- term observations. Crucial to decision is the weighing of benefit against risk, with or without an operation. This mean: What are the dangers? What may be the benefit, not only for the moment, but in the long run? And what will happen, if we don't operate? Is there a chance of recovery or a risk of later deterioration? Thus, the study and a thorough knowledge of the natural course of a disorder and of the late results of operations are the basis of every orthopaedic treatment, particularly when operative. Further considerations include the ways and means of performing clinical research in orthopaedic surgery, its possibilities and obstacles, the necessity and value of retrospective studies, the issue of prophylactic operations and their inherent dangers, the political and social implications and, finally, the medical doctor's response to all this.