No appeal by a health politician, no matter how insistent, has ever forced all the operational structures of our health-care system to examine their own efficiencies and cost reduction potentials as has SARS-CoV‑2. Fast-track surgery, developed long before the current pandemic, can become an indispensable element of modern hospital routines through the integration of interlocked care structures. Patient satisfaction and clinical outcome can be improved by significantly shortening hospital stays, decreasing complication rates, and by additionally strengthening the competence and motivation of the patients involved. Hospital staff could be relieved of heavy workloads, and overall costs could be reduced by involving external prehabilitation centers. It is now necessary to further develop standards for the establishment and implementation of appropriately coordinated prehabilitation and rehabilitation concepts for elective total hip and knee replacement surgery and, ideally, to save resources at the same time through regional networking and integration.

Preoperative management of patients following fast-track arthroplasty protocols includes comprehensive patient information and risk stratification.

The optimization of organizational processes, as well as surgical procedures intra- and perioperatively, are essential components with respect to fast-track programs in clinical routine. Treatment concepts focus on early postoperative mobilization of patients after joint replacement surgery in an interdisciplinary setting to avoid pain and complications on a scientific basis. This article gives a comprehensive and detailed overview regarding evidence-based peri- and intraoperative fast-track treatment methods: from pain treatment with intraoperative local infiltration analgesia and tranexamic acid application under minimally invasive surgical approach in short-lasting spinal anesthesia to renunciation of drains, regional pain- and urinary catheters, tourniquets, and restrictions.

Since the introduction of fast-track surgery in the field of arthroplasty, all disciplines involved have been challenged with the task of close and continuous joint communication in the context of daily routine care. Processes that have been agreed upon interdisciplinarily must be reviewed at regular intervals, and, if necessary, adapted and newly agreed upon with the aim of optimizing the perioperative risks both medically and along the therapeutic pathway. The responsibility of the anaesthesiologist is not only limited to the performance of anaesthesia, but also includes the care of patients with a view to optimal pain therapy, maintenance of homeostasis and ensuring a rapid return of the patient's self-determination.

Fast-track procedures are common in general surgery today. In our European neighbour countries and in the USA, one-day-surgery for knee and hip replacement is gaining popularity. However, it is of great importance that a detailed concept for prehabilitation with a sufficient training program and targeted instructions regarding behavioral measures are established to allow a safe outpatient procedure. Where fast-track programs are established, one-day surgery with minimally invasive operative procedures for hip and knee arthroplasty is the consequent next step.

The principals of growth arrest by epiphysiodesis and growth guidance by hemiepiphysiodesis are effective and powerful surgical techniques in pediatric orthopedics. These procedures can be used to correct leg length discrepancies as well as sagittal, coronal and oblique deformities. A differentiation is made between temporary and permanent techniques. The most significant advantage is that these techniques are minimally invasive and have low complication rates compared to acute osteotomy and gradual deformity correction. For optimal outcome an exact preoperative planning is needed to ensure accurate timing of the procedure, especially when permanent epiphysiodesis techniques are used. Although epiphysiodesis and hemiepiphysiodesis around the pediatric knee are most frequently used and can be considered the gold standard treatment of coronal plane deformities and leg length discrepancies, novel techniques for the hip and ankle are increasingly being performed. The successful clinical results with low complications support the broad use of hemiepiphysiodesis and epiphysiodesis for a variety of indications in the growing skeleton with deformities and leg length differences.

Manipulation and mobilisation for low back pain are presented in an evidence-based manner with regard to mechanisms of action, indications, efficacy, cost-effectiveness ratio, user criteria and adverse effects. Terms such as non-specific or specific are replaced by the introduction of "entities" related to possible different low back pain forms.

Scheuermann's disease represents the second most common deformity of the growing spine after the various forms of scoliosis. In cases of early diagnosis and mild kyphotic deformity conservative treatment with a brace and physiotherapy shows very good results; however, in cases of neurologic deficits, curve progression despite conservative treatment and increasing pain symptoms with a Stagnara angle of more than 70-75°, surgical treatment is meaningful. The surgical strategy can include posterior spondylodesis with prior anterior release or posterior instrumentation with posterior column osteotomy depending on the surgeon's experience. The choice of the extent of the operation with the vertebrae to be instrumented and including the straightening method should be oriented to the avoidance of complications, such as proximal or distal junctional kyphosis.

Segmental and somatic dysfunction in the thoracic section can lead to various clinical symptoms. It is necessary to distinguish three variants.