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SELECT is a large-scale, prospective, international, multicentre, double-blind, double-dummy, randomized, parallel-group trial. Patients with exacerbation of osteoarthritis were treated with the recommended dose of meloxicam (7.5 mg) or piroxicam (20 mg) once daily for 28 days; 4320 patients were administered meloxicam and 4336 piroxicam. The incidence of adverse events was significantly lower in the meloxicam group (22.5%) compared with the piroxicam group (27.9%; P < 0.001), mainly due to the significantly lower incidence of gastrointestinal (GI) adverse events in the meloxicam than in the piroxicam group (10.3% vs 15.4%,; P < 0.001), while the efficacy of both drugs was equivalent. Individual GI events occurred significantly less often with meloxicam than piroxicam: dyspepsia (3.4% vs 5.8%; P < 0.001), nausea/vomiting (2.5% vs 3.4%; P < 0.05) and abdominal pain (2.1% vs 3.6%; P < 0.001). There were 16 patients with perforations, ulcerations or bleeding (PUBs) of the upper GI tract in the piroxicam group compared with seven in the meloxicam group (relative risk piroxicam:meloxicam = 1.4). Four PUBs were complicated (perforations or bleedings); none of these occurred in the meloxicam group (relative risk piroxicam:meloxicam = 1.9). The outcome of SELECT is consistent with that of the large-scale clinical trial of similar design and size which compared 7.5 mg meloxicam with 100 mg diclofenac in patients with osteoarthritis, and with a previous global analysis of the safety of meloxicam. It adds further data to the proposed relationship between selective inhibition of cyclooxygenase-2 and improved GI tolerability of non-steroidal anti-inflammatory drugs.

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In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13%) followed by handball (8.89%) and sports during school (8.77%). The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34%) and ligament tears (18.76%); 9,00% of all injuries were fractures. We found more skin wounds (6:1) and fractures (7:2) in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6). Head injuries were seen in bicycle accidents (1:3). Head injuries were seen in male patients much more often then in female patients (21:1). Fractures were noted during football (1:9), skiing (1:9), inline (2:3), and during school sports (1:11). Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports.It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education.

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In experienced centers, ALPPS following PVO failure is feasible and safe. The FLR hypertrophy was similar to other ALPPS series. ALPPS is a potential rescue strategy after PVO failure.

In a 25-years period (1972-1997) 30,603 sportsmen, having a total of 34,742 sports related injuries, were treated in our outpatient-department specialized in sports orthopaedics and traumatology. All cases were systematically recorded and analysed right from the beginning. This is the most extensive clinical statistics currently known. The absolutely highest incidence rate of sports-related injuries is seen in common disciplines like soccer with 10,493 (34.3%), skiing with 3632 (11.9%), handball 2307 (7.5%), tennis 1643 (5.4%) and volleyball 1550 (5.1%). 3/4 were male. The distribution of age shows a significant peak between 20 and 29 years of age, whereas in women we found a wide plateau between 10 and 39 years. Compared to earlier investigations we have an increase of injuries in higher age. In 72.4% the lower extremities are mainly effected, followed by the upper extremities (21.8%) and the spine with 3.0%. With increasing tendency knee injuries take main part (36.6%--12,708 cases) followed by injuries of the ankle (19.9%--6920 cases), shoulder (7.7%), lower leg (7.0%) and fingers (5.8%). Main diagnosis were: distortion (32.6%); ruptures of ligaments and menisci (21.5%); fractures (10.5%) and lesions of muscles and tendons (8.8%). Comparing our 15- and 25-years studies we found an interesting significant increase of injuries in skiing, tennis and physical exercising by 25%, in cycling four times. New disciplines like squash, snowboarding, mountainbiking and inlineskating have been added. All together the number of injuries is distributed to 87 different disciplines. In 1998 26.7 million sportsmen (one third of the German population) were member of the German Sports Association (DSB). The number of annual accidents in sports and sporting spare time activities is estimated at about 1.5-2 million, that's 25-30% of all accidents. The analysis of almost 35,000 treated sports injuries and further evaluation of more than 5000 orthopaedic examinations of top athletes are useful for analysis comparing single disciplines.

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