The following should be regarded as prerequisites for successful surgical treatment: careful assessment of the local problem and of the patient as a complete individual; a thorough understanding of the biomechanical implications of the disease and of the operations used in its management; a clear definition of the goals of surgery in both the patient's and the surgeon's minds; and very careful planning with regard to the timing and sequence of operations. Other factors of major importance, especially in multijoint reconstructive programmes, are careful patient selection, the early establishment of good doctor/patient rapport, the support of a highly skilled multidisciplinary team of health professionals, and impeccable supervision of the convalescence, especially at the particularly difficult period for the patient following discharge from hospital. Finally, the hospital team must be prepared to offer a permanent service as a readily available advice bureau for family doctors, patients, and their relatives.