Surgically speaking, it was also quite rewarding. Some people have said that they have seen a hundred German surgeons doing surgery and may find that only one method is used. The German orthopedic surgeons I met were strict, organized, not randomly innovative, and proceduralized. Take the most common total hip replacement and revision surgery as an example, they currently use the minimally invasive anterio-lateral invasive (ALMI) surgical approach, which was first reported by Bertin in Salt Lake City and Rotinger in Munich in 2003, and published in the journal Clinicaorthopaedics and relatedresearch. ALMI surgical access (Anterio-lateral minimal invasive) Femoral head preparation – Bone banking (for revision surgery) This is still the most popular access for hip replacement and revision in Germany – Minimally invasive anterolateral surgical access. This is still the most popular approach for hip replacement and revision in Germany – the minimally invasive anterolateral approach. From the first week I went to participate in surgery to the end of the last week, I participated in more than 100 hip surgery, no matter how obese and how complex the situation of the patient, the initial hip replacement and revision surgery is the same access, and even to that level of the use of what the hook is fixed, and are measured with templates drawn before the operation, the operation of the two fluoroscopy, three postoperative drainage, postoperative routine three negative pressure drains in layers. Even these are fixed. All processes are fully embodied in the German characteristics: standardized and rigorous, organized, not random innovation sometimes even a little rigid, but do things programmed to operate. This can greatly shorten the operation time, reduce the risk of surgery, and improve the efficiency of surgery. Professor took me to a German academic conference, pointed out that at present, German academics believe that PE INLAY + ceramic is the gold standard, only rare young people, high bone quality, long-term movement of patients with large amount of ceramic-ceramic program, and most of the application of the third-generation bone cement technology and the fourth generation of ceramic technology, which is more than most of the domestic hospitals are still ahead of the curve in this regard. In this regard, it is still ahead of most hospitals in China. Moreover, in order to have a possible revision surgery for the patient in the long term, we often communicate with the patient whether to keep the femoral head or not before the surgery, and then prepare and keep the femoral head after obtaining the consent (German orthopedic surgeons do not apply artificial bone and allograft bone grafts in general, presumably due to the reason that the law prohibits allografts). I have participated in several hip revision surgeries in patients with insufficient bone volume and have used femoral heads prepared many years ago for structural bone grafting. Without this measure, the revision surgery would have been quite difficult or even impossible to complete and would have had to be left unattended. Knee arthroscopy is performed by a single surgeon, and great importance is attached to the prevention of deep vein thrombosis of the lower extremities. In order to prevent DVT, compression stockings are usually applied to the leg that is not operated on (the same is true for total hip and knee replacement surgery). Moreover, blood transfusion is generally not used, and special revision surgeries that require blood transfusion generally rarely use allogeneic blood, and generally use autologous blood transfusion. Surgeries involving ligament reconstruction generally use autologous ligament replacement, usually by removing the tendon and having a specialized nurse prepare the tendon tissue (which I was surprised to see for the first time at the time), and then transplanting it. Artificial ligaments are seldom used and are more strictly approved by the state. Allograft is prohibited by law in Germany.