In keeping with the tendency in English- and French-speaking nations, the last few years in Germany have been characterized by rapid developments in shoulder and elbow surgery. Advances in basic research in anatomy and physiology and the improved options opened up in the diagnostic imaging sector—especially magnetic resonance tomography (MRT) have led to extensive decoding of the links between complex pathologic conditions of the shoulder and functional impairments. At the same time, there has been incredibly fast ongoing development of tailored minimally invasive operating techniques and all aspects of endoprosthetic joint replacement. Inevitably, this development has led to increasing specialism among orthopaedic specialists and accident and emergency surgeons working in the shoulder and elbow sector. In 1997 the first Department for Surgery of the Shoulder and the Elbow was set up in the Orthopaedic University Hospital of Heidelberg.