Half a century of extremity surgery. One either becomes foolish or gains experience and clarity. With a "mischievous smile," the authors have updated experiences that are well-known but can also be shocking in reality: sports medicine as a PR stunt, arthroscopy for amassing wealth, and conducting emergency surgeries from bed at night. However, it is remarkable what advances have been made in extremity surgery over the past 50 years: endoprosthetics at a spectacular level, arthroscopy as a major breakthrough, and spinal surgery in new dimensions. Both authors attempt to reflect on these 50 years with expertise and humor. If the "mischievous smile" remains on the readers' faces after reading, the goal is achieved.