[Indications and alternatives for arthroplasty in young patients]

Due to the significant risk of aseptic implant loosening, the indications for endoprosthetic treatment of young adults must be assessed critically. All conservative and surgical therapy options must always be considered cautiously. Even advanced osteoarthritis of the upper extremities (shoulder, elbow and wrist joints) can often be treated with joint sparing, non-endoprosthetic therapy that leads to good clinical results and sufficient joint function. Total joint replacement is often inevitable for regaining an acceptable gait and adequate mobility in cases of advanced joint destruction of the lower extremities (hip and knee joints). Arthrodesis of the upper ankle joint in cases of isolated osteoarthritis remains a valid therapeutic option. Replacement of the upper ankle joint should be considered in cases of bilateral affliction as well as in the event of additional osteoarthritis of the adjacent joints of the lower ankle and the tarsus.