1. Upper extremity As a rule, metal endosseous implants in the upper extremity can be retained locally. If a verification reaction exists or if the implant has a mechanical effect on the patient, removal should be considered. 2.Lower extremity As a rule, individual screws made of 316L steel and joint plates and screws made of pure titanium can be retained locally. Because of the obvious superiority of titanium endografts over stainless steel endografts, this section dispenses with the need for a second surgery.