Nowadays artificial joint substitution can be assessed as a definite part of orthopedic surgery. The good primary results must not obscure the fact that in spite of great progress in the field of endoprosthesis, numerous problems must still be considered unsolved. Most important are the problems associated with anchoring the implant into living bone tissue. New ways of cement-free anchorage are being sought. The presentation of possible alternatives and their indicative limitation to alloplastic joint substitution shows that there are possibilities which can be carried out before a possible artificial joint substitution or instead of it. Since joint substitution is still in a phase of development, further advances may be expected in the future.