Bone replacement materials - state of the art and the way ahead

For the treatment of bony defects of the human skeleton there are different options. If a defect has to be filled up, autogenous cancellous bone is recommended as the 'golden standard', i.e. the material of choice for such procedures, ignorant to the fact that autogenous bone transplants are not without consequences to the patient and that their harvesting and transplantation might be connected to certain complications. As an alternative, there have been attempts to implant bone replacement materials as a substitute for the autogenous tissue. Despite a longstanding history of research in this field up to now a clinically applicable alternative could not have been found. Aim of the articel is to classify the different compounds recommended for bone replacement. After a description of the development of the materials in the different classes, the state of the art and todays knowledge of how the different materials elicite their effects, an outlook into possible future developments is given for each class. Finally recommendations for todays clinical use of the bone substitutes are presented.