[One hundred years of orthopedics in the Netherlands. VII. biomaterials]

The use of biomaterials in orthopaedics is becoming increasingly important. They are widely used in artificial joints, as bone replacement material and as resorbable material. Also (recombinant) bone morphogenetic proteins are used. Classification of biomaterials is based on composition (animal or human tissue, metals, polymers, ceramics or composites) or on biological reactions after implantation (bio-inert, bio-tolerant or bio-active). Depending on location and function biomaterials have to meet requirements with respect to durability (artificial joints), fixation (total hip prosthesis), flexibility (artificial ligaments), solubility (suture wire) and stiffness (plates and screws). The development of biomaterials is in full swing, focussing on the decrease of wear and the increase of durable fixation of artificial joints, and the induction of cells to form bone and cartilage tissue.