Carbon fiber-reinforced plastics have been used clinically as an implant material for different applications for over 20 years.A review of technical basics of the composite materials (carbon fibers and matrix systems), fields of application,advantages (e.g., postoperative visualization without distortion in computed and magnetic resonance tomography), and disadvantages with use as an implant material is given. The question of the biocompatibility of carbon fiber-reinforced plastics is discussed on the basis of experimental and clinical studies. Selected implant systems made of carbon composite materials for treatments in orthopedic surgery such as joint replacement, tumor surgery, and spinal operations are presented and assessed. Present applications for carbon fiber reinforced plastics are seen in the field of spinal surgery, both as cages for interbody fusion and vertebral body replacement.

Allogeneic and xenogeneic biological tendon and ligament materials for ligament replacement were tested in the knee of rabbits and sheep. In-vitro and ex-vivo biomechanical tests as well as micromorphological investigations following implantation were performed. The preparation procedure mainly consists in cross linking of collagen by dicarboxylic acids (DC). Modifications in the method induce changes in the biomechanical stability also after implantation. Sheep with autologous patellar tendons substitutions and glutaraldehyde (GA) fixed bovine tendons served as controls. Because of biocompatibility reasons the later seem to be not yet suitable for clinical applications. The DC-tendons need for improved midterm stability prior to clinical implantations; the biocompatibility appears to be excellent.

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