Implants and grafts are employed in the fields of orthopaedic surgery to fill osseous defects and to restore destroyed joints. These bone substitute materials may be derived from different biological and technical sources. In this overview-paper the various methods of bone and joint substitution are discussed concerning their advantages and their disadvantages in comparison to the alternative methods. The decision, which way to go, which implant or graft should be employed in each individual case must be based on the specific medical, economical and social situation of every single patient. Finally future aspects of allogeneic bone and joint grafting are discussed, an hopeful experimental approach for a biological form of joint replacement.