[Surface modifications of implants. Part 2 : Clinical application].

The chemical composition, surface structure and topography of a biomaterial have an essential influence on the effects of an implant in the human body. In orthopedic and trauma surgery they make a relevant contribution to solve the current and future challenges. Particularly high are the requirements of permanent implants in bone. Besides material aging due to oxidation, implants are subjected to cyclic loading that leads to relevant biomechanical wear and abrasion. To date significant efforts have been made to minimize adverse implant-associated immunoreactions as well as the risk of periprosthetic infections. This review gives an overview of surface modifications of implants designed for clinical application and their effects in vivo. Beside material-specific and biological principles, different surface modifications for distinct clinical applications are presented. Furthermore, current developmental strategies for the targeted clinical application of implant surfaces are outlined.