Bone substitutes may have their place in orthopaedic surgery, but it is unlikely that they will replace autogenous bone grafts any time soon. Autogenous bone grafts provide both osteoinductive and osteoconductive stimuli for bone growth. They can be used to provide mainly mechanical support or stimulate new bone formation. Even when the host has metabolic disorders the autogenous bone functions well. Autogenous bone is still the gold standard and the best source of bone graft.