[From natural growth to artificial composition: the use of artificial materials in endoprosthetics from a cultural-historical perspective].

The use of artifical materials in joint replacement is not self-evident. A paradigm change can be observed. Beginning in the 18th century orthopedic surgery became possible because of a change of the idea of man. Natural growth was seen as ideal solution in orthopedic surgery until the 19th century. Yet in the aftermath the point of view changed to a more technical determined approach. Until the middle of the 20th century the terms "efficieny" and "ability" became more and more important. Joint replacement with artificial materials was generally accepted and led to an enormous accelaration in the development of new materials and surgical techniques.