An update on current knowledge is given for surgeons and researchers involved in implant surgery and the development of implant arthroplasty. The contributions come from a distinguished international faculty of orthopaedic surgeons, biologists and engineers. They examine the junctional tissues between an implant and the bone in joint replacement surgery. The factors that influence junctional tissues and so affect the life-span of the implant are thoroughly discussed. These include: detailed data on the microscopy of the junctional tissues, the mechanical properties of cement, and the architecture of bone and implant design. The discussions following each contribution give meaningful insight into background information and the controversial aspects of surgical implants.