Hydroxyapatite, a bioactive ceramic, has been combined with biodegradable polymers to create composite three-dimensional interconnected porous scaffolds for bone graft substitutes. The materials and fabrication methods of these composite scaffolds are reviewed. The resulting mechanical and biological properties of scaffolds produced from the combination of certain materials and fabrication methods are analyzed. Requirements for a bone graft substitute and third generation scaffolds with the addition of osteoinductive and osteogenic features to composite scaffolds including biomolecule delivery and cell seeding are also introduced. Finally, the benefits of using additive manufacturing technologies to enable high level of control over the design of interconnected pore structure are discussed.

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