A bone graft substitute includes a porous matrix at least partially
covered by a reinforcing outer layer. The porous matrix may be a
collagen-ceramic composite, and the reinforcing outer layer may be formed
from highly cross-linked collagen. The implant may also include one or
more reinforcement ribs, which may be made from calcium phosphate or
dense collagen. In addition, the bone graft substitute preferably
includes an effective amount of a bioactive agent, such as BMP-2,
rhBMP-2, or functional fragments thereof. The bioactive agent is
preferably disposed within the porous matrix.