Porous coatings are used in the field of joint replacement, particularly in cementless total hip/knee arthroplasty. This article reviews the offerings and biomaterial properties in orthopedic surgery for the contemporary class of highly porous metals. It describes the traditional porous metal/coating having an open-cell structure, high porosity, and a microsctructure resembling that of cancellous bone. The traditional porous metal/coating includes fiber-metal mesh, cobalt-chromium (CoCr) beads, cancellous-structured titanium, and plasma spray. The article discusses other porous metal/coating due to the limitations of traditional porous metals for numerous open-cell-structured metals, such as titanium-base foams and trabecular metal.