{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:41:40Z","timestamp":1789738900951,"version":"4.0.1"},"reference-count":151,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Surface engineering and architectural design represent key frontiers in total ankle arthroplasty (TAA) implant development. This narrative review examines biointegration strategies, focusing on porous structures, surface modification techniques, and emerging smart technologies. Optimal porous architectures with 300\u2013600 \u00b5m pore sizes facilitate bone ingrowth and osseointegration, while functionally graded structures address regional biomechanical demands. Surface modification encompasses bioactive treatments (such as calcium phosphate coatings), topographical modifications (including micro\/nanotexturing), antimicrobial approaches (utilizing metallic ions or antibiotic incorporation), and wear-resistant technologies (such as diamond-like carbon coatings). Multifunctional approaches combine strategies to simultaneously address infection prevention, enhance osseointegration, and improve wear resistance. Emerging technologies include biodegradable scaffolds, biomimetic surface nanotechnology, and intelligent sensor-based monitoring systems. While many innovations remain in the research stage, they demonstrate the potential to establish TAA as a comprehensive alternative to arthrodesis. Successful implant design requires integrated surface engineering tailored to the ankle joint\u2019s demanding biomechanical and biological environment<\/jats:p>","DOI":"10.3390\/bioengineering12090955","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T12:18:18Z","timestamp":1757074698000},"page":"955","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Porous Structures, Surface Modifications, and Smart Technologies for Total Ankle Arthroplasty: A Narrative Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2494-1943","authenticated-orcid":false,"given":"Joshua M.","family":"Tennyson","sequence":"first","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4435-9898","authenticated-orcid":false,"given":"Michael O.","family":"Sohn","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1364-2918","authenticated-orcid":false,"given":"Arun K.","family":"Movva","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1115-4665","authenticated-orcid":false,"given":"Kishen","family":"Mitra","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4456-9445","authenticated-orcid":false,"given":"Conor N.","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-3826","authenticated-orcid":false,"given":"Albert T.","family":"Anastasio","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1020-1167","authenticated-orcid":false,"given":"Samuel B.","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/bmb\/ldn039","article-title":"History and evolution in total ankle arthroplasty","volume":"89","author":"Gougoulias","year":"2009","journal-title":"Br. Med. Bull."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/1071100713511606","article-title":"Trends in the Use of Total Ankle Replacement and Ankle Arthrodesis in the United States Medicare Population","volume":"35","author":"Pugely","year":"2013","journal-title":"Foot Ankle Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/S1083-7515(02)00061-X","article-title":"Total ankle arthroplasty: A historical perspective","volume":"7","author":"Henne","year":"2002","journal-title":"Foot Ankle Clin."},{"key":"ref_4","unstructured":"Hintermann, B. (2005). Total Ankle Arthroplasty: Historical Overview, Current Concepts, and Future Perspectives, Springer."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.cpm.2011.08.002","article-title":"Total Ankle Replacements: An Overview","volume":"28","author":"DiDomenico","year":"2011","journal-title":"Clin. Podiatr. Med. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.fcl.2008.04.005","article-title":"Mobile-Bearing Total Ankle Arthroplasty","volume":"13","author":"Younger","year":"2008","journal-title":"Foot Ankle Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"42","DOI":"10.21037\/atm-2023-28","article-title":"Foot and ankle surgery: New frontiers for translational advancements","volume":"12","author":"Anastasio","year":"2024","journal-title":"Ann. Transl. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mitra, K., Movva, A.K., Sohn, M.O., Tennyson, J.M., Talaski, G.M., Adams, S.B., and Anastasio, A.T. (2025). Alloy Selection and Manufacturing Technologies for Total Ankle Arthroplasty: A Narrative Review. Materials, 18.","DOI":"10.3390\/ma18163770"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1097\/BCO.0000000000000419","article-title":"Current and future designs for total ankle replacement","volume":"27","author":"Roukis","year":"2016","journal-title":"Curr. Orthop. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"71","DOI":"10.21037\/atm-23-1569","article-title":"An evaluation of the total ankle replacement in the modern era: A narrative review","volume":"12","author":"Shaffrey","year":"2024","journal-title":"Ann. Transl. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Suh, D.H., Han, K., Lee, J.W., Kim, H.J., Kim, B., Koo, B.M., Kim, H.K., and Choi, G.W. (2021). Risk factors associated with failure of total ankle arthroplasty: A nationwide cohort study. Sci. Rep., 11, (In English).","DOI":"10.1038\/s41598-021-82674-7"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2473011423S00050","DOI":"10.1177\/2473011423S00050","article-title":"Outcomes after Total Ankle Arthroplasty with A Minimum Average Follow-Up of 10 Years: A Systematic Review and Meta-Analysis","volume":"8","author":"Bagheri","year":"2023","journal-title":"Foot Ankle Orthop."},{"key":"ref_13","unstructured":"Revell, P. (2021). 16\u2014Total ankle arthroplasty. Joint Replacement Technology, Woodhead Publishing. [3rd ed.]."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.fas.2018.12.007","article-title":"Preclinical biomechanical testing models for the tibiotalar joint and its replacements: A systematic review","volume":"26","author":"Ho","year":"2020","journal-title":"Foot Ankle Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"5474","DOI":"10.1016\/j.biomaterials.2005.02.002","article-title":"Porosity of 3D biomaterial scaffolds and osteogenesis","volume":"26","author":"Karageorgiou","year":"2005","journal-title":"Biomaterials"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"112382","DOI":"10.1016\/j.msec.2021.112382","article-title":"Influence of porous tantalum scaffold pore size on osteogenesis and osteointegration: A comprehensive study based on 3D-printing technology","volume":"129","author":"Luo","year":"2021","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.msec.2015.10.069","article-title":"Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: An in vivo experiment","volume":"59","author":"Taniguchi","year":"2016","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jmbbm.2018.04.010","article-title":"Osteogenesis of 3D printed porous Ti6Al4V implants with different pore sizes","volume":"84","author":"Ran","year":"2018","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ghayor, C., and Weber, F.E. (2018). Osteoconductive microarchitecture of bone substitutes for bone regeneration revisited. Front. Physiol., 9.","DOI":"10.3389\/fphys.2018.00960"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Shi, F., Fang, X., Zhou, T., Huang, X., Duan, K., Wang, J., Qu, S., Zhi, W., and Weng, J. (2022). Macropore Regulation of Hydroxyapatite Osteoinduction via Microfluidic Pathway. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms231911459"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kelly, C.N., Wang, T., Crowley, J., Wills, D., Pelletier, M.H., Westrick, E.R., Adams, S.B., Gall, K., and Walsh, W.R. (2021). High-strength, porous additively manufactured implants with optimized mechanical osseointegration. Biomaterials, 279.","DOI":"10.1016\/j.biomaterials.2021.121206"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mathey, E., Pelletier, M.H., Walsh, W.R., Gall, K., and Carpenter, D. (2024). Implant Strength Contributes to the Osseointegration Strength of Porous Metallic Materials. J. Biomech. Eng., 146.","DOI":"10.1115\/1.4065405"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Mukherjee, K., and Ghosh, R. (2024). Assessment of bone ingrowth around beaded coated tibial implant for total ankle replacement using mechanoregulatory algorithm. Comput. Biol. Med., 175.","DOI":"10.1016\/j.compbiomed.2024.108551"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"012401","DOI":"10.1088\/2752-5724\/ad9493","article-title":"Overview of porous magnesium-based scaffolds: Development, properties and biomedical applications","volume":"4","author":"Motaharinia","year":"2025","journal-title":"Mater. Futures"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.biomaterials.2016.01.012","article-title":"Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review","volume":"83","author":"Wang","year":"2016","journal-title":"Biomaterials"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.1016\/j.biomaterials.2005.12.002","article-title":"Fabrication methods of porous metals for use in orthopaedic applications","volume":"27","author":"Ryan","year":"2006","journal-title":"Biomaterials"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mumith, A., Cheong, V.S., Fromme, P., Coathup, M.J., and Blunn, G.W. (2020). The effect of strontium and silicon substituted hydroxyapatite electrochemical coatings on bone ingrowth and osseointegration of selective laser sintered porous metal implants. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227232"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.actbio.2013.10.036","article-title":"Significance of calcium phosphate coatings for the enhancement of new bone osteogenesis\u2014A review","volume":"10","author":"Surmenev","year":"2014","journal-title":"Acta Biomater."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/00003086-200202000-00007","article-title":"Osteoconductive Coatings for Total Joint Arthroplasty","volume":"395","author":"Geesink","year":"2002","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Park, S., and Jung, T.-G. (2024). Surface Modification of Polyetheretherketone (PEEK) Intervertebral Fusion Implant Using Polydopamine Coating for Improved Bioactivity. Bioengineering, 11.","DOI":"10.3390\/bioengineering11040343"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"20921","DOI":"10.1021\/acsami.1c01389","article-title":"Anti-Periprosthetic Infection Strategies: From Implant Surface Topographical Engineering to Smart Drug-Releasing Coatings","volume":"13","author":"Ghimire","year":"2021","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/j.otsr.2019.05.006","article-title":"Is surface modification effective to prevent periprosthetic joint infection? A systematic review of preclinical and clinical studies","volume":"105","author":"Deng","year":"2019","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.cpm.2023.05.015","article-title":"Updates of Total Ankle Replacement Revision Options: New Generation Total Ankle Replacement Revision Options, Stemmed Implants, Peri-Articular Osteotomies","volume":"40","author":"Vacketta","year":"2023","journal-title":"Clin. Podiatr. Med. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1016\/j.msec.2015.12.087","article-title":"Role of pore size and morphology in musculo-skeletal tissue regeneration","volume":"61","author":"Perez","year":"2016","journal-title":"Mater. Sci. Eng. C Mater. Biol. Appl."},{"key":"ref_35","first-page":"404","article-title":"Remodeling of the osteoimmune microenvironment after biomaterials implantation in murine tibia: Single-cell transcriptome analysis","volume":"22","author":"Li","year":"2023","journal-title":"Bioact. Mater."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1002\/jbmr.4264","article-title":"Tmem100- and Acta2-Lineage Cells Contribute to Implant Osseointegration in a Mouse Model","volume":"36","author":"Vesprey","year":"2021","journal-title":"J. Bone Min. Res."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mukasheva, F., Adilova, L., Dyussenbinov, A., Yernaimanova, B., Abilev, M., and Akilbekova, D. (2024). Optimizing scaffold pore size for tissue engineering: Insights across various tissue types. Front. Bioeng. Biotechnol., 12, (In English).","DOI":"10.3389\/fbioe.2024.1444986"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1002\/jbm.a.31559","article-title":"Impact of pore size on the vascularization and osseointegration of ceramic bone substitutes in vivo","volume":"85","author":"Klenke","year":"2008","journal-title":"J. Biomed. Mater. Res. A"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2661","DOI":"10.1002\/jbm.a.35401","article-title":"The role of nanostructures and hydrophilicity in osseointegration: In-vitro protein-adsorption and blood-interaction studies","volume":"103","author":"Kopf","year":"2015","journal-title":"J. Biomed. Mater. Res. A"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"8257","DOI":"10.1021\/acs.nanolett.4c01101","article-title":"Nanoporous Titanium Implant Surface Accelerates Osteogenesis via the Piezo1\/Acetyl-CoA\/\u03b2-Catenin Pathway","volume":"24","author":"Zhang","year":"2024","journal-title":"Nano Lett."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Zhao, Y., Bai, L., Zhang, Y., Yao, R., Sun, Y., Hang, R., Chen, X., Wang, H., Yao, X., and Xiao, Y. (2022). Type I collagen decorated nanoporous network on titanium implant surface promotes osseointegration through mediating immunomodulation, angiogenesis, and osteogenesis. Biomaterials, 288, (In English).","DOI":"10.1016\/j.biomaterials.2022.121684"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"7732","DOI":"10.1039\/D2TB01263D","article-title":"The role of nanopores constructed on the micropitted titanium surface in the immune responses of macrophages and the potential mechanisms","volume":"10","author":"Hang","year":"2022","journal-title":"J. Mater. Chem. B"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"5100","DOI":"10.1039\/C8TB00713F","article-title":"Titanium-based implant comprising a porous microstructure assembled with nanoleaves and controllable silicon-ion release for enhanced osseointegration","volume":"6","author":"He","year":"2018","journal-title":"J. Mater. Chem. B"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jmbbm.2014.12.010","article-title":"Wear characteristics of WSU total ankle replacement devices under shear and torsion loads","volume":"44","author":"Gundapaneni","year":"2015","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1177\/0954411918823811","article-title":"Effects of implant orientation and implant material on tibia bone strain, implant-bone micromotion, contact pressure, and wear depth due to total ankle replacement","volume":"233","author":"Mondal","year":"2019","journal-title":"Proc. Inst. Mech. Eng. H"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1177\/1071100719847645","article-title":"Evaluation of Total Ankle Arthroplasty Using Highly Crosslinked Ultrahigh-Molecular-Weight Polyethylene Subjected to Physiological Loading","volume":"40","author":"Bischoff","year":"2019","journal-title":"Foot Ankle Int."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Chen, Z., Zhao, H., Zhao, D., Zhang, X., Ma, X., and Jin, Z. (2022). Comparison of joint load, motions and contact stress and bone-implant interface micromotion of three implant designs for total ankle arthroplasty. Comput. Methods Programs Biomed., 223, (In English).","DOI":"10.1016\/j.cmpb.2022.106976"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/jor.24902","article-title":"Biomechanical evaluation of total ankle arthroplasty. Part I: Joint loads during simulated level walking","volume":"39","author":"Steineman","year":"2021","journal-title":"J. Orthop. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"39235","DOI":"10.1021\/acsami.7b13960","article-title":"Influence of Porosity and Pore-Size Distribution in Ti6Al4 V Foam on Physicomechanical Properties, Osteogenesis, and Quantitative Validation of Bone Ingrowth by Micro-Computed Tomography","volume":"9","author":"Kapat","year":"2017","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Moideen, I.S.M., Lim, C.T., Yeow, R.C.H., and Chong, D.Y.R. (2022). Polka dot cementless talar component in enhancing total ankle replacement fixation: A parametric study using the finite element analysis approach. Comput. Biol. Med., 141.","DOI":"10.1016\/j.compbiomed.2021.105142"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"112026","DOI":"10.1016\/j.msec.2021.112026","article-title":"The impact of multimodal pore size considered independently from porosity on mechanical performance and osteogenic behaviour of titanium scaffolds","volume":"124","author":"Norrito","year":"2021","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Jyoti, and Ghosh, R (2024). Printable functionally graded tibial implant for TAR: FE study comparing implant materials, FGM properties, and implant designs. Comput. Biol. Med., 177, (In English).","DOI":"10.1016\/j.compbiomed.2024.108645"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Xiong, Y.Z., Gao, R.N., Zhang, H., Dong, L.L., Li, J.T., and Li, X. (2020). Rationally designed functionally graded porous Ti6Al4V scaffolds with high strength and toughness built via selective laser melting for load-bearing orthopedic applications. J. Mech. Behav. Biomed. Mater., 104, (In English).","DOI":"10.1016\/j.jmbbm.2020.103673"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Liu, L., Ma, S., Zhang, Y., Zhu, S., Wu, S., Liu, G., and Yang, G. (2024). Parametric Design of Porous Structure and Optimal Porosity Gradient Distribution Based on Root-Shaped Implants. Materials, 17, (In English).","DOI":"10.3390\/ma17051137"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Gupta, R., Grove, K., Wei, A., Lee, J., and Akkouch, A. (2023). Ankle and Foot Arthroplasty and Prosthesis: A Review on the Current and Upcoming State of Designs and Manufacturing. Micromachines, 14.","DOI":"10.3390\/mi14112081"},{"key":"ref_56","first-page":"56","article-title":"Additive manufacturing technology for porous metal implant applications and triple minimal surface structures: A review","volume":"4","author":"Yuan","year":"2019","journal-title":"Bioact. Mater."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Lv, Y., Wang, B., Liu, G., Tang, Y., Lu, E., Xie, K., Lan, C., Liu, J., Qin, Z., and Wang, L. (2021). Metal Material, Properties and Design Methods of Porous Biomedical Scaffolds for Additive Manufacturing: A Review. Front. Bioeng. Biotechnol., 9.","DOI":"10.3389\/fbioe.2021.641130"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"110342","DOI":"10.1016\/j.msec.2019.110342","article-title":"Additive manufactured porous biomaterials targeting orthopedic implants: A suitable combination of mechanical, physical and topological properties","volume":"107","author":"Bartolomeu","year":"2020","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e2409955","DOI":"10.1002\/smll.202409955","article-title":"Biomechanics and Mechanobiology of Additively Manufactured Porous Load-Bearing Bone Implants","volume":"21","author":"Jin","year":"2025","journal-title":"Small"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Dziaduszewska, M., and Zieli\u0144ski, A. (2021). Structural and material determinants influencing the behavior of porous Ti and its alloys made by additive manufacturing techniques for biomedical applications. Materials, 14.","DOI":"10.3390\/ma14040712"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1002\/jor.25381","article-title":"Articular geometry can affect joint kinematics, contact mechanics, and implant-bone micromotion in total ankle arthroplasty","volume":"41","author":"Zhang","year":"2023","journal-title":"J. Orthop. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1002\/jor.24198","article-title":"New comprehensive procedure for custom-made total ankle replacements: Medical imaging, joint modeling, prosthesis design, and 3D printing","volume":"37","author":"Belvedere","year":"2019","journal-title":"J. Orthop. Res."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Chen, H., Han, Q., Wang, C., Liu, Y., Chen, B., and Wang, J. (2020). Porous Scaffold Design for Additive Manufacturing in Orthopedics: A Review. Front. Bioeng. Biotechnol., 8.","DOI":"10.3389\/fbioe.2020.00609"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.slast.2023.04.004","article-title":"Biomimetic scaffolds using triply periodic minimal surface-based porous structures for biomedical applications","volume":"28","author":"Pugliese","year":"2023","journal-title":"SLAS Technol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Tomanik, M., Kobielarz, M., Filipiak, J., Szymonowicz, M., Rusak, A., Mroczkowska, K., Anto\u0144czak, A., and Pezowicz, C. (2020). Laser Texturing as a Way of Influencing the Micromechanical and Biological Properties of the Poly(L-Lactide) Surface. Materials, 13, (In English).","DOI":"10.3390\/ma13173786"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1002\/jbm.b.34497","article-title":"Picosecond laser texturing on titanium alloy for biomedical implants in cell proliferation and vascularization","volume":"108","author":"Yu","year":"2020","journal-title":"J. Biomed. Mater. Res. B Appl. Biomater."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Chen, Y.-W., Chiang, T., Chen, I.H., Yuh, D.-Y., Tseng, H.-Y., Wang, C.-W., and Hou, H.-H. (2024). Titanium Surfaces with a Laser-Produced Microchannel Structure Enhance Pre-Osteoblast Proliferation, Maturation, and Extracellular Mineralization In Vitro. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25063388"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1002\/jor.23340","article-title":"Controlled laser texturing of titanium results in reliable osteointegration","volume":"35","author":"Coathup","year":"2017","journal-title":"J. Orthop. Res."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Ozan, S., Kasman, \u015e., U\u00e7ar, I.C., and Wen, C. (2025). Laser surface texturing for enhanced implant biocompatibility and osseointegration: A critical review of its effects on surface properties. Clin. Biomech., 126.","DOI":"10.1016\/j.clinbiomech.2025.106540"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1002\/jbm.a.35739","article-title":"Novel hydrophilic nanostructured microtexture on direct metal laser sintered Ti\u20136Al\u20134V surfaces enhances osteoblast response in vitro and osseointegration in a rabbit model","volume":"104","author":"Hyzy","year":"2016","journal-title":"J. Biomed. Mater. Res.\u2014Part A"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Moreira, A.C., Fernandes, C.P., Oliveira, M.V.d., Duailibi, M.T., Ribeiro, A.A., Duailibi, S.E., Kfouri, F.d.\u00c1., and Mantovani, I.F. (2021). The effect of pores and connections geometries on bone ingrowth into titanium scaffolds: An assessment based on 3D microCT images. Biomed. Mater., 16.","DOI":"10.1088\/1748-605X\/ac246b"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"6175","DOI":"10.1039\/C7TB00741H","article-title":"Effects of bone substitute architecture and surface properties on cell response, angiogenesis, and structure of new bone","volume":"5","author":"Bobbert","year":"2017","journal-title":"J. Mater. Chem. B"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"5892","DOI":"10.1016\/j.biomaterials.2006.08.013","article-title":"Pore throat size and connectivity determine bone and tissue ingrowth into porous implants: Three-dimensional micro-CT based structural analyses of porous bioactive titanium implants","volume":"27","author":"Otsuki","year":"2006","journal-title":"Biomaterials"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1023\/A:1008973120918","article-title":"Role of interconnections in porous bioceramics on bone recolonization in vitro and in vivo","volume":"10","author":"Lu","year":"1999","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.actbio.2024.02.016","article-title":"Bone ingrowth into a porous structure is achieved by preceding fibrogenesis and vascularization","volume":"177","author":"Takaoka","year":"2024","journal-title":"Acta Biomater."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1016\/j.biomaterials.2007.01.046","article-title":"Assessment of bone ingrowth into porous biomaterials using MICRO-CT","volume":"28","author":"Jones","year":"2007","journal-title":"Biomaterials"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.2147\/IJN.S362720","article-title":"Nanostructured Titanium Implant Surface Facilitating Osseointegration from Protein Adsorption to Osteogenesis: The Example of TiO(2) NTAs","volume":"17","author":"Wu","year":"2022","journal-title":"Int. J. Nanomed."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s10237-007-0100-3","article-title":"Bone ingrowth into a porous coated implant predicted by a mechano-regulatory tissue differentiation algorithm","volume":"7","author":"Liu","year":"2008","journal-title":"Biomech. Model. Mechanobiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1002\/jbm.b.34979","article-title":"Vascularization in tissue engineering: The architecture cues of pores in scaffolds","volume":"110","author":"Xia","year":"2022","journal-title":"J. Biomed. Mater. Res. Part B Appl. Biomater."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"3791","DOI":"10.1089\/ten.tea.2010.0148","article-title":"The Correlation Between the Internal Structure and Vascularization of Controllable Porous Bioceramic Materials In Vivo: A Quantitative Study","volume":"16","author":"Bai","year":"2010","journal-title":"Tissue Eng. Part A"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e202200008","DOI":"10.1002\/tcr.202200008","article-title":"Strategies for Enhancing Vascularization of Biomaterial-Based Scaffold in Bone Regeneration","volume":"22","author":"Nambiar","year":"2022","journal-title":"Chem. Rec."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Fan, Z., Xing, Y., Jia, S., Mo, Z., and Gong, H. (2022). Effect of microtopography on osseointegration of implantable biomaterials and its modification strategies. Front. Bioeng. Biotechnol., 10.","DOI":"10.3389\/fbioe.2022.981062"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/jor.24876","article-title":"Biomechanical evaluation of total ankle arthroplasty. Part II: Influence of loading and fixation design on tibial bone\u2013implant interaction","volume":"39","author":"Steineman","year":"2021","journal-title":"J. Orthop. Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"5798","DOI":"10.1021\/acsbiomaterials.9b00493","article-title":"Porous Tantalum and Titanium in Orthopedics: A Review","volume":"5","author":"Han","year":"2019","journal-title":"ACS Biomater. Sci. Eng."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Li, J., Cui, X., Hooper, G.J., Lim, K.S., and Woodfield, T.B.F. (2020). Rational design, bio-functionalization and biological performance of hybrid additive manufactured titanium implants for orthopaedic applications: A review. J. Mech. Behav. Biomed. Mater., 105.","DOI":"10.1016\/j.jmbbm.2020.103671"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1053\/j.jfas.2023.04.006","article-title":"A Study of Tibial Cyst Formation in Modular Stemmed Total Ankle Arthroplasty: Exploring a Possible Relationship to Smooth and Porous Coating on the Stem Segments","volume":"62","author":"Togher","year":"2023","journal-title":"J. Foot Ankle Surg."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2601","DOI":"10.1002\/jbm.a.36766","article-title":"Bioactive glasses and glass-ceramics versus hydroxyapatite: Comparison of angiogenic potential and biological responsiveness","volume":"107","author":"Bellucci","year":"2019","journal-title":"J. Biomed. Mater. Res.\u2014Part A"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Dehghanghadikolaei, A., and Fotovvati, B. (2019). Coating techniques for functional enhancement of metal implants for bone replacement: A review. Materials, 12.","DOI":"10.3390\/ma12111795"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Kreller, T., Sahm, F., Bader, R., Boccaccini, A.R., Jonitz-Heincke, A., and Detsch, R. (2021). Biomimetic calcium phosphate coatings for bioactivation of titanium implant surfaces: Methodological approach and in vitro evaluation of biocompatibility. Materials, 14.","DOI":"10.3390\/ma14133516"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.msec.2016.12.018","article-title":"Ion-substituted calcium phosphate coatings deposited by plasma-assisted techniques: A review","volume":"74","author":"Graziani","year":"2017","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.actbio.2018.11.041","article-title":"Compositionally graded doped hydroxyapatite coating on titanium using laser and plasma spray deposition for bone implants","volume":"84","author":"Ke","year":"2019","journal-title":"Acta Biomater."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"4232","DOI":"10.1002\/ange.201405310","article-title":"Bioaktive Gl\u00e4ser: Struktur und Eigenschaften","volume":"127","author":"Brauer","year":"2015","journal-title":"Angew. Chem."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"4546","DOI":"10.1039\/D3BM01574B","article-title":"Tailoring of bioactive glass and glass-ceramics properties for in vitro and in vivo response optimization: A review","volume":"12","author":"Piatti","year":"2024","journal-title":"Biomater. Sci."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1002\/jbm.a.20035","article-title":"Influence of physicochemical reactions of bioactive glass on the behavior and activity of human osteoblasts in vitro","volume":"67A","author":"Josset","year":"2003","journal-title":"J. Biomed. Mater. Res. Part A"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"7876","DOI":"10.1039\/D1BM01311D","article-title":"Phosphorous pentoxide-free bioactive glass exhibits dose-dependent angiogenic and osteogenic capacities which are retained in glass polymeric composite scaffolds","volume":"9","author":"Delgado","year":"2021","journal-title":"Biomater. Sci."},{"key":"ref_96","first-page":"201","article-title":"A bioactive glass functional hydrogel enhances bone augmentation via synergistic angiogenesis, self-swelling and osteogenesis","volume":"22","author":"Zhao","year":"2023","journal-title":"Bioact. Mater."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1016\/j.actbio.2015.07.019","article-title":"Reprint of: Review of bioactive glass: From Hench to hybrids","volume":"23","author":"Jones","year":"2015","journal-title":"Acta Biomater."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"3395","DOI":"10.1016\/j.biomaterials.2011.01.029","article-title":"The effects of combined micron-\/submicron-scale surface roughness and nanoscale features on cell proliferation and differentiation","volume":"32","author":"Gittens","year":"2011","journal-title":"Biomaterials"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.actbio.2021.10.001","article-title":"The effects of controlled nanotopography, machined topography and their combination on molecular activities, bone formation and biomechanical stability during osseointegration","volume":"136","author":"Karazisis","year":"2021","journal-title":"Acta Biomater."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.pharmthera.2017.07.009","article-title":"Biological responses to immobilized microscale and nanoscale surface topographies","volume":"182","author":"Skoog","year":"2018","journal-title":"Pharmacol. Ther."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1038\/s41579-020-0414-z","article-title":"Mechano-bactericidal actions of nanostructured surfaces","volume":"19","author":"Linklater","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Xu, Z., Huang, J., He, Y., Su, J., Xu, L., and Zeng, X. (2022). Fabrication of an ordered micro-\/nanotextured titanium surface to improve osseointegration. Colloids Surf. B: Biointerfaces, 214.","DOI":"10.1016\/j.colsurfb.2022.112446"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1039\/D1BM01657A","article-title":"Hierarchical microgroove\/nanopore topography regulated cell adhesion to enhance osseointegration around intraosseous implants in vivo","volume":"10","author":"Tian","year":"2022","journal-title":"Biomater. Sci."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1002\/jbm.a.37134","article-title":"Effect of the immune responses induced by implants in a integrated three-dimensional micro-nano topography on osseointegration","volume":"109","author":"Yang","year":"2021","journal-title":"J. Biomed. Mater. Res. Part A"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1002\/jbm.a.37323","article-title":"Nanoscale hybrid implant surfaces and Osterix-mediated osseointegration","volume":"110","author":"Sartori","year":"2022","journal-title":"J. Biomed. Mater. Res. Part A"},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Velasco-Ortega, E., Fos-Parra, I., Cabanillas-Balsera, D., Gil, J., Ortiz-Garc\u00eda, I., Giner, M., Bocio-N\u00fa\u00f1ez, J., Montoya-Garc\u00eda, M.J., and Jim\u00e9nez-Guerra, \u00c1. (2023). Osteoblastic Cell Behavior and Gene Expression Related to Bone Metabolism on Different Titanium Surfaces. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24043523"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"241","DOI":"10.4012\/dmj.2024-115","article-title":"Effects of different acid etching protocols on the enhanced osteogenic potential of titanium surfaces: An in vitro study","volume":"44","author":"Yang","year":"2025","journal-title":"Dent. Mater. J."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1007\/s10856-013-4935-0","article-title":"Influence of acid-etching after grit-blasted on osseointegration of titanium dental implants: In vitro and in vivo studies","volume":"24","author":"Lluch","year":"2013","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"2400004","DOI":"10.1002\/admi.202400004","article-title":"Mechano-Bactericidal Activities of Orthopedic Implants with Nanostructured Surfaces: Recent Advances and Prospects","volume":"12","author":"Wu","year":"2025","journal-title":"Adv. Mater. Interfaces"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"11162","DOI":"10.1021\/acsami.6b02803","article-title":"Antibacterial Surface Design of Titanium-Based Biomaterials for Enhanced Bacteria-Killing and Cell-Assisting Functions Against Periprosthetic Joint Infection","volume":"8","author":"Wang","year":"2016","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"41751","DOI":"10.1021\/acsami.2c11139","article-title":"Trabecular Titanium for Orthopedic Applications: Balancing Antimicrobial with Osteoconductive Properties by Varying Silver Contents","volume":"14","author":"Carlsson","year":"2022","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.actbio.2022.10.033","article-title":"Using a degradable three-layer sandwich-type coating to prevent titanium implant infection with the combined efficient bactericidal ability and fast immune remodeling property","volume":"154","author":"Lian","year":"2022","journal-title":"Acta Biomater."},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Cardoso, G.C., Correa, D.R.N., Fosca, M., Pometun, E.V., Antoniac, I.V., Grandini, C.R., and Rau, J.V. (2025). Current Strategies in Developing Antibacterial Surfaces for Joint Arthroplasty Implant Applications. Materials, 18.","DOI":"10.3390\/ma18010173"},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"van Hengel, I.A.J., Tierolf, M.W.A.M., Fratila-apachitei, L.E., Apachitei, I., and Zadpoor, A.A. (2021). Antibacterial titanium implants biofunctionalized by plasma electrolytic oxidation with silver, zinc, and copper: A systematic review. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22073800"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"5531","DOI":"10.1021\/acsami.9b20158","article-title":"Antimicrobial Electrodeposited Silver-Containing Calcium Phosphate Coatings","volume":"12","author":"Mokabber","year":"2020","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Tao, Y., Nishio Ayre, W., Jiang, L., Chen, S., Dong, Y., Wu, L., Jiao, Y., and Liu, X. (2025). Enhanced functionalities of biomaterials through metal ion surface modification. Front. Bioeng. Biotechnol., 13.","DOI":"10.3389\/fbioe.2025.1522442"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1039\/D0MT00127A","article-title":"A systematic review of the interaction and effects generated by antimicrobial metallic substituents in bone tissue engineering","volume":"12","author":"Chetan","year":"2020","journal-title":"Metallomics"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.actbio.2020.02.044","article-title":"Biofunctionalization of selective laser melted porous titanium using silver and zinc nanoparticles to prevent infections by antibiotic-resistant bacteria","volume":"107","author":"Putra","year":"2020","journal-title":"Acta Biomater."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"21699","DOI":"10.1021\/acsami.3c03884","article-title":"Surface Multifunctionalization of Inert Ceramic Implants by Calcium Phosphate Biomimetic Coating Doped with Nanoparticles Encapsulating Antibiotics","volume":"15","author":"Desante","year":"2023","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jconrel.2020.06.014","article-title":"Bactericidal coating to prevent early and delayed implant-related infections","volume":"326","author":"Jahanmard","year":"2020","journal-title":"J. Control. Release"},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Ahmadabadi, H.Y., Yu, K., and Kizhakkedathu, J.N. (2020). Surface modification approaches for prevention of implant associated infections. Colloids Surf. B Biointerfaces, 193.","DOI":"10.1016\/j.colsurfb.2020.111116"},{"key":"ref_122","first-page":"83","article-title":"Progress in visible-light-activated photocatalytic coatings to combat implant-related infections: From mechanistic to translational roadmap","volume":"51","author":"Nagay","year":"2025","journal-title":"Bioact. Mater."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Shirazi, H.A., Chan, C.-W., and Lee, S. (2021). Elastic-plastic properties of titanium and its alloys modified by fibre laser surface nitriding for orthopaedic implant applications. J. Mech. Behav. Biomed. Mater., 124.","DOI":"10.1016\/j.jmbbm.2021.104802"},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Piotrowska, K., Madej, M., and Ozimina, D. (2021). Assessment of the functional properties of 316l steel alloy subjected to ion implantation used in biotribological systems. Materials, 14.","DOI":"10.3390\/ma14195525"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jmbbm.2017.09.013","article-title":"Nano- and micro-tribological behaviours of plasma nitrided Ti6Al4V alloys","volume":"77","author":"Samanta","year":"2018","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Malisz, K., \u015awieczko-\u017burek, B., and Sionkowska, A. (2023). Preparation and Characterization of Diamond-like Carbon Coatings for Biomedical Applications\u2014A Review. Materials, 16.","DOI":"10.3390\/ma16093420"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"33465","DOI":"10.1021\/acsami.0c05035","article-title":"Thermal Oxide Layer Enhances Crystallinity and Mechanical Properties for Plasma-Sprayed Hydroxyapatite Biomedical Coatings","volume":"12","author":"Bose","year":"2020","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jmbbm.2017.01.023","article-title":"Diamond-like carbon coatings with zirconium-containing interlayers for orthopedic implants","volume":"68","author":"Choudhury","year":"2017","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"10527","DOI":"10.3390\/ijms150610527","article-title":"On interlayer stability and high-cycle simulator performance of diamond-like carbon layers for articulating joint replacements","volume":"15","author":"Thorwarth","year":"2014","journal-title":"Int. J. Mol. Sci."},{"key":"ref_130","doi-asserted-by":"crossref","unstructured":"Han, X., Ma, J., Tian, A., Wang, Y., Li, Y., Dong, B., Tong, X., and Ma, X. (2023). Surface modification techniques of titanium and titanium alloys for biomedical orthopaedics applications: A review. Colloids Surf. B Biointerfaces, 227.","DOI":"10.1016\/j.colsurfb.2023.113339"},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Liu, Z., Liu, X., and Ramakrishna, S. (2021). Surface engineering of biomaterials in orthopedic and dental implants: Strategies to improve osteointegration, bacteriostatic and bactericidal activities. Biotechnol. J., 16.","DOI":"10.1002\/biot.202000116"},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Bai, L., Chen, P., Zhao, Y., Hang, R., Yao, X., Tang, B., Liu, C., Xiao, Y., and Hang, R. (2021). A micro\/nano-biomimetic coating on titanium orchestrates osteo\/angio-genesis and osteoimmunomodulation for advanced osseointegration. Biomaterials, 278.","DOI":"10.1016\/j.biomaterials.2021.121162"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.actbio.2020.04.020","article-title":"A multifaceted biomimetic interface to improve the longevity of orthopedic implants","volume":"110","author":"Croes","year":"2020","journal-title":"Acta Biomater."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"112108","DOI":"10.1016\/j.msec.2021.112108","article-title":"Antimicrobial and enzyme-responsive multi-peptide surfaces for bone-anchored devices","volume":"125","author":"Fischer","year":"2021","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.biomaterials.2016.01.016","article-title":"Multifunctional coatings to simultaneously promote osseointegration and prevent infection of orthopaedic implants","volume":"84","author":"Raphel","year":"2016","journal-title":"Biomaterials"},{"key":"ref_136","doi-asserted-by":"crossref","unstructured":"Ramakrishna, V.A.S., Chamoli, U., Rajan, G., Mukhopadhyay, S.C., Prusty, B.G., and Diwan, A.D. (2020). Smart orthopaedic implants: A targeted approach for continuous postoperative evaluation in the spine. J. Biomech., 104.","DOI":"10.1016\/j.jbiomech.2020.109690"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1186\/ar4138","article-title":"Implantable sensor technology: Measuring bone and joint biomechanics of daily life in vivo","volume":"15","author":"Fregly","year":"2013","journal-title":"Arthritis Res. Ther."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"16329","DOI":"10.1021\/acs.chemrev.2c00005","article-title":"Implants with Sensing Capabilities","volume":"122","author":"Apu","year":"2022","journal-title":"Chem. Rev."},{"key":"ref_139","doi-asserted-by":"crossref","unstructured":"Wang, J., Chu, J., Song, J., and Li, Z. (2024). The application of impantable sensors in the musculoskeletal system: A review. Front. Bioeng. Biotechnol., 12.","DOI":"10.3389\/fbioe.2024.1270237"},{"key":"ref_140","doi-asserted-by":"crossref","unstructured":"Micolini, C., Holness, F.B., Johnson, J.A., and Price, A.D. (2017). Assessment of embedded conjugated polymer sensor arrays for potential load transmission measurement in orthopaedic implants. Sensors, 17.","DOI":"10.20944\/preprints201708.0011.v1"},{"key":"ref_141","doi-asserted-by":"crossref","unstructured":"Peres, I., Rolo, P., Ferreira, J.A.F., Pinto, S.C., Marques, P.A.A.P., Ramos, A., and Soares Dos Santos, M.P. (2022). Multiscale Sensing of Bone-Implant Loosening for Multifunctional Smart Bone Implants: Using Capacitive Technologies for Precision Controllability. Sensors, 22.","DOI":"10.3390\/s22072531"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.icte.2016.08.010","article-title":"Review of Medical Implant Communication System (MICS) band and network","volume":"2","author":"Islam","year":"2016","journal-title":"ICT Express"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"2400138","DOI":"10.1002\/adsr.202400138","article-title":"Sensor-enabled Orthopedic Implants for Musculoskeletal Monitoring","volume":"4","author":"Huang","year":"2025","journal-title":"Adv. Sens. Res."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1007\/s00264-021-05175-2","article-title":"Digital twins, artificial intelligence, and machine learning technology to identify a real personalized motion axis of the tibiotalar joint for robotics in total ankle arthroplasty","volume":"45","author":"Hernigou","year":"2021","journal-title":"Int. Orthop."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/j.arth.2019.06.018","article-title":"Artificial Intelligence and Arthroplasty at a Single Institution: Real-World Applications of Machine Learning to Big Data, Value-Based Care, Mobile Health, and Remote Patient Monitoring","volume":"34","author":"Ramkumar","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jor.2023.09.006","article-title":"SMART (self- monitoring analysis and reporting technology) and sensor based technology applications in trauma and orthopaedic surgery","volume":"44","author":"Viswanathan","year":"2023","journal-title":"J. Orthop."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1097\/SCS.0000000000003923","article-title":"Stimuli-Responsive Biomaterials: Next Wave","volume":"28","author":"Ashammakhi","year":"2017","journal-title":"J. Craniofacial Surg."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"7055","DOI":"10.1039\/c3cs90057f","article-title":"III. Stimuli responsive materials","volume":"42","author":"Theato","year":"2013","journal-title":"Chem. Soc. Rev."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.synbio.2018.04.002","article-title":"A living foundry for Synthetic Biological Materials: A synthetic biology roadmap to new advanced materials","volume":"3","author":"Scrutton","year":"2018","journal-title":"Synth. Syst. Biotechnol."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"eadg7397","DOI":"10.1126\/sciadv.adg7397","article-title":"A smart coating with integrated physical antimicrobial and strain-mapping functionalities for orthopedic implants","volume":"9","author":"Zhang","year":"2023","journal-title":"Sci. Adv."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1038\/s41563-020-0789-2","article-title":"A bioinspired and hierarchically structured shape-memory material","volume":"20","author":"Cera","year":"2021","journal-title":"Nat. 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