Nanotechnology-based biomaterials for orthopaedic applications: Recent advances and future prospects.

Bioimplant engineering aims to mature biological alternatives to restore, retain, or modify damaged tissues and/or the functionality of organs. Remarkable advancements in modern material technology have helped the diversity of materials for orthopaedic implant application. As such, nanomaterials can simulate the surface properties of natural tissues, especially with respect to surface topography, surface chemistry, surface energy, and surface wettability. The novel properties of nanomaterials also encourage their use for improving the growth of different tissues. The present review lays the foundation for nanotechnology-driven biomaterials through revelation of fundamental design considerations to determine the performance of an orthopaedic implant in terms of success or failure, their antimicrobial/antibacterial activities, and response to cell adhesion, proliferation, and differentiation. In this context, the nano-functionalization of biomaterial surface has been widely investigated to improve cell adhesion, proliferation, differentiation, and migration for implants with high antimicrobial activity. The potential use of nanomaterials (in terms of nanostructured surface or functional nanocoating over implant surface) can resolve several issues (e.g., corrosion resistance and bacterial adhesion) pertaining to conventional metallic or non-metallic implants, especially for optimization of implant techniques. The future trends of orthopaedic biomaterials (e.g., porous structures, smart biomaterials, and 3D implants) are promising to achieve the desired properties and structure of an implant with stimuli-responsive behaviour. The major challenges in commercialization of nanotechnology-derived biomaterials are finally addressed to help overcome the limitations of pre-existing orthopaedic biomaterials in terms of key variables, e.g., quality, treatment cost, implant life, and pain relief.