Plasma assisted surface engineering biomaterials for orthopedic applications: comprehensive review

The durability and functionality of orthopedic implants have significantly advanced modern medicine; however, they continue to face challenges due to biological and mechanical complications, e.g., inadequate osseointegration, microbial infections, wear-induced degradation, corrosion, and mechanical failure. Orthopedic implants are utilized to address various musculoskeletal disorders. Consequently, biomaterials are extensively studied for such applications to determine their performance, longevity, and biological interactions. We present a comprehensive analysis of plasma-assisted nanofunctionalization strategies for metals, polymers, and ceramics, elucidating how nanoscale surface engineering enhances the osseointegration, antibacterial and mechanical properties of these materials. Particularly, magnetron sputtering methods have emerged as promising solutions for augmenting the performance of implantable biomaterials. These techniques have been critically evaluated for their capacity to fine-tune the properties of thin films at the nanoscale, enhancing their mechanical strength, surface wettability, and biological response. Additionally, emphasis is given on improving surface characteristics, such as biocompatibility, antibacterial activity, corrosion/wear properties, and controlled drug or ion release through tailored coatings, including ion-substituted and nanostructured layers. Furthermore, the integration of nanostructured coatings and multifunctional nanoparticles is discussed in the context of biofilm inhibition, inflammation reduction, and the regenerative potential of these coatings. Also, the economic viability and translational aspects of plasma-coated implants are addressed.