Research Progress on Osseointegration Performance of Porous Structure-Modified Titanium Alloy Implants

Xingda Huang¹Xi Gong¹Aofei Xu¹Weiying Zhang¹Yi Li¹Yunfei Jia²Weizhou Yang¹Na Yuan³Yin Yang⁴Dezhi Wang^5*Weiguo Bian^1*Jiantao Liu^1*

• ¹Department of Orthopedics, First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
• ²Department of Orthodontics, Xi'an Jiao Tong University Stomatology Hospital, Xi'an, China
• ³Department of Ultrasonography, The First Affiliated Hospital of Xi’an Jiaotong University, Xi‘an, China
• ⁴Department of Orthopedics, Xi'an Central Hospital, Xi'an, China
• ⁵Department of Anesthesiology, Honghui Hospital Jiaotong University, Xi'an, China

Large bone defects remain a major clinical challenge and often require load-bearing implants for reconstruction. Titanium alloys are widely used for bone defect repair because of their favorable mechanical properties and biocompatibility; however, their high elastic modulus and limited bioactivity can cause stress shielding and insufficient osseointegration. Porous architectures have therefore been introduced to tailor the elastic modulus and promote bone ingrowth. This review summarizes current clinical applications and unresolved challenges of porous titanium implants, and integrates recent preclinical evidence on manufacturing routes and key design parameters. We analyze how pore topology (periodic versus stochastic architectures), pore size, porosity, strut diameter, and multiscale designs affect osseointegration. Overall, the review provides design-oriented insights and highlights prospects and challenges for future preclinical and clinical research to improve the osseointegration of porous titanium implants.