Among metallic biomaterials, titanium alloys are a highly reliable option when it comes to ensuring high structural, mechanical and biocompatibility reliability. Its increasing use in the manufacture of medical devices, particularly in the field of orthopaedics, is justified by its mechanical and chemical properties, such as low density, high mechanical strength, high corrosion resistance, low Young's modulus and excellent biocompatibility. The ongoing development of novel alloys, with the aim of obtaining increasingly high levels of biocompatibility, will undoubtedly result in a greater prevalence of this type of biomaterial in future applications. Although there is currently a predominance of type α + β alloys, such as the Ti-6Al-4V alloy, the development of new type β alloys is aimed at achieving greater biological and mechanical biocompatibility. This review aims to provide concise updated information on titanium alloys, their mechanical properties, microstructure, development of new alloys and applications of titanium alloys in the medical field.
Abd-ElaziemWDarwishMAHamadaA, et al.Titanium-Based alloys and composites for orthopedic implants applications: a comprehensive review. Mater Des2024; 241: 112850.
2.
da SilvaLRRSalesWFCamposFdA, et al.A comprehensive review on additive manufacturing of medical devices. Prog Addit Manuf2021; 6: 517–553.
3.
FestasAJRamosADavimJP. Medical devices biomaterials – A review. Proc Inst Mech Eng Part L J Mater Des Appl2020; 234: 218–228.
4.
MohammedMKhanZSiddiqueeA. Beta Titanium alloys: the lowest elastic modulus for biomedical applications: a review. Int J Chem Nucl Metall Mater Eng V2014; 8: 726–731.
5.
NiinomiM. Mechanical properties of biomedical titanium alloys. Mater Sci Eng A1998; 243: 231–236.
6.
NiinomiMLiuYNakaiM, et al.Biomedical titanium alloys with Young’s moduli close to that of cortical bone. Regen Biomater2016; 3: 173–185.
7.
MarinELanzuttiA. Biomedical Applications of Titanium Alloys: A Comprehensive Review. Materials 2024; 17: 114.
8.
DavisRSinghAJacksonMJ, et al. A comprehensive review on metallic implant biomaterials and their subtractive manufacturing. Int J Adv Manuf Technol2022; 120: 1473–1530.
9.
FilipNRaduIVeliceasaB, et al.Biomaterials in orthopedic devices: current issues and future perspectives. Coatings2022; 12: 1–12.
10.
Abdel-Hady GepreelMNiinomiM. Biocompatibility of Ti-alloys for long-term implantation. J Mech Behav Biomed Mater2013; 20: 407–415.
11.
NiinomiM. Biologically and mechanically biocompatible titanium alloys. Mater Trans2008; 49: 2170–2178.
12.
ZamanHASharifSIdrisMH, et al.Metallic biomaterials for medical implant applications: a review. Appl Mech Mater2015; 735: 19–25.
13.
HezilNAissaniLFellahM, et al.Structural, and tribological properties of nanostructured α + β type titanium alloys for total hip. J Mater Res Technol2022; 19: 3568–3578.
14.
VermaRP. Titanium based biomaterial for bone implants: a mini review. Mater Today Proc2019; 26: 3148–3151.
15.
KunčickáLKocichRLoweTC. Advances in metals and alloys for joint replacement. Prog Mater Sci2017; 88: 232–280.
16.
SidhuSSSinghHGepreelMAH. A review on alloy design, biological response, and strengthening of β-titanium alloys as biomaterials. Mater Sci Eng C2021; 121: 111661.
17.
KopovaIStráskýJHarcubaP, et al.Newly developed Ti-Nb-Zr-Ta-Si-Fe biomedical beta titanium alloys with increased strength and enhanced biocompatibility. Mater Sci Eng C2016; 60: 230–238.
18.
ChenLYCuiYWZhangLC. Recent development in beta titanium alloys for biomedical applications. Metals (Basel)2020; 10: 1–29.
19.
SchneiderSGNunesCARogeroSO, et al.Mechanical properties and cytotoxic evaluation of the Ti-3Nb-13Zr alloy. Biomecánica,2000; 8 : 84–87.
20.
HoppeVSzymczyk-ZiółkowskaPRusińskaM, et al.Study of cytotoxic activity of Ti–13Nb–13Zr medical alloy with different surface finishing techniques. J Mater Sci2021; 56: 17747–17767.
21.
ChallaVSAMaliSMisraRDK. Reduced toxicity and superior cellular response of preosteoblasts to Ti-6Al-7Nb alloy and comparison with ti-6Al-4V. J Biomed Mater Res - Part A2013; 101 A: 2083–2089.
22.
FestasAJCarvalhoSHorovistizA, et al.Comparative study of titanium alloys machinability used for medical applications. Proc Inst Mech Eng E: J Process Mech Eng2022; 236: 1845–1856.
23.
TamayoJARiascosMVargasCA, et al.Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry. Heliyon2021; 7: e06892.
24.
LowtherMLouthSDaveyA, et al.Clinical, industrial, and research perspectives on powder bed fusion additively manufactured metal implants. Addit Manuf2019; 28: 565–584.
25.
ZhangLCLiuYLiS, et al.Additive manufacturing of Titanium alloys by electron beam melting: a review. Adv Eng Mater2018; 20: 1–16.
26.
PushpPDasharathSMAratiC. Classification and applications of titanium and its alloys. Mater Today Proc2022; 54: 537–542.
27.
KaurMSinghK. Review on titanium and titanium based alloys as biomaterials for orthopaedic applications. Mater Sci Eng C2019; 102: 844–862.
28.
PesodePBarveS. A review—metastable β titanium alloy for biomedical applications. J Eng Appl Sci2023; 70: 1–36.
29.
KolliRPDevarajA. A review of metastable beta titanium alloys. Metals (Basel)2018; 8: 1–41.
30.
GialanellaSMalandruccoloA. Titanium and Titanium alloys. Cham: Springer 2020; pp. 129–189. https://doi.org/10.1007/978-3-030-24440-8_4
31.
VeigaCLoureiroAJRDavimJP. Properties and applications of titanium alloys. Rev Adv Mater Sci2012; 32: s. 133–s. 148.
32.
GaoKZhangYYiJ, et al.Overview of surface modification techniques for titanium alloys in modern material science: a comprehensive analysis. Coatings2024; 14: 148.
33.
SemiatinSL. An overview of the thermomechanical processing of α/β Titanium alloys: current Status and future research opportunities. Metall Mater Trans A Phys Metall Mater Sci2020; 51: 2593–2625.
34.
AneneFAAiza JaafarCNZainolI, et al.Biomedical materials: a review of titanium based alloys. Proc Inst Mech Eng Part C J Mech Eng Sci2021; 235: 3792–3805.
35.
SłodkiBZebalaWStruzikiewiczG. Turning titanium alloy, grade 5 ELI, with the implementation of high pressure coolant. Materials2019; 12: 768.
36.
CarrionPEShamsaeiNDaniewiczSR, et al.Fatigue behavior of Ti-6Al-4V ELI including mean stress effects. Int J Fatigue2017; 99: 87–100.
37.
SinghSSinghHGepreelMA. Materials science & engineering C A review on alloy design, biological response, and strengthening of β -titanium alloys as biomaterials. Mater Sci Eng C2021; 121: 111661.
38.
FellahMLabaizMAssalaO, et al.Tribological behavior of biomaterials for total hip prosthesis. Trends Biomater Artif Organs2015; 29: 22–30.
39.
PałkaKPokrowieckiR. Porous Titanium implants: a review. Adv Eng Mater2018; 20: 1–18.
40.
AhmedWJacksonMJ. Surgical tools and medical devices, second edition. 2016. Epub ahead of print 2016. DOI: 10.1007/978-3-319-33489-9.
41.
BahlSSuwasSChatterjeeK. Comprehensive review on alloy design, processing, and performance of β Titanium alloys as biomedical materials. Int Mater Rev2021; 66: 114–139.
42.
ZhangLCChenLY. A review on biomedical Titanium alloys: recent progress and prospect. Adv Eng Mater2019; 21: 1–29.
43.
GaoYXiaoWKentD, et al.Manipulating TWIP/TRIP via oxygen-doping to synergistically enhance strength and ductility of metastable beta titanium alloys. J Mater Sci Technol2025; 215: 58–70.
44.
CaoMZHeBB. A review on deformation mechanisms of metastable β titanium alloys. 2024. Epub ahead of print 2024. DOI: 10.1007/s10853-024-10063-2.
45.
AlipourSTaromianFGhomiER, et al.Nitinol: from historical milestones to functional properties and biomedical applications. Proc Inst Mech Eng Part H J Eng Med2022; 236: 1595–1612.
46.
KapoorD. Nitinol for medical applications: a brief Introduction to the properties and processing of nickel Titanium shape memory alloys and their use in stents. Johnson Matthey Technol Rev2017; 61: 66–76.
47.
SinhaSBegamHKumarV, et al.Improved performance of the functionalized nitinol as a prospective bone implant material. J Mater Res2018; 33: 2554–2564.
48.
ImamalizadeCA. Manufacturing of nitinol-based alloys by using modern technology: a short review. Phys Chem Solid State2023; 24: 341–347.
49.
SharmaNJangraKRajT. Applications of Nickel-Titanium alloy. J Eng Technol2015; 5: 1.
50.
PatelSKBeheraBSwainB, et al.A review on NiTi alloys for biomedical applications and their biocompatibility. Mater Today Proc2020; 33: 5548–5551.
51.
JacksonMJKopacJBalazicM, et al.Titanium and titanium alloy applications in medicine. 2016. Epub ahead of print 2016. DOI: 10.1007/978-3-319-33489-9_15. 2016.
52.
BozkurtYKarayelE. 3D Printing technology; methods, biomedical applications, future opportunities and trends. J Mater Res Technol2021; 14: 1430–1450.
53.
CulmoneCSmitGBreedveldP. Additive manufacturing of medical instruments: a state-of-the-art review. Addit Manuf2019; 27: 461–473.
54.
BarakehWZeinOHemdaniehM, et al.Enhancing hip arthroplasty outcomes: the multifaceted advantages, limitations, and future directions of 3D printing technology. Cureus2024; 16: e60201.
55.
YalcinkayaSAygülEŞahinY. Titanium implant for dental applications using 3D printing technology. Int J 3D Print Technol Digit Ind2020; 4: 171–177.
56.
ChuaKKhanIMalhotraR, et al.Additive manufacturing and 3D printing of metallic biomaterials. Eng Regen2021; 2: 288–299.
57.
LiYJiangDZhuR, et al.Revolutionizing medical implant fabrication : advances in additive manufacturing of biomedical metals. Int J Extrem Manuf2024; 7: 22002.
58.
YuanLDingSWenC. Additive manufacturing technology for porous metal implant applications and triple minimal surface structures: a review. Bioact Mater2019; 4: 56–70.
59.
FestasARamosADavimJP. Machining of titanium alloys for medical application - a review. Proc Inst Mech Eng Part B J Eng Manuf2022; 236: 309–318.
60.
LiYWangF. Review of 3D-printed Titanium-based implants: materials and post-processing. ChemBioEng Rev2024; 11: e202400032.
61.
Dev SinghDMahenderTRaji ReddyA. Powder bed fusion process: a brief review. Mater Today Proc2021; 46: 350–355.
62.
FestasAJFigueiredoDACarvalhoSR, et al.A case study of hybrid manufacturing of a Ti-6Al-4V titanium alloy hip prosthesis. Int J Adv Manuf Technol2023; 129: 4617–4630.
63.
FestasARamosADavimJP. Machining of a functional hip prosthesis cone in TI - 6AL - 4V ELI titanium alloy produced by electron beam melting. J Brazilian Soc Mech Sci Eng2024; 46: 182.
64.
SongTChenZCuiX, et al.Strong and ductile titanium–oxygen–iron alloys by additive manufacturing. Nature2023; 618: 63–68.
65.
WysockiBAChmielewska-WysockaAMajP, et al.Mechanical Properties of Ti Grade 2 Manufactured Using Laser Beam Powder Bed Fusion (PBF-LB) with Checkerboard Laser Scanning and In Situ Oxygen Strengthening. Crystals2024; 14: 574.
66.
IdaszekJWysockiBUra-BińczykE, et al.Graded or random – Effect of pore distribution in 3D titanium scaffolds on corrosion performance and response of hMSCs. Biomater Adv2024; 163: 213955.
67.
KhattabNROlivas-AlanisLHChmielewska-WysockaA, et al.Evaluation of stiffness-matched, 3D-printed, NiTi mandibular graft fixation in an ovine model. Biomed Eng Online2024; 23: 105.
68.
García-HernándezCGarcía-CabezónCGonzález-DiezF, et al.Effect of processing on microstructure, mechanical properties, corrosion and biocompatibility of additive manufacturing Ti-6Al-4V orthopaedic implants. Sci Rep2025; 15: 1–20.
69.
VermaPKVasudevHSinghG, et al.A review on the microstructural and biomedical properties of implants manufactured using additive manufacturing. J Inst Eng India Ser D2024. DOI: https://doi.org/10.1007/s40033-024-00755-z
70.
OlinC. Titanium in cardiac and cardiovascular applications. In: Titanium in Medicine. Engineering Materials. Berlin, Heidelberg: Springer, 2001, pp.889–907.
71.
MorscherEWClaussMGrappioloG. Outcome with the MS-30 stem. In: Well-Cemented Total Hip Arthroplast Theory Pract. Berlin, Heidelberg: Springer, 2005, pp.235–241.
72.
GompelmannDEberhardtRSchuhmannM, et al.Self-expanding Y stents in the treatment of central airway stenosis: a retrospective analysis. Ther Adv Respir Dis2013; 7: 255–263.
73.
RajashekarP. Development of mechanical heart valves - an inspiring tale. J Pract Cardiovasc Sci2015; 1: 289.
74.
EllisEMessoE. Use of nonresorbable alloplastic implants for internal orbital reconstruction. J Oral Maxillofac Surg2004; 62: 873–881.
75.
HoneybulSMorrisonDAHoKM, et al.A randomised controlled trial comparing autologous cranioplasty with custom-made titanium cranioplasty: long-term follow-up. Acta Neurochir (Wien)2018; 160: 885–891.
76.
KhanBDavisRSinghA. Effect of input variables and cryogenic treatment in wire electric discharge machining of Ti-6Al-4V alloy for biomedical applications. Mater Today Proc2019; 27: 2503–2507.
77.
RosaNMartaMVazM, et al.Intramedullary nailing biomechanics: evolution and challenges. Proc Inst Mech Eng Part H J Eng Med2019; 233: 295–308.
