Titania nanotube arrays (TNA) have high biocompatibility, less toxicity, and a large surface area per volume; thus, TNA offer great potential in biomedical applications. Interactions between micro environment and cell on the TNA surface are intensively investigated regarding cell attachment and interaction. Anodization was used to create a highly ordered nano-porous oxide layer with nano-sized pores on the surface of the titanium. This process was carried out at 30 V with a sweep rate of 1 V/sec for a different duration (10 s, 1 min, 2 min, 5 min, 10 min, 20 min, 30 min, 1 h, 2 h, 3 h and 6 h). On an anodized titanium surface, the cell adhesion of several adherence cells was observed using a eld emission scanning electron microscope (FESEM). Due to its important role in controlling the morphology of the nanotube structures, extending anodization time causes the length of the nanotubes increases. Hence, the optimised anodization time on the TNA surface at 30 V with a sweep rate of 1 V/s directly impacts cell adhesion after incubating for 48 h. The anodic potential of TNA was successfully obtained at 30 V with a sweep rate of 1 V/sec for 30 min, which could modulate diverse cellular responses of cell adhesion observed by FESEM.

Background Medical implant failures are frequently associated with limitations of the surface technology that lead to biofouling and haemocompatibility issues. Titania nanotube array technology could provide a solution for this existing limitation. The present study describes the biofouling potential using the simulated body fluid model according to ISO 23317-2007 and haemocompatibility profiles according to ISO 10993-4 guidelines. Further haemocompatibility profiles were also assessed by evaluating full blood count, coagulation assays, haemolytic rate, whole blood clotting factor, platelet profiles, and FESEM characterization. Result Titania nanotube array nanosurface was found to present with better apatite biofouling and hydrophilic potential compared to bare titanium foil. Furthermore, good compatibility behaviour was observed based on the haemocompatibility profiles where no signs of thrombogenesis and haemolysis risks were observed. Titania nanotube array reduced fibrinogen adsorption, red blood cell and platelet adhesion and activation, which could be associated with detrimental biofouling properties. Conclusion Titania nanotube array could possess a double-edged sword of biofouling potentials that resist detrimental biofouling properties associated with thrombogenesis and haemolysis risk. It also provides better apatite biofouling potential for improved tissue and osseointegration activities. Knowledge from this study provides a better understanding of medical implant surface technology. Graphical Abstract