Being a bioactive material, hydroxyapatite (HAp) is regarded
as
one of the most attractive ceramic biomaterials for bone and hard-tissue
replacement and regeneration. Despite its substantial biocompatibility,
osteoconductivity, and compositional similarity to that of bone, the
employment of HAp is still limited in orthopedic applications due
to its poor mechanical (low fracture toughness and bending strength)
and antibacterial properties. These significant challenges lead to
the notion of developing novel HAp-based composites via different
fabrication routes. HAp, when efficaciously combined with functionally
graded materials and antibacterial agents, like Ag, ZnO, Co, etc.,
form composites that render remarkable crack resistance and toughening,
as well as enhance its bactericidal efficacy. The addition of different
materials and a fabrication method, like 3D printing, greatly influence
the porosity of the structure and, in turn, control cell adhesion,
thereby enabling biological fixation of the material. This article
encompasses an elaborate discussion on different multifunctional HAp
composites developed for orthopedic applications with particular emphasis
on the incorporation of functionally graded materials and antibacterial
agents. The influence of 3D printing on the fabrication of HAp-based
scaffolds, and the different in vitro and in vivo studies conducted
on these, have all been included here. Furthermore, the present review
not only provides insights and broad understanding by elucidating
recent advancements toward 4D printing but also directs the reader
to future research directions in design and application of HAp-based
composite coatings and scaffolds.