The demand for orthopedic implants is increasing, driven by a rising number of young patients seeking an active lifestyle post-surgery. This has led to changes in manufacturing requirements. Joint arthroplasty operations are on the rise globally, and recovery times are being reduced by customized endoprostheses that promote better integration. Implants are primarily made from metals and ceramics such as titanium, hydroxyapatite, zirconium, and tantalum. Manufacturing processes, including additive manufacturing and thermal plasma spraying, continue to evolve. These advancements enable the production of tailored porous implants with uniform surface coatings. Coatings made of biocompatible materials are crucial to prevent degradation and enhance biocompatibility, and their composition, porosity, and roughness are actively explored through biocompatibility testing. This review article focuses on the additive manufacturing of orthopedic implants and thermal plasma spraying of biocompatible coatings, discussing their challenges and benefits based on the authors’ experience with selective laser melting and microplasma spraying of metal-ceramic coatings.