As
both the average life expectancy and incidence of bone tissue
reconstruction increases, development of load-bearing implantable
materials that simultaneously enhance osseointegration while preventing
postoperative infection is crucial. To address this need, significant
research efforts have been dedicated to developing surface modification
strategies for metallic load-bearing implants and scaffolds. Despite
the abundance of strategies reported, many address only one factor,
for example, surface chemistry or topography. Furthermore, the incorporation
of surface features to increase osteocompatibility can increase the
probability of infection, by encouraging the formation of bacterial
biofilms. To truly advance this field, research efforts must focus
on developing multifunctional coatings that concurrently address these
complex and competing requirements. In addition, particular emphasis
should be placed on utilizing surface modification processes that
are versatile, low cost, and scalable, for ease of translation to
mass manufacturing and clinical use. The aim of this short Review
is to highlight recent advances in scalable and multifunctional surface
modification techniques that obtain a programmed response at the bone
tissue/implant interface. Low-temperature approaches based on macromolecule
immobilization, electrochemical techniques, and solution processes
are discussed. Although the strategies discussed in this Review have
not yet been approved for clinical use, they show great promise toward
developing the next generation of ultra-long-lasting biomaterials
for joint and bone tissue repair.