As a biomedical material, porous titanium alloy has gained widespread recognition and application within the field of orthopedics. Its remarkable biocompatibility, bioactivity, and mechanical properties establish it as a promising material for facilitating bone regeneration. A well-designed porous structure can lower the material’s modulus while retaining ample strength, rendering it more akin to natural bone tissue. The progression of additive manufacturing (AM) technology has significantly propelled the advancement of porous implants, simplifying the production of such structures. AM allows for the customization of porous implants with various shapes and sizes tailored to individual patients. Additionally, it enables the design of microscopic-scale porous structures to closely mimic natural bone, thus opening up avenues for the development of porous titanium alloy bone implants that can better stimulate bone regeneration. This article reviews the research progress on the structural design and preparation methods of porous titanium alloy bone implants, analyzes the porous structure design parameters that affect the performance of the implant, and discusses the application of porous medical titanium alloys. By comparing the effects of the parameters of different porosity, pore shape, and pore size on implant performance, it was concluded that pore diameters in the range of 500~800 μm and porosity in the range of 70%–90% have better bone-regeneration effects. At the same time, when the pore structure is a diamond, rhombohedral, or cube structure, it has better mechanical properties and bone-regeneration effects, providing a reference range for the application of clinical porous implants.

The advent of three-dimensional (3D) printing technology has revolutionized the production of customized titanium (Ti) alloy implants. The success rate of implantation and the long-term functionality of these implants depend not only on design and material selection but also on their surface properties. Surface modification techniques play a pivotal role in improving the biocompatibility, osseointegration, and overall performance of 3D-printed Ti alloy implants. Hence, the primary objective of this review is to comprehensively elucidate various strategies employed for surface modification to enhance the performance of 3D-printed Ti alloy implants. This review encompasses both conventional and advanced surface modification techniques, which include physical–mechanical methods, chemical modification methods, bioconvergence modification technology, and the functional composite method. Furthermore, it explores the distinct advantages and limitations associated with each of these methods. In the future, efforts in surface modification will be geared towards achieving precise control over implant surface morphology, enhancing osteogenic capabilities, and augmenting antimicrobial functionality. This will enable the development of surfaces with multifunctional properties and personalized designs. By continuously exploring and developing innovative surface modification techniques, we anticipate that implant performance can be further elevated, paving the way for groundbreaking advancements in the field of biomedical engineering.