Ceramics International xxx (xxxx) xxx Please cite this article as: Deepika Shekhawat, Ceramics International, https://doi.org/10.1016/j.ceramint.2020.09.214 Available online 22 September 2020 0272-8842/© 2020 Elsevier Ltd and Techna Group S.r.l. All rights reserved. Review article Bioceramic composites for orthopaedic applications: A comprehensive review of mechanical, biological, and microstructural properties Deepika Shekhawat a , Amit Singh a , M.K. Banerjee b , Tej Singh c , Amar Patnaik a, * a Mechanical Engineering Department, M.N.I.T, Jaipur, 302017, India b Department of Metallurgical and Materials Engineering, M.N.I.T, Jaipur, 302017, India c Savaria Institute of Technology, E¨ otv¨os Lor´ and University, Szombathely, 9700, Hungary A R T I C L E INFO Keywords: Bioceramics Orthopaedic implants Microstructure Mechanical properties Biocompatibility ABSTRACT Bioceramics have been widely utilized for orthopaedic applications in which the biocompatibility and me- chanical properties of the materials are vital characteristics to be considered for their clinical use. Till date, extensive studies have been devoted to developing a range of scientific ways for tailoring the microstructure of bioceramics in order to attain the trade-off of mechanical properties and biocompatibility of the final product. Owing to low reactivity, earlier stabilization and longer functional life of bioceramic, the developed implants are capable of replicating the mechanical behaviour of original bone. As the safety of the patient and its ultimate functionality are the ultimate goal of the selected implant material hence, the present literature survey in- vestigates and brings forth the important aspects associated to the mechanical, biological and microstructural characteristics of bioceramics employed in orthopaedic applications. The review paper majorly focuses on effective utilization of various materials as an additive in bioceramics and processing techniques used for enhancement of properties, enabling the use of material in orthopaedic applications. The influence of various additives on the microstructure, mechanical properties and biological performance of developed bioceramics orthopaedic implants has been elaborately discussed. Furthermore, future prospects are proposed to promote further innovations in bioceramics research. 1. Introduction Orthopaedic medical procedure relies significantly upon the advancement of biomaterials utilized for the reclamation and replace- ment of damaged parts of the human body. The human bodies are vulnerable to various disabling and painful injuries for example dislo- cation, strains and fractures. The bone breakage is termed as fracture and generally caused by the forces that surpass the strength of bone tissue. In order to heal the bone fracture, a surgery is carried out to implant the additional material which may carry the whole-body load. The implanted materials are generally termed as biomaterials and should exhibit excellent mechanical properties namely elastic modulus, yield strength and ultimate tensile strength to withstand various biomechanical forces. Besides, low density, good biocompatibility along with higher corrosion and wear resistance are the other desired prop- erties of the implanted materials. These properties may satisfy the or- thopaedic fixation devices and load bearing applications such as bone plates, rods, screws, wires, joint replacements, dental implants and also cardiovascular stents. Some implant materials fail early during their functional period owing to certain shortcomings like wear, biological factors like infection, loosening of implants, and mismatch of elastic modulus with the bone or other body parts and low strength. On those grounds, need for second surgery becomes imperative. Great challenge is faced in revision surgery in terms of cost of operation, post-surgery pain, and the rate of success of the implanted part. Medical implant encounters various sets of challenges in terms of mechanical, biological and thermal characteristics of the selected material [1,2]. These implant devices must be capable of enduring large torques, forces acting due to compression and shear in normal loading conditions for excellent me- chanical force transfer. Hence, it is vitally important to manufacture implant materials that are hard, corrosion resistant, aging resistant, tough, wear resistant, bioactive, biocompatible and is capable of deliv- ering good service life in terms of durability (survivorship). Generally, polymers, metals, ceramic and their composites are used as implant biomaterials. Owing to their similarity with that of the mineral com- ponents of the bones, their significant biocompatibility as well as osseointegration with the host tissues makes ceramic materials the * Corresponding author. National Institute of Technology, Jaipur Mechanical Engineering, Jaipur, Rajasthan, 302017, India. E-mail address: apatnaik.mech@mnit.ac.in (A. Patnaik). Contents lists available at ScienceDirect Ceramics International journal homepage: www.elsevier.com/locate/ceramint https://doi.org/10.1016/j.ceramint.2020.09.214 Received 9 August 2020; Received in revised form 19 September 2020; Accepted 21 September 2020