**17. Surface-modified biomaterials**

The biomaterial surface chemistry and topography impact protein adsorption, cell interaction, and host site response. Monocyte adhesion in vitro [71] have been shown to be altered by its surface chemistry, while in vivo surface chemistry does not significantly influence the foreign body reaction. Polymeric, ceramic, or metallic-based biomaterials exhibit variability in surface properties such as hydrophilic to hydrophobic; hard to soft in vivo [72].
