<p>This review article provides a comprehensive engineering perspective on orthopedic implants by integrating materials, processing techniques, surface engineering, and in-service performance. It begins with the historical development and evolving market trends, followed by a classification of permanent and temporary orthopedic implants. Then a detailed evaluation of implant materials—including metals, ceramics, and polymers—is presented, emphasizing their tribological, mechanical, corrosive, and biological characteristics, along with their interdependencies and application-specific selection criteria. Subsequently, the role of manufacturing processes, including traditional and non-traditional machining, is critically examined in relation to implant performance and quality. Particular attention is given to surface engineering strategies such as coatings and surface modifications that enhance wear resistance, biocompatibility, and osseointegration. The review further explores material degradation mechanisms in physiological environments and associated biological responses, including corrosion, wear debris generation, and host tissue interactions. Strategies to mitigate adverse reactions and prevent implant failure are discussed by linking material behavior with design, processing, surgical practices, and post-operative management. Recent advancements in titanium-based implants, bioactive coatings, and multifunctional surfaces are incorporated to strengthen contemporary research coverage. While synthesizing current knowledge, the review acknowledges limitations such as variability in long-term clinical performance, challenges in standardization of surface treatments, and barriers to clinical translation. Finally, research directions focus on smart, bioactive, and patient-specific implants enabled by advanced manufacturing and surface functionalization, offering pathways for improved durability and clinical outcomes.</p> Graphical Abstract <p></p>