A systematic review of diamond-like carbon coatings modified by elemental doping for biomedical applications

This review presents a critical synthesis of elemental doping strategies for diamond-like carbon (DLC) coatings in biomedical contexts, emphasizing mechanistic understanding over descriptive cataloging. Dopants are categorized by their primary mechanisms of action: antimicrobial agents (silver, copper), stress-reducing and multifunctional modifiers (silicon), bioactivity enhancers (titanium), surface energy modulators (fluorine), and biologically essential elements (calcium, phosphorus, zinc). For each category, the review examines deposition methods, structure-property relationships, biological mechanisms, and optimization strategies. Comparative analysis highlights the interplay between dopant identity, concentration, and fabrication parameters in shaping antimicrobial activity, hemocompatibility, osseointegration, and mechanical stability. By organizing content around mechanistic pathways rather than individual elements or techniques, this framework provides actionable guidance for rational design of next-generation DLC coatings tailored to specific clinical applications. The graphical abstract for this manuscript was created by the authors using Adobe Illustrator CC 2024. No AI tools have been used for making any graphics or figures. • Ag/Cu co-doping in DLC coatings enables synergistic antimicrobial and cytocompatible effects. • Si and Ti doping reduce internal stress and enhance adhesion for orthopedic applications. • F-DLC coatings achieve hemocompatibility via hydrophobicity and reduced platelet adhesion. • PACVD and magnetron sputtering allow precise dopant control for biomedical surface design. • Zn, Ca, and P co-doping promotes osseointegration through bioactive ion release mechanisms.