The crystallinity of hydroxyapatite (HA) coatings prepared by aerosol deposition may be increased by heating in air or low-temperature hydrothermal processing. From the X-ray diffraction and Fourier transform infrared spectroscopy results, it was revealed that the crystallinity of the HA coatings significantly increased after the post-annealing. Transmission electron microscopy showed that the conventional furnace heating induced the substantial growth of the HA crystallites, whereas the hydrothermal treatment did not bring about any remarkable change in the HA crystallite size, which remained below 20 nm. The bioactivity of the HA coatings was estimated by the acellular simulated body fluid immersion test. After immersion for 7 days, newly-precipitated apatite crystals were only observed on the surfaces of the samples hydrothermally treated at 170 and 190 degrees C. In addition, the alkaline phosphatase activity of MC3T3-E1 preosteoblast cells cultured on the hydrothermally treated samples was significantly higher than those on the as-deposited coating and conventional furnace heated samples. The enhanced bioactivity and excellent biological in vitro cellular response of the hydrothermally treated samples were attributed to their nanostructured nature and high degree of crystallinity. (C) 2011 Elsevier B.V. All rights reserved.