The hydrothermal process is a commonly used technique for manufacturing nanoparticles and nanostructured surfaces, and has been used to manufacture titanium dioxide (TiO2) nanostructured bactericidal surfaces. This work examines the mechanical properties, surface morphology and stability of the TiO2 surface as a function of NaOH concentration. At NaOH concentrations below 1.50 M, individual pillar-like nanostructures with high Young’s modulus were formed. When NaOH concentration was increased above 1.50 M, nanostructure tips fused together to form a large interconnected mesh-like network. This mesh-like structure caused a reduction in the Young’s modulus and hardness of the titanium dioxide surface. The mechanical properties of the TiO2 remained constant over a 6 month period, indicating stability of the nanostructures. This work demonstrates the synthesis of stable TiO2 nanostructured surfaces of different Young’s modulus, hardness and surface morphology using the hydrothermal method, with potential application in orthopedic implants.