The Titanic Knurl is a new item in Risk of Rain 2.
This item increase your health by 40 and grants 0.6 health regeneration which doesn't count as healing, therefore holding this item while doing the Naturopath achievement is acceptable.
As a boss item, it only drops from Stone Titans that appear as teleporter bosses.
- The regeneration provided by Titanic Knurl benefits from the Rejuvenation Rack.
- Titanic Knurl is a reference to the Risk of Rain 1 item, Colossal Knurl.