Synergistic integration of biomaterials in orthopedic implantation for infection preventing and tissue engineering

Abstract The treatment of infected bone defects（IBD）is challenging in orthopedics because of their complex pathological mechanisms and high recurrence rates. An ideal therapeutic strategy should simultaneously eradicate infection and promote bone regeneration. However, conventional approaches rarely achieve both objectives effectively. It has concurrently high recurrence rates, prolonged treatment courses, and limited therapeutic efficacy. Clinically, implant-associated infections (IAI) leading to IBD are often exacerbated by patients’underlying diseases, material-related risks, and perioperative factors, thereby necessitating multifunctional strategies to achieve an integrated solution. With the rapid development of bone graft materials, researchers have focused on biocomposites because of their unique multifunctionality. By integrating the advantages of different materials and incorporating various bioactive components, biocomposites allow comprehensive treatment of patients with IBD. In this article, we reviewed the advancements in the application of different types of biocomposites in treating IBD, highlighting their synergistic effects in promoting bone healing and combating infections through various mechanisms. Additionally, it addresses the limitations associated with clinical translation and proposes a regulatory science-based framework for full lifecycle assessment. This framework offers a standardized evaluation system and precise regulatory strategies for personalized biocomposites with multiple functions. These insights provide scientific support and reveal novel approaches for clinical applications.