Titanium‐Coated Implants With Advanced Antioxidant Properties Are Used in the Design and Development of a Regenerative Repair Strategy for Reversing Senile Osteoporosis

ABSTRACT Senile osteoporosis (SOP) creates a hostile peri‐implant microenvironment characterized by impaired osteogenesis, excessive bone resorption, and persistent oxidative stress, leading to poor osseointegration. Here, we developed a dual‐functional titanium surface (Ti‐Ta@RS) co‐modified with a thioctic acid derivative and risedronate sodium to simultaneously regulate oxidative stress and osteoclast activity. Ti‐Ta@RS improved the physicochemical properties of the titanium surface and significantly enhanced BMSC viability, migration, spreading, and osteogenic differentiation under senescence‐associated conditions, as evidenced by increased ALP activity, collagen deposition, mineralization, and osteogenesis‐related protein expression. Moreover, Ti‐Ta@RS effectively reduced intracellular oxidative stress and inhibited RANKL‐induced osteoclastogenesis, demonstrating its dual regulatory effects on the pathological SOP microenvironment. In vivo, Ti‐Ta@RS markedly promoted peri‐implant bone formation, improved trabecular microarchitecture, and enhanced osseointegration in senile osteoporotic rats. Transcriptomic analysis further suggested that these beneficial effects were associated with the regulation of extracellular matrix remodeling, calcium signaling, and cell cycle‐related pathways. Collectively, these findings demonstrate that Ti‐Ta@RS effectively rebalances the pathological SOP microenvironment by integrating antioxidative regulation with local anti‐resorptive activity, thereby providing a promising surface‐engineering strategy for enhancing implant osseointegration under senile osteoporotic conditions.