Enhanced piezoelectricity and nanotopography resolve the infection-regeneration conflict in implant-associated osteomyelitis.

Authors

Changxu Chen, Jianfeng Sun, Zijian Wang, Jiaxuan Li, Xiaozhou Wen, Xuqiao Zhao, Jinxi Liu, Yong Chen, Yilin Qi, Shuncheng Yao, Zhipeng Qu, Engui Wang, Han Ouyang, Swee Hin Teoh, Xi Cui, Zhou Li

Published in

Science bulletin. Oct 03, 2026. Epub Oct 03, 2026.

Abstract

Implant-associated osteomyelitis remains a major clinical challenge because antibacterial therapy and bone regeneration impose competing demands within a dysregulated osteoimmune microenvironment. Strategies targeting antibacterial activity or osteogenesis alone are insufficient to address these interlinked challenges. Here, we develop a microenvironment-responsive interface composed of poly(L-lactic acid) (PLLA) and zinc oxide (ZnO) that integrates enhanced piezoelectricity with engineered nanotopography to support bone repair. Surface-exposed ZnO nanowire arrays markedly enhance the piezoelectric output of the PLLA interface and enable pH-responsive Zn²⁺ release. This synergistic design enables on-demand activation under infection-associated acidic conditions, while the nanowire topography provides potent antibacterial activity through mechanical penetration, thereby addressing the infection-regeneration conflict. The interface thereby enables spatiotemporally coordinated antibacterial, immunomodulatory, and osteogenic responses, reshaping the osteoimmune microenvironment. In vitro, the interface exhibits broad-spectrum antibacterial activity, promotes macrophage polarization toward a pro-healing phenotype, and enhances the osteogenic differentiation of mesenchymal stem cells. In a rat model of implant-associated osteomyelitis, the interface significantly suppresses bacterial colonization, attenuates inflammatory responses, and promotes bone regeneration and osseointegration, achieving a 3-fold higher bone volume/tissue volume ratio than uncoated controls while maintaining favorable biosafety. Collectively, this work establishes a microenvironment-adaptive interface that integrates antibacterial and bone-regenerative functions, offering a promising strategy for treating implant-associated osteomyelitis.

PMID:
42928035
Bibliographic data and abstract were imported from PubMed on 26 Oct 2026.

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