Trifunctional synergistically designed 3D-Printed bone scaffold for infectious bone defect therapy: design strategy and clinical translation outlook

Abstract

Objective Infection-induced bone defects are a challenging disease in orthopedic clinical practice. Traditional treatments face core problems such as limited bone sources, high risk of antibiotic systemic application-induced resistance, and difficulties in synchronizing infection control and bone regeneration. Method 3D printing technology, with its advantages of personalized customization, precise structural regulation, and compatibility and adaptability of multiple materials, has become the core preparation method for repair scaffolds for infection-induced bone defects. Constructing an integrated scaffold with three functions - antibacterial, osteogenic, and vascularization - that is temporally coupled and spatially stratified, and oriented towards clinical translation is a key direction to break through the treatment bottleneck of this disease. Results This review differs from existing reviews that only focus solely on antibacterial materials, 3D printing scaffold preparation, or bone regeneration mechanisms. It is the first to systematically construct a three-function collaborative framework of “infection control - angiogenesis - bone regeneration” with temporal coupling and spatial stratification. It deeply analyzes the adaptability of different material systems in the infection microenvironment, the logic of selecting anti-infection strategies, and the design rules of biomimetic structures. It comprehensively summarizes the key bottlenecks in clinical translation, real clinical case evidence, and industrialization paths, and clarifies the time-controlled regulatory mechanism and clinical translation targeting path of the three-function collaboration. Conclusion 3D printed anti-infection bone scaffolds can achieve synchronous repair of infection clearance, bone regeneration, and angiogenesis. The three-function temporal and spatial collaborative design and integrated research for clinical translation are the core development directions in this field, providing theoretical support and practical guidance for the precise treatment of infection-induced bone defects.