Therapeutic Biomaterials for Chronic Osteomyelitis: Time-Space-Control Strategies for Infection Control and Bone...

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Infectious Diseases

Background:

• Chronic osteomyelitis and infected bone defects involve persistent biofilms, immune dysfunction, and impaired bone healing.
• Conventional treatments often fail due to inability to address the complex interplay of infection and regeneration.

Purpose of the Study:

• To review how biofilm-associated immune dysfunction affects angiogenesis and osteogenesis.
• To summarize biomaterials designed to simultaneously control infection and promote tissue regeneration.
• To propose a framework for developing advanced therapeutic biomaterials for bone repair.

Main Methods:

• Literature review focusing on biofilm-associated immune dysfunction and regenerative biomaterials.
• Integration of representative biomaterial platforms into a "Time-Space-Control" framework.
• Development of a 4P principle for guiding programmable therapeutic biomaterials.

Main Results:

• Biomaterials can be designed with time-programmed release of antimicrobial and regenerative cues.
• Space-focused designs enhance localization and penetration into infected bone defects.
• Controllable strategies allow for pathology-responsive or externally triggered modulation of therapeutic effects.

Conclusions:

• A "Time-Space-Control" framework and 4P principle can guide the development of biomaterials for chronic infected bone repair.
• Explicitly managing timing, localization, and controllability is crucial for aligning antimicrobial therapy, immune reprogramming, and regenerative support.
• This approach holds promise for improving treatment strategies for challenging bone infections and defects.