Remodelling the Electrical Microenvironment for Facilitating Bone Regeneration: a Decade of Progress

The increasing global incidence of bone injuries and degenerative diseases, often compounded by conditions like diabetes and osteoporosis, presents a significant health care challenge. Critical-sized bone defects frequently fail to heal due to compromised bioelectric microenvironments. This review summarises the conceptual framework of electric microenvironment remodelling in bone tissue, covering its physiological basis, disruption in disease and therapeutic modulation using electroactive scaffolds. The authors outline how the electric microenvironment of bone tissue is generated and continuously remodelled physiologically, analyse how its deficiency compromises regeneration and highlight strategies for dynamic regulation under pathological conditions. Restoring the bioelectric environment via electroactive scaffolds promotes bone healing by enhancing osteogenesis, angiogenesis and immunomodulation, while suppressing bone resorption. Diverse electroactive materials, including piezoelectric polymers and self-powered nanogenerators, are critically examined. Future bone tissue engineering will likely involve smart composite electroactive scaffolds that respond to external stimuli, enabling non-invasive, dynamic and precise modulation of electrical signalling cues for effective treatment of complex bone defects.