Balancing mechanical strength and microbial adhesion through architectural design in 3D-printed 3YSZ porous implants

Bone defect treatment remains a major challenge in orthopedics, particularly for load-bearing applications requiring both biological compatibility and long-term mechanical performance. Additive manufacturing enables the fabrication of porous ceramic implants with tailored architectures that reduce Elastic Modulus while maintaining compressive strength; however, their influence on microbial colonization remains poorly understood. In this study, four porous 3-YSZ architectures were fabricated by filament-based material extrusion and evaluated for mechanical performance, antimicrobial behavior, and biofilm formation against eight clinically relevant pathogens. Differences in infection susceptibility and colonization patterns were observed among architectures and microorganisms, demonstrating that pore design significantly influences microbial adhesion and biofilm development. These findings highlight the importance of considering microbiological response alongside mechanical properties when designing porous ceramic implants and provide a basis for developing next-generation load-bearing implants with reduced infection risk.