Abstract:

Segmental bone defect repair remains a persistent challenge in clinical orthopedics. Implanting degradable bioactive scaffold to induce bone regeneration represents a promising therapeutic strategy. However, existing scaffold materials struggle to simultaneously achieve both precise shape-matching with irregular bone defect sites and mechanical properties adapted to bone tissue, both critical for providing mechanical support and transmitting biomechanical stimuli to facilitate bone defect repair. Here, we developed an in-situ formed high-strength degradable scaffold with osteogenic bioactivity and porous structure (OP-IHDS) via radical ring-opening polymerization. OP-IHDS fills irregular bone defects with arbitrary shapes while establishing robust interfacial anchoring with bone tissue through in-situ curing, with a push-out binding force up to 1378 N. Furthermore, OP-IHDS exhibits a compressive strength of 79 MPa and compressive modulus of 780 MPa, closely resembling those of human tibia cancellous bone. In a rat critical tibial defect model, OP-IHDS sustains stable integration at the implantation site and develops an interconnected porous structure within 4 weeks in vivo. Through synergistic effects of biomineralization and vascularization processes, OP-IHDS demonstrates 47.4% new bone formation and 75.5% biomechanical restoration in tibial defects after 12 weeks. This work introduces a novel paradigm for bone defect repair scaffolds.