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However, the inherent bioinert and mismatched mechanical surface of PEEK have limited their optimized bone fixation and repair. In this work, a PEEK implant is printed and a bioactive mechanical\u2010adaptive surface via in situ chemical linking of photoluminescent elastomeric poly(citrate\u2010silicon) (PCS) polymer (PEEK\u2010PCS) is subsequently constructed, which could be used for real\u2010time bioimaging and enhanced osseointegration. The PEEK\u2010PCS surface exhibits viscoelastic properties, enabling it to conform to complex tissue geometries and effectively alleviate surface stress. Furthermore, PEEK\u2010PCS modulates the inflammatory response by promoting macrophage M2 phenotypic polarization and reducing the expression of inflammatory factors. Additionally, PEEK\u2010PCS promotes the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), significantly enhancing the osseointegration and osteogenesis ability of PEEK implants. Notably, PEEK\u2010PCS demonstrates excellent autofluorescence properties both in vitro and in vivo, along with remarkable fluorescence stability over 14 d in vivo, suggesting real\u2010time tracking potential of bioimaging. Compared to traditional coated implants, PEEK\u2010PCS provides distinct advantages in surface adhesion, mechanical compatibility, real\u2010time bioimaging, and osseointegration, representing a promising solution for implant\u2010related bone repair.<\/jats:p>","DOI":"10.1002\/adhm.202404435","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:48:34Z","timestamp":1741718914000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["3D Printed Bioactive Mechanical\u2010Adaptive Polyetheretherketone Implants with Non\u2010Invasive Tracking for Immunomodulatory Osseointegration"],"prefix":"10.1002","volume":"14","author":[{"given":"Hongyun","family":"Ma","sequence":"first","affiliation":[{"name":"Foot and Ankle Surgery Department Honghui Hospital Xi'an Jiaotong University  Xi'an 710054 P. R. 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