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Key hurdles include its avascular, low\u2010cell structure (impeding repair cell migration) and persistent post\u2010injury compressive\/shear stresses (damaging tissue and disrupting new formation). This study designed a sandwich composite hydrogel: GelMA\/HAMA loaded with BMSCs, combined with a PVA\u2010bacterial cellulose membrane carrying chondrocyte\u2010derived exosomes. The membrane provides mechanical support and slowly releases exosomes to regulate BMSC proliferation\/differentiation. Biomechanical analysis showed reduced stress concentration at perforation edges, protecting regeneration. In vitro experiments confirmed upregulated cartilage matrix genes (e.g., COL1A1, ACAN) in BMSCs. Implantation in a rabbit TMJ disc perforation model for eight weeks led to new cartilage\u2010like tissue and successful repair. This system, optimizing mechanical microenvironment, regulating stem cell fate, and promoting matrix regeneration, offers a novel strategy for functional TMJ disc repair.<\/jats:p>","DOI":"10.1002\/adhm.202503929","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:15:13Z","timestamp":1778058913000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reinforced Bacterial Cellulose\/GelMA\u2010HAMA Bionic Cartilage Hydrogel with Spatiotemporal Delivery of Exosomes and BMSCs for Temporomandibular Joint Disc Regeneration"],"prefix":"10.1002","volume":"15","author":[{"given":"Jie","family":"Lu","sequence":"first","affiliation":[{"name":"Stomatological Hospital of Chongqing Medical University  Chongqing China"},{"name":"Chongqing Key Laboratory of Oral Diseases  Chongqing China"},{"name":"Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education  Chongqing 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