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Standard titanium implants are widely used due to their strength and biocompatibility, but their bioinert surfaces often lead to poor osseointegration. The emergence of 3D printing has enabled patient\u2010specific titanium implants with tailored architecture and mechanical properties. However, these constructs still lack the bioactivity required for robust and spatially uniform bone integration, particularly within the implant core. To address this limitation, we developed a bioactive, cell\u2010free strategy that integrates porous titanium implants with a nanofibrillar peptide\u2010hyaluronic acid scaffold, delivered either as a hydrogel or in lyophilized form. The scaffold exhibited enhanced enzymatic stability and supported osteoblast\u2010like cell adhesion in vitro. In a rabbit calvarial critical\u2010size bone defect model, scaffold\u2010integrated implants significantly outperformed inert controls, with hydrogel integration nearly doubling inner bone volume and improving trabecular architecture. Histological analysis confirmed enhanced bone\u2010implant integration, active periosteum, healthy marrow, and reduced inflammation. This acellular, growth\u2010factor\u2010free approach combines the structural precision of titanium with the regenerative potential of ECM\u2010mimicking scaffolds, offering a translatable pathway for personalized skeletal repair.<\/jats:p>","DOI":"10.1002\/adhm.202505131","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T06:44:02Z","timestamp":1767595442000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["3D\u2010Printed Titanium Implants with Bioactive Peptide\u2010Polysaccharide Scaffolds for Personalized Bone Reconstruction"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2850-1106","authenticated-orcid":false,"given":"Noam","family":"Rattner","sequence":"first","affiliation":[{"name":"Department of Oral Biology Goldschleger School of Dental Medicine Gray Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv 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