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In this study, HA\u2010V\u2010MTO\/LMP@Gel, an injectable sono\u2010piezocatalytic hydrogel, is developed for local treatment of HCC after iRFA. It combines hyaluronic acid\u2010modified, oxygen vacancy\u2010engineered Mn\u2013Ti metal\u2013organic framework nanosheets (HA\u2010V\u2010MTO) with reactive oxygen species (ROS)\u2010responsive liposomes co\u2010loaded with STING agonist MSA\u20102 and an anti\u2010PD\u20101 antibody (LMP) within a thermosensitive chitosan\/\u03b2\u2010glycerophosphate (CS\/\u03b2\u2010GP) hydrogel. Oxygen\u2010vacancy engineering lowers the O\n                    <jats:sub>2<\/jats:sub>\n                    adsorption energy from 0.187 to \u22122.559 eV and raises the piezoelectric coefficient\n                    <jats:italic>d<\/jats:italic>\n                    <jats:sub>33<\/jats:sub>\n                    from 35.36 to 108.73 pm V\n                    <jats:sup>\u22121<\/jats:sup>\n                    . Under ultrasound, HA\u2010V\u2010MTO generates ROS through sono\u2010piezocatalysis, with an additional Fenton\u2010like reaction from the Mn\u2010containing framework. The resulting oxidative stress induces mitochondrial injury and promotes cytosolic mtDNA release, thereby facilitating cGAS\u2010mediated STING activation. ROS\u2010mediated LMP destabilization releases MSA\u20102, which further enhances STING signaling. The hydrogel undergoes temperature\u2010triggered gelation for sustained local release. In a post\u2010iRFA model, HA\u2010V\u2010MTO\/LMP@Gel + US raises intratumoral IFN\u2010\u03b2 7.9\u2010fold, increases the proportion of mature dendritic cells to 50.8% and that of intratumoral CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells to 26.5%, suppresses residual regrowth, prolongs survival, and protects against tumor rechallenge. This work presents a locally retained sono\u2010piezocatalytic system that couples tumor killing with STING\u2010driven immune activation after iRFA.\n                  <\/jats:p>","DOI":"10.1002\/adma.75010","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:34:48Z","timestamp":1789364088000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Defect\u2010Engineered Sono\u2010Piezocatalytic In Situ Hydrogel for Preventing Hepatocellular Carcinoma Recurrence After Incomplete Radiofrequency Ablation"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5199-0436","authenticated-orcid":false,"given":"Jianji","family":"Ke","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery General Surgery Center The First Hospital of Jilin University  Changchun 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