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Recently, numerous bone repair materials have been developed to address the complex pathological microenvironment associated with infectious bone defects. However, dynamic changes in the defect size after infectious debridement pose a significant challenge for achieving effective bone integration of artificial bone grafts. Therefore, there is a need to develop an integrated scaffold with antibacterial, immunomodulatory, and osteogenic properties to achieve filling of irregular bone defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using low-temperature printing combined with the freeze-drying technology, a shape-memory scaffold with a biomimetic porous structure of cancellous bones was fabricated by compositing left-handed poly(L-lactic acid)-trimethylene carbonate (PLLA-TMC) with citric acid-modified hydroxyapatite (CHA). The scaffold (PT\/CHA) was further coated with a metal-polyphenol network tannic acid-magnesium (TA-Mg) on its surface through the \u201cmussel\u201d effect, enabling the sequential treatment of infectious bone defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The scaffold can adaptively integrate with defect interfaces at the physiological temperature (37\u00b0C), achieving superior bone integration performance. The incorporation of citric-acid-modified hydroxyapatite effectively optimizes the polymer-inorganic phase printing ink system, significantly enhancing the mechanical strength and mineralization capacity of the scaffold. Meanwhile, the external tannic-acid-magnesium metal-polyphenol coating (TA-Mg) demonstrates excellent pathogen clearance properties both in vitro and in vivo. It also influences macrophage polarization to regulate the immune microenvironment, ultimately promoting bone regeneration in infectious bone defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PT\/CHA@TA-Mg scaffold achieves bone integration through adaptive filling and enables the multi-stage treatment of infectious bone defects via antibacterial, immune-regulatory, and osteogenic differentiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/burnst\/tkaf072","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:03:20Z","timestamp":1762520600000},"source":"Crossref","is-referenced-by-count":3,"title":["Sequential treatment of infectious bone defects with three dimensional-printed body temperature-responsive shape memory scaffold coated with metal-polyphenol layers"],"prefix":"10.1093","volume":"14","author":[{"given":"Shuhao","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine\/Orthopaedic Research Laboratory, The First Affiliated Hospital of Chongqing Medical University , No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400042 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianshui","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine\/Orthopaedic Research Laboratory, The First Affiliated Hospital of Chongqing Medical University , No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400042 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Yuzhong District, Chongqing 400014 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixiang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine\/Orthopaedic Research Laboratory, The First Affiliated Hospital of Chongqing Medical University , No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400042 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianye","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine\/Orthopaedic Research Laboratory, The First Affiliated Hospital of Chongqing Medical University , No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400042 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