The treatment of infected bone defects (IBD) remains challenging due to persistent infection, inflammatory dysregulation, and impaired osteogenesis. Traditional antibiotic-centered strategies suffer from limited therapeutic efficacy, high risks of bacterial resistance and systemic toxicity, and a requirement for multiple invasive surgeries. To overcome these drawbacks, we fabricated a bifunctional hydrogel (Gel/LB) based on polyethylene glycol and oxidized dextran backbones, via lysozyme physical blending and bone morphogenetic protein-2 (BMP-2) derived peptide grafting, to achieve sequential drug release for early rapid antibacterial activity and long-term sustained osteogenesis. In vitro characterization revealed the hydrogel had a three-dimensional porous structure, excellent injectability, and self-healing capacity. It exerted potent anti-Staphylococcus aureus effects via rapid lysozyme release, while sustained BMP-2-derived peptide release significantly promoted adhesion, proliferation, and osteogenic differentiation of bone marrow mesenchymal stem cells, as verified by elevated alkaline phosphatase activity, upregulated osteogenic gene expression, and enhanced mineralized nodule formation. In vivo, Gel/LB eradicated infection in mouse femoral infected defect models, markedly promoted new bone formation and collagen deposition, improved bone-related parameters, and regulated inflammatory and osteogenic markers. Collectively, this bifunctional hydrogel enables effective antibacterial and pro-osteogenic effects via sequential release, providing a novel biomaterial strategy for clinical IBD management.

Rationale: The treatment of infected bone defects is always a serious challenge in orthopedics. Infection control in the first stage followed by bone reconstruction in the second stage is the main clinical treatment process. The design of dual-functional materials with sequential antibacterial and bone-promoting properties according to the content and temporal characteristics of these two clinical tasks is a promising solution. Methods: In this study, the hydrogel composed of poly (ethylene glycol)-poly (L-alanine N-carboxyanhydride-co-L-phenylalanine N-carboxyanhydride) was constructed by ring-opening polymerization, and then its osteogenic and antibacterial properties were obtained by BMP-2 peptide grafting and vancomycin loading, respectively, and the engineered bifunctional hydrogel was constructed by combining these two functional hydrogels for sequential treatment of infected bone defects. A series of in vitro characterization experiments, biocompatibility analysis and evaluation of antibacterial and osteogenic properties were conducted. The specific therapeutic effect in vivo of constructed hydrogel was assessed using a model of infectious bone defect in the radius of rabbits. Results: Our results confirmed that the engineered hydrogel had the physicochemical properties suitable for clinical scenarios and rapid and sustained antibiotic release performance in the early stage, which resulted in significant inhibition of both Gram-positive and Gram-negative bacteria in vitro. Moreover, the hydrogel had appropriate cytocompatibility and demonstrated the ability to promote osteogenic differentiation of stem cells. By establishing an infected bone defect of radius in rabbit model, we confirmed that the hydrogel could accelerate the repair of infected bone defect by simultaneously achieving satisfactory infection control and bone reconstruction. Conclusions: This study provides a time-efficient single-stage strategy for the effective treatment of infected bone defects by constructing a dual-functional hydrogel with sequential antibacterial and osteogenic properties, which provides promising directions for future clinical treatment improvement.

Fractures are prevalent in clinical orthopedics. Conventional metal implants used for fracture fixation pose risks of iatrogenic injury and infection, and often fail to achieve precise alignment in complex cases. Bone adhesives represent a promising alternative, as they can accommodate the fixation requirements of various complex fractures while circumventing many of the issues associated with metallic fixation. However, currently available clinical adhesives often fail to meet the complex requirements of bone tissue adhesion. Therefore, there is an urgent need to develop novel bone adhesives that align more closely with clinical demands. This review systematically elucidates the key properties requisite for bone adhesives and offers an in-depth discussion on design strategies focused on interfacial adhesion, mechanical strength, degradability, and biological performance. Furthermore, this article summarizes the evaluation criteria for assessing the clinical applicability and translational potential of bone adhesives. This review aims to establish a comprehensive understanding of the essential criteria for bone adhesives and to provide systematic guidance for their rational design. Ultimately, this will accelerate the development of high-performance novel adhesives and propel advancements in fracture management.

Osteoporosis is an increasingly important global health concern, particularly in aging populations, with prevalence rising markedly after the age of 60. Age-related alterations in the bone microenvironment play a pivotal role in disrupting skeletal homeostasis. Regulators of the bone microenvironment contribute centrally to osteoporosis pathogenesis by modulating bone remodeling through multiple, intersecting mechanisms. Accumulating evidence indicates that aging is accompanied by reduced levels of protective factors, such as osteoprotegerin and bone morphogenetic proteins (BMPs), alongside increases in pro-resorptive mediators, including receptor activator of nuclear factor-κB ligand (RANKL), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). This shift favors osteoclastogenesis and impairs osteoblast function, ultimately accelerating bone loss and increasing the risk of fragility fractures and disability. In this review, we synthesize current evidence on bone microenvironment regulatory factors in osteoporosis, with emphasis on their roles in bone remodeling and downstream cellular signaling pathways. We further discuss emerging intervention strategies that target these regulators to preserve or restore bone health in older adults. By clarifying age-associated microenvironmental changes and the interactions among key regulatory factors, this review aims to identify promising therapeutic targets and provide a conceptual framework to support osteoporosis prevention and treatment in the context of global population aging.

>股骨转子间骨折是老年髋部骨折中最常见的骨折类型 [1] ，占髋部骨折的45%～50%，因其死亡率可达15%～30% [2] ，故被称为“人生最后一次骨折”。因股骨转子间骨折多发生于65岁以上的老年患者，故随着全球人口老龄化的进展，其发生数量逐年上升。根据GULLBERG等 [3] 的研究表明，到2050年全球髋部骨折患者将达到450万例。

OBJECTIVE:A new three-dimensional(3D) classification of posterior cruciate ligament (PCL) tibial avulsion fracture based on computed tomography(CT) features was established and the significance in clinical treatment was explored in this study. METHODS:From May 2013 to November 2023, 43 cases of PCL tibial avulsion fracture in the Second Hospital of Jilin University were analyzed retrospectively, including 29 males and 14 females, aged (34.3±8.5) years. According to traditional Meyers and McKeever classification, 3 cases were typeⅠ;2 cases of typeⅡ;38 cases were type Ⅲ. Based on the characteristics of CT images, 43 patients were given specific treatment strategies and followed up to evaluate the curative effect. According to the degree of fracture displacement, involved range and the integrity of fracture block demonstrated by CT images, the new three-dimensional classification of PCL avulsion fracture was established. Kappa coefficient was used for consistency test. RESULTS:A new 3D classification of PCL tibial avulsion fracture was established. TypeⅠwas the non-displaced fracture (displacement degree ≤3 mm), in which typeⅠa was the avulsion range limited in the posterior intercondylar fossa, and Ib was the avulsion range beyond the posterior intercondylar fossa. TypeⅡrepresented the displaced fracture in the posterior intercondylar fossa (avulsion limited to the posterior intercondylar fossa and fracture displacement>3 mm), in which typeⅡa represented a slight displacement with a intact broken block and the posterior elevation of the avulsion (hinge mechanism), typeⅡb represented the complete separation of fracture ends with a intact fracture block, and typeⅡc was the comminuted fracture. Type Ⅲ was the displaced fracture beyond the posterior intercondylar fossa (avulsion involving the articular surface of the tibial plateau or the intercondylar ridge and the degree of displacement > 3 mm), among which type Ⅲa was the simple fracture with intact broken block, type Ⅲb represented the comminuted fracture, and type Ⅲc was the complex fracture with tibial plateau fracture. According to this new 3D classification, 43 patients were classified as type Ia in 2 cases and typeⅠb in 1 case;typeⅡa in 2 cases, typeⅡb in 15 cases and typeⅡc in 7 cases;type Ⅲa in 2 cases, type Ⅲb in 5 cases and type Ⅲc in 9 cases. All the 43 cases in this study achieved bone union. At the last follow-up, according to the hospital for special surgery knee score(HSS)evaluation system for the knee joint function, 27 cases were excellent, 11 cases were good, 5 cases were fair. The average Kappa value of inter-observer reliability in the first stage was 0.793, and the second stage was 0.855. The average Kappa value of the whole stage was 0.839, indicating high level of consistency. The average Kappa value of intra-observer reliability was 0.893, indicating high level of consistency. CONCLUSION:The 3D classification of PCL tibial avulsion fracture is intuitive, demonstrating a high level of reliability. It has a certain guiding significance for the selection of clinical treatment methods, and it is suggested to be promoted and applied as a new classification system in clinical practice.

Purpose:Femoral neck fractures are clinically rare and are associated with a high risk of complications in children. Traditional internal fixation implants such as Kirschner wires and partial-thread cannulated screws (PTCS) have complications such as screw withdrawal and internal fixation failure. To address this problem, in this study we investigated the effectiveness of headless cannulated compression screws (HCCS) in the treatment of femoral neck fractures in children patients. Methods:Children diagnosed with Delbet-Colonna II or III femoral neck fracture treated by closed reduction and percutaneous fixation with HCCS were retrospectively reviewed. The extent of fracture reduction and postoperative hip function were assessed according to the Haidukewych standard and with the Harris score, respectively. Postoperative complications were recorded. Results:According to the inclusion criteria and exclusion criteria in this retrospective study, A total of 12 patients (8 males and 4 females) aged 3-14 years (average age: 8.3 years) were reviewed. The mean blood loss from surgery was 34.58 ± 9.40 ml and mean operation time was 102.50 ± 32.72 min. Overall, fracture reduction was achieved in most cases, with 7 that were excellent (58.33%) and 5 that were good (41.67%) according to the Haidukewych standard. The average follow-up period was 24.67 months. Radiographic analysis revealed an average time for fracture healing of 8.58 ± 3.87 weeks. Harris score was 88.67 ± 2.61 at 3 months after surgery, and increased to 92.25 ± 1.91 at the 6-month follow-up; excellent outcomes were achieved at the last follow-up evaluation (95.17 ± 1.95). No surgery-related complications were reported during the follow-up period. Conclusions:We recommend closed reduction and internal fixation with HCCS as a feasible alternative for the treatment of Delbet-Colonna II and III femoral neck fractures in children.

Treatment of large bone defects resulting from acute injury or infection remains challenging. The Masquelet technique is a two-stage procedure for treating bone defects caused by bone tumor resection, infection, or trauma. There are currently no reports of successful repair of ≥28 cm bone defects using the Masquelet technique. We describe the case of a 55-year-old man with postoperative infection of a femoral fracture and a 28-cm infected bone defect formed after multiple debridement procedures. The Masquelet technique, when coupled with a Lantern-Mimicking Frame System (LMFS), achieved favorable clinical results. The patient could walk normally without crutches 14 months postoperatively and did not experience pain in daily life. This was the longest bone defect in a single limb currently reported to had been cured in the literature. The Masquelet technique coupled with LMFS achieved favorable clinical results for the treatment of a 28-cm infected bone defect. For extremely large bone defects in a single limb, the length of the defect was not an absolute limiting condition for the indications of Masquelet technique.

Elucidating the molecular mechanisms underlying orthopedic diseases is crucial for guiding therapeutic strategies and developing innovative interventions. N6-methyladenosine (m6A)—an epitranscriptomic modification—has emerged as a key regulator of cellular fate and tissue homeostasis. Specifically, m6A plays a pivotal role in several RNA biological processes such as precursor RNA splicing, 3’-end processing, nuclear export, translation, and stability. Recent advancements indicate that m6A methylation regulates stem cell proliferation and osteogenic differentiation by modulating various signaling pathways. Extensive research has shown that abnormalities in m6A methylation contribute significantly to the onset and progression of various orthopedic diseases such as osteoporosis (OP), osteoarthritis (OA), rheumatoid arthritis (RA), and bone tumors. This review aims to summarize the key proteases involved in m6A methylation and their functions. The detailed mechanisms by which m6A methylation regulates osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) through direct and indirect ways are also discussed, with a focus on specific molecular pathways. Finally, this review analyzes the roles and mechanisms of m6A modification in the development and progression of multiple orthopedic diseases, offering a comprehensive understanding of the pathophysiology of these conditions and proposing new directions and molecular targets for innovative treatment strategies.

Glenoid fractures of the scapula can be treated via anterior deltopectoral, Judet, modified Judet, or posterior minimally invasive approaches; however, these may result in soft tissue injury, hematoma formation, nerve damage, or inadequate internal fixation stability. While arthroscopy minimizes soft tissue dissection, it may pose challenges in visualizing inferior glenoid fragments. To address these potential complications, we designed a new posterior axillary approach, the Tian Yun-Wu Dankai approach (T-W approach), in the treatment of certain glenoid fractures of scapula. We retrospectively reviewed 101 patients (Iderberg Ia, 71; II, 24; IV, 1; and V, 5) treated for glenoid fractures of the scapula using the T-W approach across six medical centers. All patients were followed-up for at least 12 months (range, 12-36 months). Postoperative radiographs and computed tomography scans indicated satisfactory fracture reduction and rigid fixation with plates and screws. The mean incision length, blood loss, and operation time were 10.8 ± 1.3 cm, 104.0 ± 32.7 mL, and 98.0 ± 32.0 min, respectively. At the last follow-up, the mean DASH and Constant scores were 14.0 ± 5.1 and 88.6 ± 3.7, respectively. The mean range of motion of forward flection, abduction, and external rotation was 160.0 ± 19.0°, 156.0 ± 20.0°, and 64.0 ± 8.5°, respectively. Two patients experienced delayed incision healing that resolved with dressing changes. Mild heterotopic ossification was observed in two patients; however, it did not affect shoulder function. Postoperative traumatic shoulder arthritis was observed in one patient. Three patients experienced numbness in the surgical area posterior to the incision site. The T-W approach to treat scapular glenoid fractures (all Ideberg Ia and II, parts IV and V) can fill the gap in the non-inferior approach for the shoulder joint. This approach offers several advantages, including minimal tissue damage, short operative time, effective reduction, rigid fixation, and high functional scores with aesthetic benefits.

Minimally invasive plate osteosynthesis (MIPO) has become an effective option for tibial shaft fracture surgery owing to its protection of the osteogenic microenvironment. However, the nonexposure of the fracture site also makes satisfactory reduction challenging. In this study, we designed a strategy of percutaneous clamping reduction assisted by the implanted plate as a template. A retrospective analysis of patients with tibial shaft fractures who underwent percutaneous clamping reduction using a plate as a template was performed. From March 2017 to April 2022, a total of 110 patients (mean age: 30.3 years) were included. The reduction time, intraoperative blood loss, the effect of reduction, and postoperative radiographs were recorded and evaluated. The healing time, recovery of limb function, and complications were also assessed. The average reduction time was 8.3 ± 5.8 min. The average intraoperative bleeding was 20.6 ± 5.9 ml. The radiographs after reduction showed most patients achieved near-perfect alignment with the average coronal varus or valgus angulation of 1.8° ± 0.7° and the average sagittal anterior/posterior angulation of 2.9° ± 0.9°, and one (0.9

With the increasing incidence of bone defects in clinical practice, the demand for bone grafts or substitutes has become more urgent. Polydopamine (PDA)-coated bone tissue engineering materials offer a promising alternative in such cases. PDA coating is characterized by a solid coating formed by polymerization of dopamine under alkaline and oxygen-containing conditions, which can provide implants good hydrophilicity through the active functional groups contained in the structure. More importantly, the strong adhesion of the coating can provide an anchor between bone implant materials and drugs to achieve functional modification of the implant surface to enhance bone regeneration. In this review, the different effects of dopamine derivatives and their polymerization in current research were summarized. The mechanisms underlying the effects of PDA in promoting bone regeneration have also discussed in detail, providing a theoretical basis for the clinical application of PDA. Finally, a series of PDA-coated materials for the promotion of bone repair have been summarized and discussed. This review provides cutting-edge design ideas for PDA-based biomaterials and highlights promising treatment strategies for bone defects.

The accuracy of screw placement is a key factor for the stability of the cannulated screws used in the fixation of femoral neck fractures. In this study we designed a navigation device for ensuring the screw reaches the ideal position for optimal fixation. From March 2019 to September 2020, 66 patients with femoral neck fracture were enrolled and divided into 2 groups, one group was treated using the traditional free-hand cannulated screw fixation and the other using the new navigation device with assisted fixation. The effectiveness of the 2 methods was compared based on surgery duration, intraoperative bleeding, number of fluoroscopic examination and guidewire insertion attempts, screw parallelism, and effective fixation area. Fracture healing, complications and hip joint function were assessed after operation. The new navigation device reduced the duration of surgery without causing additional intraoperative bleeding, and significantly reduced number of fluoroscopy examination and guidewire insertion attempts (4.00±1.58 vs. 6.09±1.94 with traditional surgery). The accuracy of screw implantation was improved, as demonstrated by increased screw parallelism (0.71±0.57° vs. 1.66 ±1.01° with traditional surgery) and higher effective fixed area (64.88±10.52 vs. 58.61±9.19 mm2 with traditional surgery). In the postoperative follow-up, except for one case of femoral head necrosis and one case of bone nonunion in the traditional surgical group, the other patients showed fracture healing. There was no significant difference in hip joint function between the 2 groups. The new navigation device enables rapid and accurate guidewire positioning for cannulated screw fixation through simple operation procedures, resulting in good prospect for clinical transformation.

Titanium alloy materials are commonly used in orthopedic clinical treatments. However, conventional titanium implants usually lead to insufficient bone regeneration and integration because of mismatched biomechanics and poor bioactivities. To tackle these challenges, a porous titanium alloy scaffold with suitable mechanical properties was prepared using three-dimensional (3D) printing, and then an adipose-derived mesenchymal stem cell (ADSC) loaded platelet-rich plasma (PRP) gel was placed into the pores of the porous scaffold to construct a bioactive scaffold with dual functions of enhancing angiogenesis and osteogenesis. This bioactive scaffold showed good biocompatibility and supported cell viability proliferation and morphology of encapsulated ADSCs. Osteogenic and angiogenic growth factors in the PRP gel promoted the migration and angiogenesis of human umbilical vein endothelial cells (HUVECs) in vitro and enhanced osteogenic-related gene and protein expression in ADSCs, thus promoting osteogenic differentiation. After implantation into the femoral defects of rabbits, the bioactive scaffold promoted vascular network formation and the expression of osteogenesis-related proteins, thus effectively accelerating bone regeneration. Therefore, the osteogenic and angiogenic bioactive scaffold comprising a 3D printed porous titanium alloy scaffold, PRP, and ADSCs provides a promising design for orthopedic biomaterials with clinical transformation prospects and an effective strategy for bone defect treatment.

PurposeCurrently, treating femoral neck fractures (FNFs) with the inverted triangle configuration requires alignment between the femoral neck's long axis and the axis of cannulated compression screws (CCS). To address whether the 'parallel' alignment is the most effective approach for fractures with varying Pauwels angles, we employed finite element analysis (FEA) to investigate how different angles between fracture line and CCS affect stability, based on various Pauwels angles. This study aims to offer improved guidance for treating FNFs with the inverted triangle configuration.MethodsFNF models with Pauwels angles of 40 degrees, 50 degrees, 60 degrees, and 70 degrees were developed. The CCS were positioned in an inverted triangle configuration based on the angle between the fracture line and CCS. Using FEA, we compared the biomechanical properties of each model to evaluate the stability by evaluating five key parameters: maximal stress in the proximal femoral fracture fragment (MPFS) and implants (MIS), maximal displacement of the bone (MBD) and implants (MID), and maximal relative displacement of the fragments (MRD).ResultsFor Pauwels angles of 40 degrees, 50 degrees, 60 degrees, and 70 degrees across different FNF models, various parameters exhibited similar results. The MPFS showed an upward trend with a decrease in the angle, whereas the MIS, MBD, MID, and MRD all exhibited downward trends.ConclusionThe FEA results suggest that decreasing the angle between the fracture line and the CCS for the treatment of FNF can increase the tension resistance of the model, thus increasing the model's stability.

The treatment of bone defects is a difficult problem in orthopedics. The excessive destruction of local bone tissue at defect sites destroys blood supply and renders bone regeneration insufficient, which further leads to delayed union or even nonunion. To solve this problem, in this study, we incorporated icariin into alginate/mineralized collagen (AMC) hydrogel and then placed the drug-loaded hydrogel into the pores of a 3D-printed porous titanium alloy (AMCI/PTi) scaffold to prepare a bioactive scaffold with the dual functions of promoting angiogenesis and bone regeneration. The experimental results showed that the ACMI/PTi scaffold had suitable mechanical properties, sustained drug release function, and excellent biocompatibility. The released icariin and mineralized collagen (MC) synergistically promoted angiogenesis and osteogenic differentiation in vitro. After implantation into a rabbit radius defect, the composite scaffold showed a satisfactory effect in promoting bone repair. Therefore, this composite dual-functional scaffold could meet the requirements of bone defect treatment and provide a promising strategy for the repair of large segmental bone defects in clinic.

Abstract Background For the treatment of coronoid process fractures, medial, lateral, anterior, anteromedial, and posterior approaches have been increasingly reported; however, there is no general consensus on the method of fixation of coronal fractures. Here, we present a highly-extensile minimally invasive approach to treat coronoid process fractures using a mini-plate that can achieve anatomic reduction, stable fixation, and anterior capsular repair. Further, the study aimed to determine the complication rate of the anterior minimally invasive approach and to evaluate functional and clinical patient-reported outcomes during follow-up. Methods Thirty-one patients diagnosed with coronoid fractures accompanied with a “terrible triad” or posteromedial rotational instability between April 2012 and October 2018 were included in the analysis. Anatomical reduction and mini-plate fixation of coronoid fractures were performed using an anterior minimally invasive approach. Patient-reported outcomes were evaluated using the Mayo Elbow Performance Index (MEPI) score, range of motion (ROM), and the visual analog score (VAS). The time of fracture healing and complications were recorded. Results The mean follow-up time was 26.7 months (range, 14–60 months). The average time to radiological union was 3.6 ± 1.3 months. During the follow-up period, the average elbow extension was 6.8 ± 2.9° while the average flexion was 129.6 ± 4.6°. According to Morrey’s criteria, 26 (81%) elbows achieved a normal desired ROM. At the last follow-up, the mean MEPI score was 98 ± 3.3 points. There were no instances of elbow instability, elbow joint stiffness, subluxation or dislocation, infection, blood vessel complications, or nerve palsy. Overall, 10 elbows (31%) experienced heterotopic ossification. Conclusion An anterior minimally invasive approach allows satisfactory fixation of coronoid fractures while reducing incision complications due to over-dissection of soft tissue injuries. In addition, this incision does not compromise the soft tissue stability of the elbow joint and allows the patient a more rapid return to rehabilitation exercises.

The contamination of bone defects is a serious therapeutic problem. The treatment of infected bone defects involves rigorous infection control followed by bone reconstruction. Considering these two processes, the development of biomaterials possessing antibacterial and osteogenic properties offers a promising approach for the treatment of infected bone defects. In this study, a dual-functional, thermosensitive, and injectable hydrogel composed of chitosan (CS), quaternized CS (QCS), and nano-hydroxyapatite (nHA) was designed, and the ratio of CS to QCS in the hydrogel was optimized to enhance the antibacterial efficacy of CS while reducing the cytotoxicity of QCS. In vitro studies demonstrated that the hydrogel with an 85 %:15 % ratio of CS to QCS exhibited excellent biocompatibility and antibacterial properties while also possessing suitable mechanical characteristics and degradability. The incorporation of nHA into the hydrogel enhanced MC3T3-E1 proliferation and osteogenic differentiation. Moreover, this hydrogel demonstrated superior in vivo therapeutic effectiveness in a rabbit model of infected bone defect. In summary, this study provides a promising material design and a comprehensive one-step treatment strategy for infected bone defects.

Introduction: The management of infected nonunion has always been an orthopedic challenge, and it is more difficult to treat it if it is accompanied by shortening and angulation deformity. Case report : we present a case of osteomyelitis and infected nonunion of the right tibia with right lower extremity shortening and angular deformities. The Ilizarov technique was applied to treat large segmental bone defects with deformities via simultaneous lengthening of the free bone segment and the broken distal tibia. Conclusion : Use of the Ilizarov technique in combination with MIPPO can effectively treat bone deformities caused by infected nonunion while reducing the duration of external fixation, protecting against refracture and allowing for early rehabilitation.

Bacterial bone infection in open fractures is an urgent problem to solve in orthopedics. Antimicrobial peptides (AMPs), as a part of innate immune defense, have good biocompatibility. Their antibacterial mechanism and therapeutic application against bacteria have been widely studied. Compared with traditional antibiotics, AMPs do not easily cause bacterial resistance and can be a reliable substitute for antibiotics in the future. Therefore, various physical and chemical strategies have been developed for the combined application of AMPs and bioactive materials to infected sites, which are conducive to maintaining the local stability of AMPs, reducing many complications, and facilitating bone infection resolution. This review explored the molecular structure, function, and direct and indirect antibacterial mechanisms of AMPs, introduced two important AMPs (LL-37 and β-defensins) in bone tissues, and reviewed advanced AMP loading strategies and different bioactive materials. Finally, the latest progress and future development of AMPs-loaded bioactive materials for the promotion of bone infection repair were discussed. This study provided a theoretical basis and application strategy for the treatment of bone infection with AMP-loaded bioactive materials.