Polysaccharide-Based Networks-engineered Orthopedic Implant for Synergistic Antimicrobial Defense and Osteogenic Regeneration to Potentiate PI3K-AKT/HIF-1-Mediated Open Fractures Treatment
Open fracture fixation faces dual critical challenges: bacterial infection and impaired bone healing. This study presents a rationally designed biomacromolecular network coating (Ti-GOED) on titanium alloy bone plates to simultaneously address these issues. The coating integrates antimicrobial and osteogenic components, achieving an optimal balance between antibacterial efficacy and biocompatibility. In vitro assays demonstrated that Ti-GOED eliminates over 99% of common pathogenic bacteria by inhibiting peptidoglycan synthesis, disrupting bacterial cell wall formation, compromising membrane integrity, and leading to intracellular DNA leakage and bacterial death. Concurrently, Ti-GOED enhances the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) via activation of the PI3K-Akt and HIF-1 signaling pathways. In vivo animal experiments confirmed strong antibacterial and osteogenic properties. This work provides a strategy for developing antibacterial coatings on medical devices, with significant potential for preventing and treating infections post-fracture fixation.