Bone defect repair materials after bone tumour resection: from structural substitutes to biofunctionalized synergistic therapy
Abstract Background Critical-sized bone defects following malignant tumour resection remain among the most difficult challenges in orthopaedic oncology. Conventional substitutes such as autografts or polymethyl methacrylate (PMMA) provide initial stability but often fail to ensure durable integration or prevent recurrence. This review aims to summarize recent progress in bone defect reconstruction materials, with particular attention to strategies that unite structural reliability with biological functionality. Discussion Over the past decade, repair materials have evolved from inert fillers to multifunctional scaffolds capable of combining load-bearing support with local therapeutic action. Current designs integrate chemotherapy, photothermal hyperthermia or magnetic hyperthermia, immunomodulation, antibacterial function, and angiogenic–osteogenic cues. Intelligent drug delivery systems and additive manufacturing enable patient-specific, stimuli-responsive implants, while early clinical use of antibiotic-loaded cements and custom-printed prostheses demonstrates translational potential. Nevertheless, most evidence remains preclinical and heterogeneous, with inconsistent tumour, infection, regeneration, and safety endpoints; long-term safety, manufacturing reproducibility, cost-effectiveness, and regulatory acceptance remain unresolved. Conclusions Reconstruction after bone tumour resection is entering a new era in which implants are expected not only to restore anatomy and stability but also to actively suppress tumour recurrence and foster regeneration. Multifunctional and patient-tailored scaffolds hold promise to redefine limb-salvage surgery, provided that future work delivers robust clinical validation and scalable manufacturing pathways.