To address the high complexity and challenging nature of large-scale tendon injury repair, an innovative Janus structured hydrogel patch (JAHP@bFGF) was designed in this study. The patch combines microenvironmental responsiveness with efficient repair function, aiming to optimise and accelerate the tendon healing process. The outer layer is a PVA/SA/Na3Cit hydrogel with excellent mechanical properties, protein resistance, and low friction, which provides firm support to the tendon and reduces adhesions to ensure the recovery of gliding function. The inner layer of TCSB@bFGF microgel responds intelligently to changes in the microenvironment, precisely regulates the release of bFGF, promotes cell proliferation and migration, accelerates tissue regeneration, and has high adhesion strength and antimicrobial properties, which significantly reduces the risk of postoperative infection. Experimental results show that JAHP@bFGF significantly optimises the healing process, accelerates the repair speed and improves the repair quality under simulated large-scale tendon injury conditions. The unique Janus surface design and the intelligent drug release function, in synergy, not only bring new hope to patients with large-scale tendon injuries, but also provide an important reference for the application of biomedical materials in the repair of complex tissues, which heralds the arrival of the era of more efficient and personalised tendon repair.