Inadequate elimination of tumor cells, bacterial infection, and insufficient bone fusion are the primary factors contributing to the recurrence of osteosarcoma and implant failure. To overcome these challenges, a multifunctional bioactive titanium-based implant consisting of fluorine-doped titanium dioxide (TiO2) nanoparticles was designed for synergistic therapy activated by near-infrared II (NIR-II) light and ultrasound. The F-doped TiO2 nanoparticles exhibit excellent photothermal and acoustic properties upon excitation by 1060 nm NIR-II laser and ultrasound, respectively. The synergistic effect of hyperthermia and reactive oxygen species (ROS) under photoacoustic action endows the TiO2 nanoparticles with remarkable anti-tumor and anti-bacterial activities, enabling them to eradicate Saos-2 cells within 10 min and S. aureus within 15 min. Meanwhile, the nanostructured surface and appropriate doping of F endow nanoparticles with excellent bone promoting ability.