Smart Implants Research Articles

Materials Evolution in Dental Implantology: A Comprehensive Review

This comprehensive review navigates the dynamic landscape of dental implant materials, exploring historical milestones, mechanical intricacies, and emerging innovations. Tracing the evolution from early experimentation to the establishment of titanium as a benchmark, the review sheds light on the critical interplay of strength, elasticity, and fatigue resistance in materials' biomechanical performance. The diverse array of materials, including metals like titanium, ceramics such as zirconia, and polymers like polyetheretherketone (PEEK), is examined in depth, emphasizing their unique attributes and contributions to clinical needs. Surface modifications emerge as transformative elements, accentuating the role of precision engineering in optimizing implant performance. Challenges, encompassing biocompatibility, mechanical incongruity, and infection vulnerabilities, underscore the intricacies of material selection in implant dentistry. The ongoing pursuit of solutions to esthetic limitations and long-term stability constitutes a focal point for future research. Emphasizing the importance of ongoing research, the review highlights emerging materials, such as bioactive ceramics and advanced polymer composites, driven by nanotechnology and 3D printing. Smart implants, antimicrobial surfaces, and regenerative approaches signal a transformative era in precision dentistry. The journey towards refined materials transcends disciplines, uniting researchers, clinicians, and materials scientists in a collaborative pursuit. As the narrative of dental implant materials unfolds, the future beckons with promises of seamless integration with biological tissues, esthetic advancements, and redefined standards in oral rehabilitation. This review encapsulates a dynamic field in continual evolution, extending an invitation to collectively shape the future of dental implantology.

625 A Review of the Current Use and Future Impact of Smart Implants in Spinal Fusion Surgery

625 A Review of the Current Use and Future Impact of Smart Implants in Spinal Fusion Surgery

Current Concepts in Management of Distal Femur Fractures

Recent studies report the overall incidence of distal femur fractures as 8.7/100,000/year. This incidence is expected to rise with high energy motor vehicle collisions and elderly osteoporotic fractures in native and prosthetic knees keep increasing. These fractures are more common in males in the younger age spectrum while females predominate for elderly osteoporotic fractures. Surgical treatment is recommended for these fractures to maintain articular congruity, enable early joint motion and assisted ambulation. Over the last two decades, development of minimally invasive and quadriceps sparing surgical approaches, availability of angle stable implants have helped achieve predictable healing and early return to function in these patients. Currently, laterally positioned locked plate is the implant of choice across all fracture patterns. Retrograde with capital implantation of intramedullary nails with provision for multiplanar distal locking is preferred for extra-articular and partial articular fractures. Even with these advancements, nonunion after distal femur fracture fixation can be as high as 19%. Further recent research has helped us understand the biomechanical limitations and healing problems with lateral locked plate fixation and intramedullary nails. This has lead to development of more robust constructs such as nail-plate and double plate constructs aiming for improved construct strength and to minimise failures. Early results with these combination constructs have shown promise in high risk situations such as fractures with extensive metaphyseal fragmentation, osteoporosis and periprosthetic fractures. These constructs however, run the risk of being over stiff and can inhibit healing if not kept balanced. The ideal stiffness that is needed for fracture healing is not clearly known and current research in this domain has lead to the development of smart implants which are expected to evolve and may help improve clinical results in future.

Predicting Blood Glucose Levels with Organic Neuromorphic Micro-Networks.

Accurate glucose prediction is vital for diabetes management. Artificial intelligence and artificial neural networks (ANNs) are showing promising results for reliable glucose predictions, offering timely warnings for glucose fluctuations. The translation of these software-based ANNs into dedicated computing hardware opens a route toward automated insulin delivery systems ultimately enhancing the quality of life for diabetic patients. ANNs are transforming this field, potentially leading to implantable smart prediction devices and ultimately to a fully artificial pancreas. However, this transition presents several challenges, including the need for specialized, compact, lightweight, and low-power hardware. Organic polymer-based electronics are a promising solution as they have the ability to implement the behavior of neural networks, operate at low voltage, and possess key attributes like flexibility, stretchability, and biocompatibility. Here, the study focuses on implementing software-based neural networks for glucose prediction into hardware systems. How to minimize network requirements, downscale the architecture, and integrate the neural network with electrochemical neuromorphic organic devices, meeting the strict demands of smart implants for in-body computation of glucose prediction is investigated.

Revolutionizing bone tumor management: cutting-edge breakthroughs in limb-saving treatments.

Limb salvage surgery has revolutionized the approach to bone tumors in orthopedic oncology, steering away from historical amputations toward preserving limb function and enhancing patient quality of life. This transformative shift underscores the delicate balance between tumor eradication and optimal postoperative function. Primary and metastatic bone tumors present challenges in early detection, differentiation between benign and malignant tumors, preservation of function, and the risk of local recurrence. Conventional methods, including surgery, radiation therapy, chemotherapy, and targeted therapies, have evolved with a heightened focus on personalized medicine. A groundbreaking development in limb salvage surgery is the advent of 3D-printed patient-specific implants, which significantly enhance anatomical precision, stability, and fixation. These implants reduce soft tissue disruption and the associated risks, fostering improved osseointegration and correction of deformities for a more natural and functional postoperative outcome. Biological and molecular research has reshaped the understanding of bone tumors, guiding surgical interventions with advancements such as genomic profiling, targeted intraoperative imaging, precision targeting of molecular pathways, and immunotherapy tailored to individual tumor characteristics. In the realm of imaging technologies, MRI, CT scans, and intraoperative navigation systems have redefined preoperative planning, minimizing collateral damage and optimizing outcomes through accurate resections. Postoperative rehabilitation plays a crucial role in restoring function and improving the quality of life. Emphasizing early mobilization, effective pain management, and a multidisciplinary approach, rehabilitation addresses the physical, psychological, and social aspects of recovery. Looking ahead, future developments may encompass advanced biomaterials, smart implants, AI algorithms, robotics, and regenerative medicine. Challenges lie in standardization, cost-effectiveness, accessibility, long-term outcome assessment, mental health support, and fostering global collaboration. As research progresses, limb salvage surgery emerges not just as a preservation tool but as a transformative approach, restoring functionality, resilience, and hope in the recovery journey. This review summarizes the recent advances in limb salvage therapy for bone tumors over the past decade.

Passive Biotelemetric Detection of Tibial Debonding in Wireless Battery-Free Smart Knee Implants.

Aseptic loosening is the dominant failure mechanism in contemporary knee replacement surgery, but diagnostic techniques are poorly sensitive to the early stages of loosening and poorly specific in delineating aseptic cases from infections. Smart implants have been proposed as a solution, but incorporating components for sensing, powering, processing, and communication increases device cost, size, and risk; hence, minimising onboard instrumentation is desirable. In this study, two wireless, battery-free smart implants were developed that used passive biotelemetry to measure fixation at the implant-cement interface of the tibial components. The sensing system comprised of a piezoelectric transducer and coil, with the transducer affixed to the superior surface of the tibial trays of both partial (PKR) and total knee replacement (TKR) systems. Fixation was measured via pulse-echo responses elicited via a three-coil inductive link. The instrumented systems could detect loss of fixation when the implants were partially debonded (+7.1% PKA, +32.6% TKA, both p < 0.001) and fully debonded in situ (+6.3% PKA, +32.5% TKA, both p < 0.001). Measurements were robust to variations in positioning of the external reader, soft tissue, and the femoral component. With low cost and small form factor, the smart implant concept could be adopted for clinical use, particularly for generating an understanding of uncertain aseptic loosening mechanisms.

Objective gait analysis following total knee arthroplasty with a smart implant directs early intervention with manipulation under anesthesia

Total knee arthroplasty (TKA) is a procedure increasingly in demand. While advancements in surgical techniques and implant designs have led to low complication rates and improved outcomes following TKA, patient satisfaction has not risen commensurately. Routine care may include clinical assessments, physical therapy notes, and patient reported outcome measures, each of which provides a discrete evaluation but may miss significant changes in daily activities. Here we present the case of a patient who underwent TKA with a tibial implant fitted with an embedded inertial measurement unit capable of providing extensive data on gait kinematics. Despite a successful, well-balanced knee replacement surgery and good clinical outcomes at 2 weeks, by 4.5 weeks post-surgery, she had increased self-reported pain scores and her walking speed, stride length and tibial range of motion (ROM) were declining compared to her TKA peers. The patient was called in to the office for evaluation, 3.5 weeks prior to her scheduled 8-week routine follow up. We proceeded with early manipulation under anesthesia, which lead to normalization of her knee ROM. In this case, gait data from the smart implant alerted us to a TKA patient who was failing to progress, prior to her routine follow-up visit. The daily remotely acquired kinematic data was instrumental in the early recognition and intervention. Availability of objective, trended, high-fidelity gait data from smart implants has the potential to identify clinical concerns early, improve efficiency in care, and increase patient and physician engagement in the recovery process.

Mobile Application Use and Patient Engagement in Total Hip and Knee Arthroplasty.

» Mobile applications (MAs) are widely available for use during the perioperative period and are associated with increased adherence to rehabilitation plans, increased satisfaction with care, and considerable cost savings when used appropriately.» MAs offer surgeons and health care stakeholders the ability to collect clinical data and quality metrics that are important to value-based reimbursement models and clinical research.» Patients are willing to use wearable technology to assist with data collection as part of MAs but prefer it to be comfortable, easy to apply, and discreet.» Smart implants have been developed as the next step in MA use and data collection, but concerns exist pertaining to patient privacy and cost.» The ongoing challenge of MA standardization, validation, equity, and cost has persisted as concerns regarding widespread use.

AO FRACTURE MONITOR: CONTINUOUS SENSOR MONITORING FOR PERSONALIZED FRACTURE CARE

In absence of available quantitative measures, the assessment of fracture healing based on clinical examination and X-rays remains a subjective matter. Lacking reliable information on the state of healing, rehabilitation is hardly individualized and mostly follows non evidence-based protocols building on common guidelines and personal experience. Measurement of fracture stiffness has been demonstrated as a valid outcome measure for the maturity of the repair tissue but so far has not found its way to clinical application outside the research space. However, with the recent technological advancements and trends towards digital health care, this seems about to change with new generations of instrumented implants – often unfortunately termed “smart implants” – being developed as medical devices.The AO Fracture Monitor is a novel, active, implantable sensor system designed to provide an objective measure for the assessment of fracture healing progression (1). It consists of an implantable sensor that is attached to conventional locking plates and continuously measures implant load during physiological weight bearing. Data is recorded and processed in real-time on the implant, from where it is wirelessly transmitted to a cloud application via the patient's smartphone. Thus, the system allows for timely, remote and X-ray free provision of feedback upon the mechanical competence of the repair tissue to support therapeutic decision making and individualized aftercare.The device has been developed according to medical device standards and underwent extensive verification and validation, including an in-vivo study in an ovine tibial osteotomy model, that confirmed the device's capability to depict the course of fracture healing as well as its long-term technical performance. Currently a multi-center clinical investigation is underway to demonstrate clinical safety of the novel implant system. Rendering the progression of bone fracture healing assessable, the AO Fracture Monitor carries potential to enhance today's postoperative care of fracture patients.

Design-encoded dual shape-morphing and shape-memory in 4D printed polymer parts toward cellularized vascular grafts.

Current additive manufacturing technologies wherein as-printed simple two-dimensional (2D) structures morph into complex tissue mimetic three-dimensional (3D) shapes are limited to multi-material hydrogel systems, which necessitates multiple fabrication steps and specific materials. This work utilizes a single shape memory thermoplastic polymer (SMP), PLMC (polylactide-co-trimethylene carbonate), to achieve programmable shape deformation through anisotropic design and infill angles encoded during 3D printing. The shape changes were first computationally predicted through finite element analysis (FEA) simulations and then experimentally validated through quantitative correlation. Rectangular 2D sheets could self-roll into complete hollow tubes of specific diameters (ranging from ≈6 mm to ≈10 mm) and lengths (as long as 40 mm), as quantitatively predicted from FEA simulations within one minute at relatively lower temperatures (≈80 °C). Furthermore, shape memory properties were demonstrated post-shape change to exhibit dual shape morphing at temperatures close to physiological levels. The tubes (retained as the permanent shape) were deformed into flat sheets (temporary shape), seeded with endothelial cells (at T < Tg), and thereafter triggered at ≈37 °C back into tubes (permanent shape), utilizing the shape memory properties to yield bioresorbable tubes with cellularized lumens for potential use as vascular grafts with improved long-term patency. Additionally, out-of-plane bending and twisting deformation were demonstrated in complex structures by careful control of infill angles that can unprecedently expand the scope of cellularized biomimetic 3D shapes. This work demonstrates the potential of the combination of shape morphing and SMP behaviors at physiological temperatures to yield next-generation smart implants with precise control over dimensions for tissue repair and regeneration.

Beyond Tissue replacement: The Emerging role of smart implants in healthcare.

Smart implants are increasingly used to treat various diseases, track patient status, and restore tissue and organ function. These devices support internal organs, actively stimulate nerves, and monitor essential functions. With continuous monitoring or stimulation, patient observation quality and subsequent treatment can be improved. Additionally, using biodegradable and entirely excreted implant materials eliminates the need for surgical removal, providing a patient-friendly solution. In this review, we classify smart implants and discuss the latest prototypes, materials, and technologies employed in their creation. Our focus lies in exploring medical devices beyond replacing an organ or tissue and incorporating new functionality through sensors and electronic circuits. We also examine the advantages, opportunities, and challenges of creating implantable devices that preserve all critical functions. By presenting an in-depth overview of the current state-of-the-art smart implants, we shed light on persistent issues and limitations while discussing potential avenues for future advancements in materials used for these devices.

Translation of nanotechnology-based implants for orthopedic applications: current barriers and future perspective.

The objective of bioimplant engineering is to develop biologically compatible materials for restoring, preserving, or altering damaged tissues and/or organ functions. The variety of substances used for orthopedic implant applications has been substantially influenced by modern material technology. Therefore, nanomaterials can mimic the surface properties of normal tissues, including surface chemistry, topography, energy, and wettability. Moreover, the new characteristics of nanomaterials promote their application in sustaining the progression of many tissues. The current review establishes a basis for nanotechnology-driven biomaterials by demonstrating the fundamental design problems that influence the success or failure of an orthopedic graft, cell adhesion, proliferation, antimicrobial/antibacterial activity, and differentiation. In this context, extensive research has been conducted on the nano-functionalization of biomaterial surfaces to enhance cell adhesion, differentiation, propagation, and implant population with potent antimicrobial activity. The possible nanomaterials applications (in terms of a functional nanocoating or a nanostructured surface) may resolve a variety of issues (such as bacterial adhesion and corrosion) associated with conventional metallic or non-metallic grafts, primarily for optimizing implant procedures. Future developments in orthopedic biomaterials, such as smart biomaterials, porous structures, and 3D implants, show promise for achieving the necessary characteristics and shape of a stimuli-responsive implant. Ultimately, the major barriers to the commercialization of nanotechnology-derived biomaterials are addressed to help overcome the limitations of current orthopedic biomaterials in terms of critical fundamental factors including cost of therapy, quality, pain relief, and implant life. Despite the recent success of nanotechnology, there are significant hurdles that must be overcome before nanomedicine may be applied to orthopedics. The objective of this review was to provide a thorough examination of recent advancements, their commercialization prospects, as well as the challenges and potential perspectives associated with them. This review aims to assist healthcare providers and researchers in extracting relevant data to develop translational research within the field. In addition, it will assist the readers in comprehending the scope and gaps of nanomedicine's applicability in the orthopedics field.

The Era of Biomaterials: Smart Implants?

Conditions, accidents, and aging processes have brought with them the need to develop implants with higher technology that allow not only the replacement of missing tissue but also the formation of tissue and the recovery of its function. The development of implants is due to advances in different areas such as molecular-biochemistry (which allows the understanding of the molecular/cellular processes during tissue repair), materials engineering, tissue regeneration (which has contributed advances in the knowledge of the properties of the materials used for their manufacture), and the so-called intelligent biomaterials (which promote tissue regeneration through inductive effects of cell signaling in response to stimuli from the microenvironment to generate adhesion, migration, and cell differentiation processes). The implants currently used are combinations of biopolymers with properties that allow the formation of scaffolds with the capacity to mimic the characteristics of the tissue to be repaired. This review describes the advances of intelligent biomaterials in implants applied in different dental and orthopedic problems; by means of these advances, it is expected to overcome limitations such as additional surgeries, rejections and infections in implants, implant duration, pain mitigation, and mainly, tissue regeneration.

Overview of 3D and 4D Printing Techniques and their Emerging Applications in Medical Sectors

Abstract: Additive manufacturing is a highly effective and versatile technology, especially in the medical sector, due to its customization, material complexity, design flexibility, waste minimization, and ability to fabricate intricate shapes that are cumbersome to manufacture by conventional manufacturing techniques. 4D printing plays a significant role in the medical field, especially in the areas not covered by 3D printing technologies, such as smart implants, devices and tools. Also, 4D printing helps doctors to treat more patients with high accuracy and quality. Hence, this manuscript aims to provide an overview of distinct 3D and 4D printing techniques and their emerging applications in the medical sector. A study of 3D printing technologies is presented by explaining the working principles of distinct 3D printing methods: stereo lithography, fusion deposition modeling, inkjet printing, selective laser sintering, selective laser melting and electron beam melting. In addition, the emerging applications of 3D printing in medical sectors (e.g., bioprinting, surgical guides, pharmaceuticals, prostheses, medical devices, dentistry, physiotherapy, etc.), as well as challenges and the future scope of 3D printing, are also discussed. Further, the concept of 4D printing, the market for both 3D and 4D printing, the benefits of 4D printing, the comparison of 3D and 4D printing, limitations, applications, and the future scope of 4D printing in the medical sector are also covered.

Sensor Technology in Fracture Healing.

SMART sensor technology may provide the solution to bridge the gap between the current radiographic determination of fracture healing and clinical assessment. The displacement and rigidity between the fracture ends can be accurately measured using strain gauges. Progressively increasing stiffness is a sign of fracture consolidation which can be monitored using sensors. The design of standard orthopaedic implants can remain the same and needs no major modifications as the sensor can be mounted onto the implant without occupying much space. Data regarding various fracture morphologies and their strain levels throughout the fracture healing process may help develop AI algorithms that can subsequently be used to optimise implant design/materials. The literature search was performed in PubMed, PubMed Central, Scopus, and Web of Science databases for reviewing and evaluating the published scientific data regarding sensor technology in fracture healing. SMART sensor technology comes with a variety of uses such as determining fracture healing progress, predicting early implant failure, and determining fractures liable for non-union to exemplify a few. The main limitations are that it is still in its inception and needs extensive refinement before it becomes widely and routinely used in clinical practice. Nevertheless, with continuous advances in microprocessor technology, research designs, and additive manufacturing, the utilisation and application of SMART implants in the field of trauma and orthopaedic surgery are constantly growing. Mass production of such SMART implants will reduce overall production costs and see its use in routine clinical practice in the future and is likely to make a significant contribution in the next industrial revolution termed 'Industry 5.0' which aims at personalised patient-specific implants and devices. SMART sensor technology may, therefore, herald a new era in the field of orthopaedic trauma.

4D printed multipurpose smart implants for breast cancer management

Breast-conserving surgery (BCS) is the primary strategy for treating early-stage breast cancer; however, the incidence of local recurrence and breast tissue loss negatively impacts patients and survivors. Furthermore, radiotherapy and/or systemic therapies are frequently advised to avoid recidivism and increase the patient’s chance of survival, resulting in longer duration of treatments, and unpleasant systemic side effects. Given the poor prognosis and the heterogeneity between individuals and tumors, a patient-centered approach is fundamental. Herein we developed a multipurpose 4D printed implant made of a blend of carboxymethyl cellulose sodium salt (CMC) and cellulose nanocrystals (CNC), loaded with doxorubicin (DOX). To predict printability performance, full rheological characterization was carried out. The smart device was programmed to change size, under swelling, to better fit in the tissue cavity, resulting in a great potential for personalization, thus improving the aesthetic outcomes. The influence of the formulation and printing parameters on the morpho transformation was investigated through the swelling test, confirming the possibility to program the 4D shape. The manufactured implants were characterized by a variety of methods, including in vitro release studies. Lastly, the anticancer activity was conducted in vitro, on MDA-MB-231 cells. Implants promoted an anticancer effect of −58% viability after 72 h incubation, even when tested 4 weeks after the printing process. Overall, the morpho transformation and the in vitro studies have shown that the implant could represent a potential strategy for breast cancer following resection, to fill the void in the breast resulting from the surgery and provide an anticancer effect to avoid recurrence.

Smart implants: 4D-printed shape-morphing scaffolds for medical implantation.

Biomedical implants have recently shown excellent application potential in tissue repair and replacement. Applying three-dimensional (3D) printing to implant scaffold fabrication can help to address individual needs more precisely. Fourdimensional (4D) printing emerges rapidly based on the development of shape-responsive materials and design methods, which makes the production of dynamic functional implants possible. Smart implants can be pre-designed to respond to endogenous or exogenous stimuli and perform seamless integration with regular/ irregular tissue defects, defect-luminal organs, or curved structures via programmed shape morphing. At the same time, they offer great advantages in minimally invasive surgery due to the small-to-large volume transition. In addition, 4D-printed cellular scaffolds can generate extracellular matrix (ECM)-mimetic structures that interact with the contacting cells, expanding the possible sources of tissue/organ grafts and substitutes. This review summarizes the typical technologies and materials of 4D-printed scaffolds, and the programming designs and applications of these scaffolds are further highlighted. Finally, we propose the prospects and outlook of 4D-printed shape-morphing implants.

Best practice in digital orthopaedics.

Digitization in orthopaedics and traumatology is an enormously fast-evolving field with numerous players and stakeholders. It will be of utmost importance that the different groups of technologists, users, patients, and actors in the healthcare systems learn to communicate in a language with a common basis. Understanding the requirements of technologies, the potentials of digital application, their interplay, and the combined aim to improve health of patients, would lead to an extraordinary chance to improve health care. Patients' expectations and surgeons' capacities to use digital technologies must be transparent and accepted by both sides. The management of big data needs tremendous care as well as concepts for the ethics in handling data and technologies have to be established while also considering the impact of withholding or delaying benefits thereof. This review focuses on the available technologies such as Apps, wearables, robotics, artificial intelligence, virtual and augmented reality, smart implants, and telemedicine. It will be necessary to closely follow the future developments and carefully pay attention to ethical aspects and transparency.

On PVDF composite as partially absorbable smart implants.

For various orthopedic needs, several studies have been testified on non-absorbable implants, prepared with different metals/alloys, and composites. But yet little has been stated on the partially absorbable smart implants of thermoplastic composites for online health monitoring of veterinary patients. This article highlights the in-house development of affordable, polyvinylidene fluoride (PVDF) composite-based partially absorbable smart implants (with online sensing capability) for orthopedic needs in canines. Hydroxyapatite (HAp) and chitosan (CS) nanoparticles were reinforced in the PVDF matrix by a melt processing route with various weight proportions (wt.%) to fabricate a partially absorbable smart implant for the canine. The study suggests that the 8.0 wt.% HAp and 2.0 wt.% CS in PVDF is the superlative composition/proportion of reinforcement for preparing feedstock stock filaments (for 3D printing of partially absorbable smart implants), based on rheological, mechanical, thermal, dielectric, and voltage-current-resistance (V-I-R) characteristics. For the selected composition/proportion of PVDF composite, acceptable mechanical properties (such as modulus of toughness (MoT) 2.0 MPa, Young's modulus (E) 889 MPa), and dielectric properties (dielectric constant (εr) 9.6 at room temperature (30°C) and 20 MHz) for online sensing capabilities (for health monitoring) was observed. The results are braced by attenuated total reflection Fourier transform infrared (ATR-FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS) analysis.

Gradient Nanoaggregation in a Magnetically Actuated Scaffold for Multiscale Immunoregulation and Microenvironment Remodeling Accelerates Nerve and Muscle Repair

Biophysical cues are important additive considerations in smart degradable implants apart from chemical modification in tissue engineering. Similar with electrical and ultrasonic stimulation, intrinsic magnetic actuation in integrated implants of iron oxide nanoparticles and topological structures affects cell fate decision to enhance tissue injury repair. It also saves the trouble of carrying an external stimulator to better suit clinical and daily use. In this study, a gradient magnetized iron oxide nanoparticle scaffold (GIONS) is designed using 3D multilayered method. It has a high magnetic saturation with nanoaggregation of iron oxide nanoparticles and is featured with evenly distributed micropores and multilayer structure to realize moderate elasticity and mechanical stability. GIONS facilitates directed growth and protuberance extension of neurons and immunoregulates pro-regenerative polarization of macrophages. In a rat nerve defect injury model, GIONS successfully improves remyelination and axon sprouting in the regenerated region, and activates reparative microenvironment by stimulating neurogenesis, angiogenesis and reducing muscle atrophy. It further facilitates glial cell activation and macrophage immunoregulation in vivo by mechanochemical signaling to significantly accelerate the repair of different severed tissues. Consequently, this smart implant increases nerve conducting velocity and locomotor function and contributes to multifunctional regeneration of severe tissue injury.