After the clinical treatment of bone defects, it is indispensable to fill the surgical defect with an implant, which combines the advantage of promoting osseous regeneration and a local drug delivery system to form local high concentrations and reduce systemic side effects. The present study was first designed to fabricate a series of PLA/n-HA composite scaffolds with different weight ratios for bone tissue engineering and to optimize the best prescription (10/2) based on a number of indicators, such as morphology, mechanical properties, porosity, hydrophilicity, in vitro mineralization capacity and in vitro degradation behavior. The personalized amikacin sulfate local drug delivery system was then designed and fabricated via semisolid extrusion (SSE) 3D printing technology. Three irregular geometric shapes and five different periodic porous internal architectures were created and analyzed to investigate the feasibility, reproducibility and accuracy of SSE 3D printing technology in the production of implants consisting of irregular shapes and interconnected macroporous architectures. All of the printed personalized implants showed satisfactory structural integrity and acceptable drug content uniformity as well as good mechanical properties. In vitro dissolution curves indicated that the shapes and macroporosity widths of implants have certain effects on the in vitro drug release and that all of the personalized implants achieved long-term sustained drug release behavior. All the results illustrate that SSE 3D printing technology provides a feasible approach to prepare personalized implants with varied shapes and sophisticated micro- and macroarchitectures, and the local drug delivery system may be promising for bone defect repair and local antimicrobial therapy after debridement surgery.