Non-destructive debridement and tuneable ion release via magnesium abrasion and electro-dissolution promote bone regeneration and osseointegration of infected implants

Infection of metallic implants remains a major clinical challenge, often leading to failure and the need for revision. One approach to the treatment of Infection is by debridement to remove infected tissue and biofilm - unfortunately this damages the implant surface and compromises secondary osseointegration. We report a non-destructive, dual-function strategy: magnesium abrasion and electro-dissolution (MAE) that simultaneously achieves surface decontamination, osseo-regeneration, and secondary osseointegration. MAE utilizes, magnesium particles to mechanically disrupt biofilms since magnesium is softer than titanium, it does not damage the implant surface. Subsequent electro-dissolution removes excess magnesium to avoid prolonged exposure, maintaining a transient immune-stimulatory window. In vivo, MAE modulates early inflammation by promoting neutrophil Apoptosis, reducing neutrophil extracellular traps (NETs) formation, and polarizing macrophages toward a reparative M2 phenotype. Transcriptomic analysis reveals downregulation of key inflammatory pathways, supporting an anti-inflammatory, pro-regenerative immune environment. These immune effects facilitate enhanced bone regeneration, including improved Collagen deposition, trabecular organization, and accelerated mineralization of newly formed bone. Importantly, MAE-treated implants achieve robust secondary osseointegration. This study highlights the clinical potential of MAE as a surface-preserving strategy for managing infected metallic implants by integrating in situ debridement with immune modulation without requiring implant removal or invasive revision surgery.