Next-Generation Biomaterials for Load-Bearing Tissue Interfaces: Sensor-Integrated Scaffolds and Mechanoadaptive Constructs for Skeletal Regeneration

Advancements in load-bearing tissue repair increasingly demand biomaterials that not only support structural integrity but also interact dynamically with the physiological environment. This review examines the latest progress in smart biomaterials designed for skeletal reconstruction, with emphasis on mechanoresponsive scaffolds, bioactive composites, and integrated microsensors for real-time monitoring. We explore material formulations that enhance osseointegration, resist micromotion-induced loosening, and modulate inflammatory responses at the bone-implant interface. Additionally, we assess novel fabrication methods—such as additive manufacturing and gradient-based material deposition—for tailoring stiffness, porosity, and degradation profiles to match host biomechanics. Special attention is given to sensor-augmented platforms capable of detecting mechanical strain, biofilm formation, and early-stage implant failure. Together, these technologies promise a new class of bioresponsive, diagnostic-capable constructs that extend beyond static support to become active agents in regenerative healing and post-operative monitoring. This multidisciplinary review integrates insights from materials science, mechanobiology, and device engineering to inform the future of implantable systems in skeletal tissue repair.