To endow an implant surface with enhanced properties to ensure an appropriate seal with the host tissue for inflammation/infection resistance, next-generation bone implant collagen–polyphenol nanolayers were built on conventional titanium surfaces through a multilayer approach. X-ray Photoelectron Spectroscopy (XPS) analysis was performed to investigate the chemical arrangement of molecules within the surface layer and to provide an estimate of their thickness. A short-term (2 and 4 weeks) in vivo test of bone implants in a healthy rabbit model was performed to check possible side effects of the soft surface layer on early phases of osteointegration, leading to secondary stability. Results show the building up of the different nanolayers on top of titanium, resulting in a final composite collagen–polyphenol surface and a layer thickness of about 10 nm. In vivo tests performed on machined and state-of-the-art microrough titanium implants do not show significant differences between coated and uncoated samples, as the surface microroughness remains the main driver of bone-to-implant contact. These results confirm that the surface nanolayer does not interfere with the onset and progression of implant osteointegration and prompt the green light for specific investigations of the potential merits of this bioactive coating as an enhancer of the device/tissue seal.

Peripheral nerve injuries affect over one million individuals annually worldwide due to various causes such as trauma, metabolic disorders, and autoimmune diseases. While autologous nerve grafting remains the gold standard for treating large-gap nerve injuries, its limitations, including limited tissue availability, donor site morbidity, infection risk, and suboptimal functional recovery, have spurred interest in alternative approaches. Among these, allogeneic nerve grafting has emerged as a promising option, offering structural and functional advantages due to the native architecture of donor nerves. However, immune rejection due to histocompatibility antigens remains a significant challenge. Decellularisation protocols utilising mild detergents have shown the most promise in preserving the extracellular matrix’s structural and regenerative properties while mitigating immunogenicity. The study aimed to adapt and validate a decellularisation protocol for human nerves within our tissue bank, adhering to European and national regulatory guidelines. The protocol, based on the cleanroom-compliant method previously developed by our group, was optimised to reduce tissue handling time and ensure regulatory compliance. Decellularised sural nerves were assessed for extracellular matrix preservation and sterility using European (EU) Pharmacopoeia and European Directorate for the Quality of Medicines & HealthCare (EDQM) guidelines. The results demonstrated the feasibility of producing high-quality acellular nerve allografts (ANAs) that are suitable for peripheral nerve repair, paving the way for cost-effective and widely accessible grafting solutions.

Purpose: Musculoskeletal tissue regeneration remains a major clinical challenge due to the limited intrinsic healing capacity of cartilage, bone and interface tissues, as well as the complexity of recreating their hierarchical structure and mechanical properties. In recent years, costal cartilage (CC) has emerged as a promising and versatile resource for regenerative applications, owing to its hyaline cartilage composition, biological plasticity and relative surgical accessibility. This systematic review aims to critically evaluate in vivo and clinical evidence published over the last decade regarding the use of CC‐derived cells and matrices for musculoskeletal tissue regeneration. Methods: A systematic search of PubMed, Scopus and Web of Science databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, identifying 26 eligible studies, including 18 in vivo and 8 clinical investigations. Results: CC was employed either as a source of costal chondrocytes or cartilage‐derived stem cells, or as decellularized or particulate extracellular matrix scaffolds. Preclinical studies demonstrated consistent regenerative potential across cartilage, osteochondral, bone and enthesis models, with outcomes showing hyaline‐like tissue formation, improved biomechanical properties, enhanced integration with host tissue and coordinated chondrogenic and osteogenic responses. Clinical studies, primarily focused on cartilage and osteochondral defects, reported significant improvements in patient‐reported outcomes, imaging‐based repair quality and functional recovery, with follow‐up periods extending up to 5 years and a favourable safety profile. Conclusions: Cell‐based CC approaches showed robust biological efficacy but were associated with greater regulatory and translational complexity due to substantial manipulation requirements. In contrast, matrix‐based CC strategies offered a more readily translatable option, leveraging the intrinsic bioactivity of the extracellular matrix while reducing regulatory burden. CC could be considered a highly promising and adaptable platform for musculoskeletal regeneration. However, heterogeneity in study design, limited sample sizes and variable methodological quality highlight the need for standardized protocols and well‐designed, long‐term randomized clinical trials to definitively establish clinical indications and optimize therapeutic strategies. Level of Evidence: N/A.

Biodegradable magnesium (Mg) alloys are promising materials for temporary orthopaedic implants, combining favourable mechanical properties and superplastic behaviour with in vivo resorption. This enables (i) prolonged implant duration, (ii) fabrication of complex-shaped prostheses via superplastic forming (SPF), (iii) elimination of removal surgery, and (iv) reduced risk of long-term complications. However, rapid corrosion under physiological conditions remains a major limitation, highlighting the need for surface treatments that slow degradation while preserving implant integrity. This study investigates the effects of hydrothermal surface treatment on MgAZ31-SPF alloys, focusing on immunomodulatory responses, antibacterial potential, and degradation behaviour. Hydrothermally treated MgAZ31-SPF (MgAZ31-SPF-HT) extracts released lower Mg²⁺ concentrations (29.2 mg/dL) compared to untreated MgAZ31-SPF (47.5 mg/dL) while maintaining slightly alkaline pH (7–8.7), indicating improved control of early degradation. In vitro assays with human peripheral blood mononuclear cells (hPBMCs) and normal human dermal cells (NHDCs) showed that MgAZ31-SPF-HT extracts maintained higher cell viability over 24–72 h. Gene expression analysis revealed significant downregulation of pro-inflammatory markers CTSE and TNF-α, while protein quantification via ELISA and BioPlex confirmed reduced secretion of TNF-α, TGF-β1, TGF-β2, IL-6, and IL-8, suggesting mitigation of early immune activation. Antibacterial assays demonstrated limited Staphylococcus aureus colonisation on both MgAZ31-SPF and MgAZ31-SPF-HT scaffolds, with CFU counts (~10⁵–10⁶) well below the threshold for mature biofilm formation (~10⁸), and SEM analysis confirmed sparse bacterial distribution without dense EPS-rich layers. Overall, hydrothermal treatment improves Mg alloy biocompatibility by controlling Mg²⁺ release, modulating early immune responses, and limiting bacterial adhesion, highlighting its potential to enhance clinical performance of Mg-based implants.