We developed an implant combined with both antitumor and bone regeneration functions.

A biomimetic PEKK implant was developed to promote osteoporotic bone regeneration and delay adjacent bone loss.

Tracking and eradicating drug-resistant bacteria are critical for combating implant-associated infections, yet effective antibacterial therapies remain elusive. Herein, we propose an oxygen vacancy–rich (BiFe) _0.9 (BaTi) _0.1 O _{3− x} nanoreactor as a piezoelectric sonosensitizer by spatiotemporal ultrasound–driven sono- and chemodynamic tandem catalysis to amplify antibacterial efficacy. The piezoelectric charge carriers under a built-in electric field synchronize the reaction of O ₂ and H ₂ O, efficiently generating H ₂ O ₂ . The electron-rich oxygen vacancies modulate the local electronic structure of an Fe site. It facilitates reactive oxygen species generation by piezoelectric electrons and accelerates valence state cycles of Fe(III)/Fe(II) to achieve the sustained maintenance of hydroxyl radicals via H ₂ O ₂ /Fe(II)–catalyzed chemodynamic reactions, which lead to bacterial membrane damage. Transcriptomics analysis revealed that intracellular Fe overload induced by excessive Fe(II)-mediated dysregulation of the two-component system disrupts bacterial metabolism, triggering bacterial ferroptosis-like death. Thus, the porous titanium scaffold, engineered with a piezoelectric nanoreactor, demonstrates superior antibacterial efficacy under ultrasound and facilitates osteogenesis via piezoelectric immunomodulation–activated therapy.