Linying Xia,1,* Chao Zhou,2,* Qingping Li,1 Lu Liu,1 Chanyi Jiang,3 Haidong Dai,4 Hengjian Zhang,4 Jiayi Zhao,4 Wenqing Liang4 

1Medical Research Center, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, Zhejiang, 316000, People’s Republic of China; 2Department of Orthopedics, Zhoushan Guanghua Hospital, Zhoushan, Zhejiang, 316000, People’s Republic of China; 3Department of Pharmacy, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, Zhejiang, 316000, People’s Republic of China; 4Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, Zhejiang, 316000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wenqing Liang, Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan, Zhejiang, 316000, People’s Republic of China, Tel +86-580-2615027, Fax +86-580-2616545, Email liangwq@usx.edu.cn Jiayi Zhao, Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan, Zhejiang, 316000, People’s Republic of China, Tel +86-580-2615024, Fax +86-580-2616545, Email zjy2038689@sina.com

Abstract: Nanotechnology has profoundly transformed medical science, with orthopedics experiencing significant advancements in diagnostic techniques, drug delivery systems, and tissue regeneration. The complex nature of orthopedic tissues presents substantial challenges for conventional therapeutic interventions, but the development of nanomaterials with specialized chemical, physical, and biological properties has facilitated the creation of novel treatment modalities. Nanotechnology has significantly advanced orthopedic care by enabling targeted drug delivery, enhanced implant performance, and improved diagnostic tools. This review uniquely integrates recent breakthroughs in biocompatible nanomaterials, focusing on their clinical translation and regulatory challenges. It highlights the complexity of orthopedic tissues and the limitations of conventional therapies, emphasizing how nanomaterials address these through controlled drug release, and improved tissue regeneration. Key sections address advancements in drug delivery systems, innovative implant technologies, toxicity issues, and biocompatibility considerations. It also explores the existing regulatory landscape, challenges in clinical approval, and future directions for the successful translation of nanotechnologies in orthopedic care.

Keywords: orthopedics, nanomaterials, toxicity of nanomaterials, biocompatibility, orthopedic implants, drug delivery, diagnostics, rheumatoid arthritis, osteoporosis, osteoarthritis