Osteoarthritis (OA) is a degenerative joint disease closely associated with aging for which current treatments are limited primarily to symptomatic relief and fail to reverse pathological progression. A growing body of evidence indicates that the accumulation of senescent cells is a central driver of OA pathogenesis. This review systematically summarizes the latest advancements in antisenescence biomaterials for OA therapy, emphasizing their potential to overcome the limitations of conventional approaches by improving drug targeting, prolonging drug release kinetics, and increasing bioavailability. We categorize these biomaterials on the basis of their antisenescence mechanism and delivery platform, including polymeric nanoparticles (NPs), nanozymes, lipid nanoparticles (LNPs), extracellular vesicles (EVs), hydrogels, and composite hydrogels. These systems have demonstrated efficacy in selectively eliminating senescent cells through various molecular mechanisms such as modulating mitochondrial dysfunction, inflammatory signaling, DNA damage, mechanical overload and autophagy. Furthermore, this review proposes innovative strategies that integrate cellular reprogramming, organelle-targeted therapy, the artificial intelligence (AI)-guided design of antisenescence materials, and stem cell/organoid technologies to address challenges such as barriers to drug delivery and the heterogeneity of the aging microenvironment. Although these biomaterials still require further validation regarding safety, scalability, and regulatory approval for their clinical translation, antisenescence biomaterials represent multidimensional and sustainable therapeutic options for OA and hold promise for reshaping the therapeutic landscape of degenerative joint diseases by targeting the root causes of tissue degeneration. STATEMENT OF SIGNIFICANCE: Osteoarthritis (OA) is an age-related joint disease for which current therapies provide only symptom relief without halting progression. Increasing evidence shows that senescent cells drive OA development. This review summarizes recent advances in antisenescence biomaterials, including nanoparticles, nanozymes, lipid carriers, extracellular vesicles, and hydrogels. These systems improve drug targeting, prolong release, and enhance bioavailability while selectively eliminating senescent cells through mechanisms such as regulating mitochondrial dysfunction, inflammation, and DNA damage. We also highlight innovative approaches integrating cellular reprogramming, organelle-targeted therapy, AI-guided design, and stem cell technologies. Although further validation is required, antisenescence biomaterials offer sustainable strategies that target OA at its root, reshaping future treatment of degenerative joint diseases.
