A self-powered, fully implantable bone defect electrical stimulation (BD-ES) system was developed to accelerate bone regeneration. This system combines a hybrid tribo/piezoelectric nanogenerator (HTP-NG) with a conductive bioactive hydrogel to generate biphasic electric pulses in response to rehabilitation exercise. The HTP-NG, which produces electricity from knee joint movements, is implanted in the subcutaneous tissue of the thigh, while the hydrogel is used to deliver the electric pulses to the bone defect site. The system enhances osteogenesis-related biological processes, including calcium ion import and osteogenic differentiation. In a rat model of critical-sized femoral defects, the BD-ES system successfully reversed the bone defect and facilitated complete healing within 6 weeks. The system is expected to advance the development of battery-free and circuit-free electrical stimulation therapy devices. The HTP-NG device is designed to convert mechanical energy into electricity using a combination of triboelectric and piezoelectric effects. It is composed of a triboelectric, piezoelectric, and encapsulation module, with the core being the triboelectric and piezoelectric modules that capture knee joint motion energy. The HTP-NG was tested in vitro and showed excellent electrical output performance, including a high open-circuit voltage and stable output under various conditions. The device is flexible, lightweight, and capable of generating sufficient charge to power the system. The conductive hydrogel, composed of an extracellular matrix (ECM) network with polydopamine-modified black phosphorus nanosheets (BP@PDA) and alginate methacryloyl (AlgMA), was designed to support electroactive tissue repair. The hydrogel was found to be biocompatible and to promote cell proliferation, migration, and adhesion. It also enhanced osteogenic differentiation of bone marrow stem cells (BMSCs) and supported angiogenesis and skeletal system development. The BD-ES system was tested in vivo, where it successfully promoted bone regeneration in a rat model of critical-sized femoral defects. The system demonstrated significant improvements in bone mineral density, bone volume, trabecular number, and trabecular thickness compared to control groups. The system also enhanced angiogenesis and the expression of osteogenesis-related proteins, indicating its potential for clinical application in bone repair. The system's ability to generate biphasic electric pulses in response to rehabilitation exercise makes it a promising candidate for future clinical applications in bone regeneration.A self-powered, fully implantable bone defect electrical stimulation (BD-ES) system was developed to accelerate bone regeneration. This system combines a hybrid tribo/piezoelectric nanogenerator (HTP-NG) with a conductive bioactive hydrogel to generate biphasic electric pulses in response to rehabilitation exercise. The HTP-NG, which produces electricity from knee joint movements, is implanted in the subcutaneous tissue of the thigh, while the hydrogel is used to deliver the electric pulses to the bone defect site. The system enhances osteogenesis-related biological processes, including calcium ion import and osteogenic differentiation. In a rat model of critical-sized femoral defects, the BD-ES system successfully reversed the bone defect and facilitated complete healing within 6 weeks. The system is expected to advance the development of battery-free and circuit-free electrical stimulation therapy devices. The HTP-NG device is designed to convert mechanical energy into electricity using a combination of triboelectric and piezoelectric effects. It is composed of a triboelectric, piezoelectric, and encapsulation module, with the core being the triboelectric and piezoelectric modules that capture knee joint motion energy. The HTP-NG was tested in vitro and showed excellent electrical output performance, including a high open-circuit voltage and stable output under various conditions. The device is flexible, lightweight, and capable of generating sufficient charge to power the system. The conductive hydrogel, composed of an extracellular matrix (ECM) network with polydopamine-modified black phosphorus nanosheets (BP@PDA) and alginate methacryloyl (AlgMA), was designed to support electroactive tissue repair. The hydrogel was found to be biocompatible and to promote cell proliferation, migration, and adhesion. It also enhanced osteogenic differentiation of bone marrow stem cells (BMSCs) and supported angiogenesis and skeletal system development. The BD-ES system was tested in vivo, where it successfully promoted bone regeneration in a rat model of critical-sized femoral defects. The system demonstrated significant improvements in bone mineral density, bone volume, trabecular number, and trabecular thickness compared to control groups. The system also enhanced angiogenesis and the expression of osteogenesis-related proteins, indicating its potential for clinical application in bone repair. The system's ability to generate biphasic electric pulses in response to rehabilitation exercise makes it a promising candidate for future clinical applications in bone regeneration.