The skeletal system serves as a crucial support structure for the human body, any damage or disease to bones can result in prolonged pain, impaired mobility, and other negative outcomes. For the treatment of bone diseases, with the in-depth study of the therapeutic mechanism, various small molecule drugs, cells, cytokines, growth factors, bioactive ions, collectively referred to as "drugs" in this context, are increasingly investigated for their potential application in surgical procedures, defect repair, or treatment of diseased bone regions. However, various challenges, including, low stability, the necessity for precise dosage control, are encountered in the administration of drugs. Consequently, the advancement of drug delivery platforms is crucial to safeguard drug efficacy and address the requirement for dosage regulation. Given the attributes of current drug delivery platforms, hydrogels exhibit favorable biocompatibility and offer the ability to easily regulate drug loading and release. As a carrier with diverse properties, abundant varieties, optimal performance, hydrogels present a promising solution in drug delivery. This paper aims to analyze the potential of hydrogel as a delivery platform for treating orthopedics diseases by reviewing the characteristics of hydrogel delivery systems, mechanisms of drug binding, current research findings, and projecting future developments in this field.