Multifunctional EGCG-loaded and silver-doped bioactive glass-reinforced calcium sulfate cement for chronic osteomyelitis management

• The corporation of silver-doped bioactive glass improved the mechanical properties and enhanced osteogenic differentiation of calcium sulfate cement. • The addition of EGCG further promoted the DPPH scavenging and reduction of biofilm biomass in vitro . • Codelivery of EGCG and Ag + suppressed bacterial adhesion, and disrupted extracellular polymeric substance (EPS) formation. In clinical practice, chronic osteomyel itis often leads to bone tissue necrosis, with biofilm formation being a key factor in treatment failure. Although traditional antibiotic-loaded polymethacrylate (PMMA) bone cement is effective for initial bacterial inhibition, it faces challenges such as non-degradability, and the risk of promoting antibiotic resistance. Therefore, in this study, an epigallocatechin gallate (EGCG)-loaded biodegradable calcium sulfate (CSC) and silver-doped bioactive glass cement (AgBGC) composite bone cement was developed (E-AgCSBC). The combination of CSC and AgBGC enhanced the mechanical properties, effectively prolonged the setting time, and improved the anti-washout property of the CSC cement. The antibacterial properties of the composite cement were validated through plate coating and in vitro anti-biofilm tests. In addition, E-AgCSBC composite cement exhibited good cytocompatibility and promoted the migration and osteogenic differentiation of BMSCs in vitro , indicating its potential for the treatment of chronic osteomyelitis.