Emerging biomaterials for osteomyelitis treatment: from material design to anti-infection and tissue regeneration

Osteomyelitis (OM) is an infectious disease caused by the invasion of bone tissue by pathogenic microorganisms. It is frequently associated with biofilm formation, residual sequestra, local ischemia and hypoxia, elevated oxidative stress, and immune dysfunction. Conventional treatments rely on systemic antibiotics, surgical debridement, antibiotic-loaded bone cement, and bone transport techniques. Although these approaches can control infection in some cases, they remain limited by insufficient drug penetration, nondegradable materials, the need for secondary surgery, difficulty in repairing bone defects, and the risk of recurrence. In recent years, emerging biomaterials have provided new therapeutic strategies for OM by enabling the local delivery of antimicrobial agents, antimicrobial peptides, metal ions, or gaseous molecules, often in combination with photothermal therapy, sonodynamic therapy, pH/enzyme-responsive systems, and immunomodulation. The aim of this mini-review is to briefly summarize the pathological features of OM, outline the major design strategies of biomaterials currently used for OM treatment, and discuss the challenges associated with their clinical translation.