Bioactive glass (BG) ceramics have attracted considerable attention as ideal bone grafts for treating avascularosteonecrosis owing to similarities in biological function with that of native bone. Metal ion-dopedBGs exhibit outstanding biocompatibility, controllable biodegradability, excellent osteoinductivity, andangiogenic ability. Moreover, effective oxygen generation can support the healing of osteonecroticdefects. In this study, we developed simple sol–gel, gel-casting, and surface modification methods to fabricatephotosynthetic microporous BG ceramic beads with improved therapeutic efficacy for avascularosteonecrosis by combining the oxygen generation ability, osteoconductivity, osteoinductivity, andangiogenic ability. The BG ceramic beads exhibited interconnected microporous structures with uniformmicropores and unequiaxed grains, and this microstructure was not affected by Sr- and Cu-co-doping. Conversely, Sr- and Cu-co-doping, epigallocatechin gallate immobilization, and thylakoid coating affectedthe in vitro biological activity of the BG ceramic beads. Biological activity assays revealed that thethylakoid-coated photosynthetic microporous BG (BG12ET) ceramic beads promoted osteoblastic cellproliferation and endothelial cell tube formation more effectively than other ceramic beads. Therefore,BG12ET ceramic beads incorporated with osteoinductive and angiogenic factors can potentially providea new generation of bone grafts for synergistic osteonecrosis therapy.