Original Article
Volume: 41 | Issue: 2 | Published: Jun 25, 2025 | Pages: 15 - 15 | DOI: 10.24911/BioMedica/5-1628
Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study
Authors: Zuhair Zubair , Muhammad Iqbal , Sajjad Ahmad , Bilal Aslam , Muhammad Asjad Ali , Shoaib Aslam , Muhammad Arsalan Sharif Awan
Article Info
Authors
Zuhair Zubair
Consultant Orthopedic Surgeon, Government Hospital, Khurrianwala, Pakistan
Muhammad Iqbal
Senior Registrar, Department of Orthopedic Surgery, Sharif Medical and Dental College Lahore, Pakistan
Sajjad Ahmad
Postgraduate Resident, Department of Orthopedic Surgery, Mayo Hospital, Lahore, Pakistan
Bilal Aslam
Consultant Orthopedic Surgeon, Masood Hospital, Lahore, Pakistan
Muhammad Asjad Ali
Senior Registrar, Sughra Shafi Medical Complex/Shara Medical College, Narowal, Pakistan
Shoaib Aslam
Department of Orthopaedic Surgery, Sadiq Abbasi Hospital, Bahawalpur, Pakistan
Muhammad Arsalan Sharif Awan
Consultant Orthopedic Surgeon, Mayo Hospital Lahore, Pakistan
Publication History
Received: January 02, 2025
Accepted: June 08, 2025
Published: June 25, 2025
Abstract
Background and Objective: Chronic osteomyelitis of the tibia is a persistent bone infection that, if inadequately managed, can cause significant disability. Antibiotic-loaded intramedullary nails (ALIN) and antibiotic-loaded beads (ALB) are commonly used for infection control and limb preservation, yet their comparative effectiveness remains unclear. This study aimed to compare functional outcomes, pain control, reinfection rates, quality of life (QoL), and complications between ALIN and ALB in managing chronic tibial osteomyelitis in local patients.
Methods: In this randomized comparative study, 60 patients with chronic tibial osteomyelitis were allocated into the Nail Group (n = 30) receiving ALIN or the Bead Group (n = 30) receiving ALB. Pain was assessed using the Visual Analog Scale (VAS), limb function via the American Orthopaedic Foot and Ankle Society (AOFAS) score, and QoL with the SF-36 questionnaire. Reinfection was assessed clinically, and complications were recorded. Follow‑up was conducted over 12 months. Independent t-test was used for continuous variables and chi-square test for categorical variables, with p < 0.05 considered statistically significant.
Results: The Nail Group showed superior outcomes in pain reduction (VAS: 1.5 ± 0.4 vs. 2.0 ± 0.5; p < 0.05), functional status (AOFAS: 85 ± 6 vs. 78 ± 7; p < 0.05), and QoL (SF‑36: 72 ± 5 vs. 65 ± 6; p < 0.05). Reinfection rates were not significantly different (27% vs. 31%; p > 0.05). Complications were fewer in the Nail Group, with fewer nail failures compared to bead migration in the Bead Group.
Conclusion: Antibiotic-loaded intramedullary nails offer better pain relief, functional recovery, and QoL than antibiotic-loaded beads in chronic tibial osteomyelitis, without increasing reinfection rates. These findings support ALIN as a preferred option in suitable patients.
Keywords: Chronic osteomyelitis, antibiotic-loaded intramedullary nails, antibiotic-loaded beads, quality of life.
Pubmed Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan. Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study. BioMedica. 2025; 25 (June 2025): 15-15. doi:10.24911/BioMedica/5-1628
Web Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan. Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study. https://biomedicapk.com/articles/1628 [Access: August 08, 2025]. doi:10.24911/BioMedica/5-1628
AMA (American Medical Association) Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan. Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study. BioMedica. 2025; 25 (June 2025): 15-15. doi:10.24911/BioMedica/5-1628
Vancouver/ICMJE Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan. Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study. BioMedica. (2025), [cited August 08, 2025]; 25 (June 2025): 15-15. doi:10.24911/BioMedica/5-1628
Harvard Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan (2025) Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study. BioMedica, 25 (June 2025): 15-15. doi:10.24911/BioMedica/5-1628
Chicago Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan. "Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study." 25 (2025), 15-15. doi:10.24911/BioMedica/5-1628
MLA (The Modern Language Association) Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan. "Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study." 25.June 2025 (2025), 15-15. Print. doi:10.24911/BioMedica/5-1628
APA (American Psychological Association) Style
Zuhair Zubair, Muhammad Iqbal, Sajjad Ahmad, Bilal Aslam, Muhammad Asjad Ali, Shoaib Aslam, Muhammad Arsalan Sharif Awan (2025) Functional outcomes of antibioticloaded intramedullary nails versus antibiotic-loaded beads in the management of chronic osteomyelitis of the Tibia: a comparative study. , 25 (June 2025), 15-15. doi:10.24911/BioMedica/5-1628