BioMedica |

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 28, 2025]. doi:10.24911/BioMedica/5-1628

AMA (American Medical Association) Style

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 28, 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

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