44 patients who previously received intramedullary locking nail fixation of the tibia and femur and were diagnosed with osseous infection were randomized to receive intramedullary reaming with a reamer-irrigator-aspirator (RIA) system or conventional reaming with an antibiotic-loaded cement spacer. The primary outcome of interest was the 2-year remission rate of intramedullary infection. Additional outcomes of interest included pain on a Visual Analog Scale (VAS). Results found no significant differences in the 2-year remission rate of intramedullary infection between the RIA and conventional reaming groups. Both groups displayed significant improvements in VAS pain score following surgery.