To investigate the effect of debridement and implant retention with antibiotic bone cement interstitial filling and vacuum sealing drainage in the adjuvant treatment of periprosthetic joint infection after total knee arthroplasty, so as to provide reference for clinical treatment.

Twelve cases of periprosthetic joint infection after total knee arthroplasty from June 2014 to June 2019 were selected, including six males and six females, aged from 43 to 72 years (average age: 59.6±8.8 years). All the patients underwent debridement, exchanged polyethylene liner to a vancomycin cement matrixand vacuum sealing drainage (VSD) continuous irrigation with saline for one week per cycle.After infection controlled, anew liner withsamesize was replaced and the surgical incision was closed. Vancomycin was diluted and injected into the articular cavity after operation, and white blood cells, procalcitonin, erythrocyte sedimentation rate and C-reactive protein were checked. Independent sample t test was used to compare the visual analogue scale (VAS) and the Hospital for Special Surgery knee score (HSS) before surgery and three months after surgery to assess the improvement of symptoms and functional recovery.

After three to four weeks of treatment, all patients were healed satisfactorily. The indexes of leukocyte, procalcitonin, erythrocyte sedimentation rate and C-reactive protein gradually returned to normal. All the patients were followed up for (30.1±17.8) months on average. None of the patients had recurrent infection or new infection. Compared with the scores before the treatment [VAS (5.5±1.4), HSS (43.0±16.2)], postoperative VAS (1.1±1.0) and HSS scores (87.3±5.4) at three months were significantly improved (t=8.713, -8.970, both P<0.05).

Debridement and implant retention with antibiotic bone cement spacer and vacuum sealing drainage can effectively control infection and preserve good joint function in the treatment of periprosthetic infection after total knee arthroplasty.