To evaluate the clinical efficacy of debridement, antibiotics, and implant retention (DAIR) in the treatment of acute infection after total knee arthroplasty.

A retrospective analysis of the joint surgery of the 940th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from December 1, 2008 to November 30, 2018, was diagnosed with acute prosthetic joint infection (PJI) cases according to the diagnostic criteria of the American Society for Musculoskeletal Infection (MSIS), a total of 26 clinical data of patients with infection after acute knee arthroplasty. All the patients were treated with one-stage thorough debridement, replacement of knee joint polyethylene pads, postoperative wound irrigation and drainage, and adequate treatment with sensitive antibiotics. The pain visual analogue scale (VAS), Hospital for Special Surgery (HSS) score of the knee, sedimentation rate (ESR), C-reactive protein (CRP), interleukin (IL) -6 before and after the knee surgery were compared by t test.

Twenty-six patients were enrolled, three cases were lost during the follow-up, and the follow-up time was (44±28) months. Among them, 17 cases were cured, the infection control rate was 73.9%.The postoperative knee joint VAS score was lower than that before surgery (t=24.815, P<0.05), and the postoperative HSS score was higher than that before surgery (t=41.966, P<0.05). ESR(t=14.140), CRP(t=3.503), and IL-6 (t=2.999)at last follow-up were all lower than those at admission (all P<0.05).

Controlling the timing of surgery and the indications for surgery strictly, DAIR can control the acute infections after total knee arthroplasty effectively, restore joint function, and obtain satisfactory clinical results.