Debridement, Antibiotics, and Implant Retention with Vacuum Sealing Drainage in Deep Portion for Acute Periprosthetic Joint Infection of the Hip

Background: The treatment of acute periprosthetic joint infection (PJI) remains a great challenge. This study aimed to explore the efficacy of vacuum sealing drainage (VSD) used as an adjunct to debridement, antibiotics, and implant retention (DAIR) for acute periprosthetic joint infection of the hip. Methods Patients undergoing debridement, irrigation with component retention, and application of vacuum seal drainage in the deep portion surrounding the infected sites from January 2014 to February 2021 were retrospectively reviewed. The definition of failure included the requirement of prosthesis removal; persistent infection-related symptoms; suppressive antibiotics therapy due to failure of controlling the infection; infection-related death. Results 11 patients were included in this study with a mean follow-up of 32.3 ± 18.3 months. There were 9 males and 2 females with a mean age of 58.6 ± 16.3 years. Eight had sinus tract. The overall success rate was 81.82% with 2 failures. The Harris Hip Scores (HHS) improved in the last follow-up compared with preoperative evaluation (83.0 ± 11.6 vs 43.9 ± 11.8, t=-13.58, P༜0.001). Conclusion The addition of VSD in the deep portion does improve the outcome of DAIR, which might be a safe and effective option for acute PJI.