Vacuum-assisted infection control and implant retention in total joint arthroplasty – A report of four complex cases

We submit a short series of our experience in the use of Vacuum (VAC) for control of prosthetic joint infection (PJI) and implant retention in four patients who had undergone complex primary or revision prosthetic joint reconstructions. Our series consists of four patients, one complex primary hip and one complex primary knee replacement and one revision hip and one complex revision knee replacement, all complicated with acute infections with multiple comorbidities. All underwent serial debridement and VAC applications until final wound closure. Of the four cases, three had definitive infection control as of at least 12 months follow-up. One patient who stopped her antibiotics and diabetic medications had recurrent cellulitis of the leg followed by synovitis of the knee, which settled with antibiotics. She is on long-term antibiotic suppression and has not had a recurrence of infection at 6-month follow-up. In conclusion, VAC may be considered a useful adjunct in the management of PJIs, especially when implant retention is contemplated.