Abstract
Rheumatoid arthritis (RA) patients undergoing total knee arthroplasty (TKA) face infection
risk. The study evaluates vancomycin-loaded calcium sulfate bone as infection prevention.
Patients with RA treated with TKA who had their femoral canal filled using either
vancomycin-loaded calcium sulfate bone (experimental group [n = 35]) or the patient's own excised autologous bone (control group [n = 30]) at the Qingdao University Affiliated Hospital, Qingdao, China from January
1, 2017, to March 1, 2023, were retrospectively enrolled in this study. An experienced
surgeon used midvastus approach. Surgeries included disinfection, antibiotics, and
femoral filling. The age, gender, body mass index (BMI), comorbidities, and intraoperative
details were extracted from the patient's medical records. Preoperation and postoperation
markers (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]), pain scale
(Visual Analog Scale [VAS]), infection rate, and Knee Society Score (KSS) were collected.
Groups matched in age, gender, and BMI. No preoperative inflammatory marker differences
were observed. However, compared to the control group, the postoperative inflammatory
markers were significantly lower in the experimental group at 1-week postsurgery (CRP:
40.80 ± 23.17 vs. 60.80 ± 43.12 mg/L, p = 0.021; ESR: 72.06 ± 17.52 vs. 83.87 ± 21.52 mm/h, p = 0.012) and at 1-month postsurgery (CRP: 15.63 ± 6.56 vs. 21.17 ± 13.16 mg/L, p = 0.032; ESR: 25.25 ± 20.44 vs. 38.40 ± 25.26 mm/h, p = 0.024). There were no significant differences in the VAS (2.79 ± 0.90 vs. 2.70 ± 0.84
score, p = 0.689) and KSS (64.31 ± 17.88 vs. 66.57 ± 12.36) at 1-month postsurgery. Experimental
group: zero infections; control group: only one infection. Administering vancomycin
and calcium sulfate during TKA in RA patients reduces postoperative inflammation,
but does not significantly affect infection risk; further research may be necessary
for validation.
Keywords
vancomycin - calcium sulfate - rheumatoid arthritis - total knee arthroplasty - inflammatory
markers
