Abstract:Objective To explore the treatment of refractory swelling and hydrops of the knee after total knee arthroplasty(TKA). Methods A retrospective analysis was performed in 29 patients with intractable swelling and hydrops of knee joint,who underwent TKA in the First Affiliated Hospital of Jinan University from June 2013 to December 2018.According to the patients′ basic conditions before operation,intraoperative findings and rehabilitation measures after operation,the causes of swelling and hydrops of knee joints were analyzed,and the treatment effect was observed during follow-up period. Results The range of motion of the knee was not changed obviously in 6 cases,and the altered antibiotics were used because of mild pain ［visual analog score(VAS)］.Five patients walked in the very early postoperative stage without protection and were ordered to bedrest for 5 days to reduce joint activity.In 8 cases,effusion of more than 50 ml depth in the opened joint cavity was extracted,and vancomycin was injected into it during operation.In 7 cases,glucocorticoids were injected into the joint cavity repeatedly half a year before operation.In 3 patients with diabetes mellitus,the joint prosthesis was preserved,and debridement,irrigation and polyethylene liner exchange were conducted.After 6 months of follow-up,no progressive swelling and infections occurred. ConclusionBased on the basic information of patients before operation,the joint effusion during operation and the special circumstances encountered in the postoperative rehabilitation,the different treatment plans can be formulated early,timely and reasonablely so as to better prevent the occurrence of irreversible periprosthetic infection after total knee arthroplasty.