Application of antibiotic-loaded bone cement in unicompartmental knee arthroplasty: inhibiting IL-6 levels and reducing postoperative infection rate

Objective We aim to clarify the inhibitory effect of antibiotic-loaded bone cement (ALBC) on inflammatory factors, and its preventive effect on postoperative infections in unicompartmental knee arthroplasty (UKA).Methods This prospective randomized controlled trial enrolled 104 osteoarthritis patients undergoing UKA, randomly assigned to the non-ALBC group (n = 52, bone cement without antibiotics) and ALBC group (ALBC with 1.0 g vancomycin hydrochloride, n = 52). Primary outcomes were postoperative inflammatory markers (CRP, ESR, TNF-α, IL-6); secondary outcomes included infection rate and HSS score. Independent-samples t-tests were used for continuous variables, χ2 test for categorical variables (infection rate, efficacy), and repeated measures analysis of variance for intra-group longitudinal comparisons.Results The ALBC group demonstrated lower inflammatory markers at postoperative day 7 and at 3 months [CRP (3.52 ± 0.81 vs 6.92 ± 1.17, Cohen’s d = 3.379), ESR (16.29 ± 2.31 vs 20.19 ± 4.05, Cohen’s d = 1.183), TNF-α (29.71 ± 4.03 vs 36.25 ± 5.17, Cohen’s d = 1.411), and IL-6 (17.05 ± 3.72 vs 22.05 ± 4.38, Cohen’s d = 1.230)] (all p < 0.001), and also showed superior clinical outcomes, with lower postoperative infection rate (p = 0.016), higher HSS score (p < 0.001), and better overall clinical efficacy (p = 0.010) than the non-ALBC group.Conclusion The application of ALBC in UKA was associated with reduced postoperative inflammatory markers such as IL-6 and a lower incidence of postoperative infection. These findings suggest that ALBC may play a beneficial role in postoperative recovery and joint function rehabilitation.