Objective To investigate the early efficacy of highly-polished antibiotic-loaded articulating cement spacer in treating periprosthetic hip joint infection.Methods Fifteen patients with periprosthetic joint infection after hip arthroplasty diagnosed in our hospital between August 2018 and December 2019 were included. A highly-polished antibiotic-loaded articulating cement spacer was used in the first-stage operation. The second-stage hip revision was performed on patients who were free from infection after an effective anti-infective therapy. The hip function and quality of life were assessed based on the Harris Hip Score (HHS) and Hip Disability and Osteoarthritis Outcome Score (HOOS). The intraoperative blood loss, operative duration and postoperative complications were also evaluated.Results The follow-up time for all the patients was (17.13 ± 5.03) months, and none of the patients had spacer dislocation and rupture or other complications before the second-stage hip revision, which was performed (3.79 ± 1.07) months after the first-stage operation. All spacers were easy to remove during the second-stage hip revision, and the degree of bone defect was not different from that following the first-stage operation. Dislocation occurred in one patient after the second-stage revision, who was functionally recovered after a closed reduction. There was no recurrence of infection, prosthesis loosening, or other complications in all the patients during the follow-up. The HHS was (58.30 ± 4.57), (76.85 ± 6.89), and (89.47 ± 3.60) at 1 month after the first-stage operation, before the second-stage hip revision, and the last follow-up, respectively, and was higher at these time points compared with that before the first-stage surgery (43.41 ± 3.11) (P < 0.05). The HOOS was (260.30 ± 7.52), (339.45 ± 14.75), and (380.78 ± 8.40) at 1 month after the first-stage operation, before the second-stage hip revision, and the last follow-up, respectively, and was also significantly increased at these time points relative to that before the first-stage surgery (253.62 ± 10.47) (P < 0.05).Conclusions The highly-polished antibiotic-loaded articulating cement spacer is easy to prepare. Besides, it can effectively enhance the joint movement, relieve pain, improve the quality of life, and retain the bone mass while eradiating the infection. Thus, if applied in the first-stage operation, it would create favorable conditions for the second-stage hip revision.