Value of inflammation and nutrition markers in predicting the failure of prosthesis removal and antibiotic bone cement spacer implantation for PJI treatment

Jinchengh Huang¹Songtao Han²Xuguang Cheng³MENG ZHANG¹Zongyan Gao¹Xiao Chen¹Dapeng Wu^4*Tao Liu^1*Yi Jin^1*

• ¹Henan Provincial People's Hospital, Zhengzhou, China
• ²Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan Province, China
• ³Hebi City People's Hospital, Hebi, China
• ⁴The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China

Introduction: This study aimed to evaluate the value of inflammation and nutrition markers in predicting the failure of prosthesis removal and antibiotic bone cement spacer implantation (PRABCSI) for periprosthetic joint infection (PJI) treatment. Materials and methods: Data of 78 PJI patients who received PRABCSI were retrospectively analyzed. Patients were divided as successful group and failed group according to the outcome at the last follow up. Patient demographics, laboratory values (White blood cell count, Hemoglobin, C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), ESR and CRP ratio (ESR/CRP), lymphocytes, Platelet Count (PLT), Albumin, CRP and Albumin ratio (CAR), prognostic nutritional index (PNI)) were compared. Results: The successful group had lower levels of CRP, ESR/CRP, PLT, and CAR compared to the failed group. Conversely, the successful group had higher levels of albumin and PNI. The markers with the highest predictive value for PRABCSI failure were CRP and CAR. Elevated levels of CRP and low levels of CAR were associated with a higher risk of PRABCSI failure. Conclusions CRP>35.43 and CAR>0.847 are associated with higher risk of failure of PRABCSI in PJI treatment, and may serve as preoperative risk stratification tools.