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

## TL;DR

This study finds that inflammation and nutrition markers like CRP and CAR can predict the success of joint infection treatment involving prosthesis removal and antibiotic cement spacers.

## Contribution

The study identifies CRP and CAR as novel predictive markers for failure risk in PRABCSI treatment for PJI.

## Key findings

- Higher CRP and CAR levels are associated with increased risk of PRABCSI failure.
- Lower albumin and PNI levels correlate with PRABCSI failure.
- CRP > 35.43 and CAR > 0.847 can serve as preoperative risk indicators.

## Abstract

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.

Data from 78 patients with PJI who received PRABCSI were retrospectively analyzed. Patients were divided into a successful group and a failed group according to the outcome at the last follow-up. Patient demographics and 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], and prognostic nutritional index [PNI]) were compared.

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.

CRP>35.43 and CAR>0.847 are associated with a higher risk of PRABCSI failure in PJI treatment and may serve as preoperative risk-stratification tools.