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

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 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. 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 a higher risk of PRABCSI failure in PJI treatment and may serve as preoperative risk-stratification tools.