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

Sep 28, 2026

Retrospective analysis evaluated whether inflammation and nutrition biomarkers can predict failure after prosthesis removal and antibiotic bone cement spacer implantation (PRABCSI) for periprosthetic joint infection (PJI). Data from 78 PJI patients were compared between successful and failed groups using demographic and laboratory measures including WBC, hemoglobin, CRP, ESR, ESR/CRP, platelet count, albumin, CAR, and prognostic nutritional index (PNI). Higher CRP and lower CAR indicated greater failure risk, with CRP and CAR showing the strongest predictive value and supporting preoperative risk stratification.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Introduction

Materials and methods

Patient collective

Results

Conclusions

TYPE Original Research PUBLISHED 19 December 2025 DOI 10.3389/fcimb.2025.1610156 OPEN ACCESS EDITED BY Serban Dragosloveanu, Foisor Clinical Hospital, Romania REVIEWED BY Rares-Mircea Birlutiu, Traumatologie si TBC Osteoarticular, Romania Jingsheng Shi, Fudan University, China *CORRESPONDENCE Dapeng Wu [584622564@qq.com](584622564@qq.com)[ ](584622564@qq.com)Tao Liu [liutaogk@163.com](liutaogk@163.com)[ ](liutaogk@163.com)Yi Jin [hnjinyimd@163.com](hnjinyimd@163.com) †These authors share ﬁrst authorship RECEIVED 11 April 2025 REVISED 27 November 2025 ACCEPTED 27 November 2025 PUBLISHED 19 December 2025 CITATION Huang J, Han S, Cheng X, Zhang M, Gao Z, Chen X, Wu D, Liu T and Jin Y (2025) Value of inﬂammation and nutrition markers in predicting the failure of prosthesis removal and antibiotic bone cement spacerimplantation for PJI treatment. Front. Cell. Infect. Microbiol. 15:1610156 . doi: 10.3389/fcimb.2025.1610156 COPYRIGHT © 2025 Huang, Han, Cheng, Zhang, Gao, Chen, Wu, Liu and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Value of inﬂammation and nutrition markers in predicting the failure of prosthesis removal and antibiotic bone cement spacer implantation for PJI treatment Jincheng Huang 1†, Songtao Han 2†, Xuguang Cheng 3†, Meng Zhang 1, Zongyan Gao 1, Xiao Chen 1, Dapeng Wu 4*, Tao Liu 1* and Yi Jin 1* 1 Department of Orthopedics, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China, 2 Department of Orthopedics, Third Afﬁliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China, 3 Department of Orthopedics, Hebi People’s Hospital, Hebi, Henan, China, 4 Department of Orthopedics, The First Afﬁliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 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 from 78 patients with PJI who received PRABCSI were retrospectively analyzed. Patients were divided into a successful group anda failed group according to the outcome at the last follow-up. Patient demographics and laboratory values (white blood cell count, hemoglobin, Creactive 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 riskstratiﬁcation tools. KEYWORDS albumin, antibiotic bone cement spacer, C-reactive protein, CRP and albumin ratio, periprosthetic joint infection, prognostic nutritional index Frontiers in Cellular and Infection Microbiology 01 [frontiersin.org](frontiersin.org) Introduction Despite two-stage revision surgery being selected as the ﬁrst choice for chronic PJI treatment by most surgeons, its failure rate is around 10%(Barto

FAQs

What was the main purpose of the study?

To evaluate the value of inflammation and nutrition markers in predicting failure of prosthesis removal and antibiotic bone cement spacer implantation (PRABCSI) for PJI treatment.

How were patients grouped in the analysis?

Patients were retrospectively divided into a successful group and a failed group based on the outcome at the last follow-up.

Which biomarkers showed the highest predictive value for PRABCSI failure?

CRP and CAR had the highest predictive value, and elevated CRP with low CAR was associated with higher failure risk.

What do the study’s conclusions suggest for preoperative assessment?

CRP and CAR thresholds were associated with higher PRABCSI failure risk and may be used as preoperative risk stratification tools in PJI treatment.

Sep 28, 2026

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