Evidence map›Paper›PMID 34991649›Full record

ArticleJournal of orthopaedic surgery and research2022

Globulin and albumin to globulin ratio precisely diagnose periprosthetic joint infection and determine the timing of second-stage reimplantation.

Guangqian Shang, ZhiXuan Fei, Hao Xu, Yingzhen Wang, Shuai Xiang

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In one paragraph

Article in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  6. Diagnostic work-up in periprosthetic joint infections of the knee: can the albumin-to-globulin ratio be a screening tool?Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025
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  14. C-reactive protein (CRP)/albumin-to-globulin ratio (AGR) is a valuable test for diagnosing periprosthetic joint infection: a single-center retrospective study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Guangqian Shang *Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China.
ZhiXuan Fei *Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China.
Hao XuDepartment of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China.
Yingzhen WangDepartment of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China. 18661808238@163.com.
Shuai XiangDepartment of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China. 15169093669@163.com.ORCID http://orcid.org/0000-0003-1566-2106

Funding

Natural Science Foundation of Shandong Province ZR2020QH079Young Scientists Fund 82002349
6 · The paper itself

Abstract

backgroundPeriprosthetic joint infection (PJI) is one of the most challenging complications of total joint arthroplasty (TJI). An early and accurate diagnosis of PJI is associated with better treatment outcomes. However, whether the platelet-related markers and globulin-related markers can be used to assist the diagnosis of PJI remains elusive.

methodsA total of 206 patients who underwent revision hip or knee arthroplasty in our institution were divided into two groups: 79 patients in PJI group and 127 patients in aseptic failure group. The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet-related markers including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT) and PLT to MPV ratio (PMR) and globulin-related markers such as globulin (GLB), albumin to globulin ratio (AGR) and PLT to AGR ratio were compared. The diagnostic value was measured using area under the curve (AUC) after constructing receiver operating characteristic (ROC) curves. The potential of each marker for determining the timing of second-staged reimplantation was also evaluated.

resultsSignificantly increased levels of ESR, CRP, PLT, PCT, PMR, GLB and PLT to AGR ratio were identified in PJI group, while decreased levels of MPV and AGR were also found. The diagnostic values of all platelet-related markers and GLB were considered as fair, and good diagnostic values of AGR and PLT to AGR ratio were found, which were comparable to those of ESR and CRP. The levels of GLB and AGR can also be used to predict negative culture result and the timing of second-stage reimplantation.

conclusionsGlobulin and albumin to globulin ratio were found to have good diagnostic values for PJI, and they can precisely predict the culture results and persistent infection.

Indexed as

ReplantationAgedAged, 80 and overAlbuminsArthritis, InfectiousArthroplasty, Replacement, HipBiomarkersBlood SedimentationC-Reactive ProteinFemaleGlobulinsHumansMaleMiddle AgedPersistent InfectionProsthesis-Related InfectionsAlbuminsBiomarkersC-Reactive ProteinGlobulinsSerum AlbuminSerum GlobulinsGlobulinPeriprosthetic joint infectionPlateletReimplantation

Identifiers

PMID34991649
PMCPMC8740003

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.