ArticleInfection and drug resistance2025
Blood Cell Ratio Combinations for Diagnosing Periprosthetic Joint Infections: A Preliminary Study.
Article in Infection and drug resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Key Inflammatory Pathways, Biomarkers, and Targeted Management Strategies in Primary Total Joint Arthroplasty: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Diagnostic performance of the platelet-to-lymphocyte ratio (PLR) for periprosthetic joint infection after total hip and knee arthroplasty: a systematic review and meta-analysis.Knee surgery & related research · 2026Review
- Article
- Periprosthetic joint infection after arthroplasty: advances and future prospects.Journal of orthopaedic surgery and research · 2025Review
- Prognostic nutrition index reveals LAG3 in cytotoxic CD8+ T cells and MHC class II in gastric cancer cells.Cancer immunology, immunotherapy : CII · 2025Article
- Synovial fluid fibrin degradation product can be used as a new auxiliary marker for periprosthetic joint infection diagnosis.Frontiers in cellular and infection microbiology · 2025Article
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Authors and funding
5 authors.
Funding
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Abstract
Background: Periprosthetic joint infection (PJI) is a serious complication following total joint arthroplasty (TJA), which requires prompt and accurate diagnosis for effective management. Many biomarkers have been used for PJI diagnosis; however, the identification of the most effective inflammatory biomarker combination for optimal diagnostic accuracy may be poorly reported. Methods: In this prospective, multi-center study, a total of 269 individuals undergoing knee or hip revision arthroplasty were recruited and subsequently categorized based on 2018 ICM PJI criteria into two groups: 93 with periprosthetic joint infection (PJI) and 176 with aseptic failure (AF). Various preoperative biomarkers were analyzed and compared, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil-to-lymphocyte ratio (NLR), CRP-to-albumin ratio (CAR), CRP-Albumin-lymphocyte ratio (CALLR), platelet-to-lymphocyte ratio (PLR), platelet-to-albumin ratio (PAR), and neutrophil-to-albumin ratio (NAR). The diagnostic performance of these biomarkers was evaluated using ROC curve analysis and the area under the curve (AUC). Additionally, the Youden index was used to determine optimal threshold values, and positive predictive value (PPV) and negative predictive value (NPV) were calculated to evaluate diagnostic precision. Results: In the PJI group, levels of PAR, CAR, and CALLY were notably higher compared to the AF group, reaching statistical significance (P < 0.05). PAR and CAR were confirmed to have high diagnostic values, with AUC values of 0.779 and 0.718, respectively. CALLY exhibited moderate diagnostic effectiveness, with an AUC of 0.647. When PAR was combined with CRP and ESR, sensitivity and specificity notably improved to 93.8% and 92.5%, respectively. However, subgroup analysis revealed no significant differences in combined inflammatory biomarker levels between the two groups. Conclusion: PAR and CAR prove to be effective combined inflammatory biomarkers for PJI diagnosis, whereas other markers exhibited limited diagnostic utility for PJI.
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