Two-stage exchange is most commonly used for treatment of prosthetic joint infections (PJI) but, this may fail to eradicate\ninfections. C-reactive protein/albumin ratio (CAR) has been used to predict survival and operative success in other surgical\nsubspecialties and so, we assess the association between CAR and reimplantation success during two-stage revision for PJI defined\nby the Musculoskeletal Infection Society following a primary total hip (THA) or knee (TKA) arthroplasty. From January, 2005 to\nDecember, 2015, two institutional databases were queried and patient demographics, antibiotic duration, C-reactive protein, and\nalbumin were collected prior to reimplantation. Two-stage revisions were considered successful if patients were off of antibiotics\nand did not require a repeat surgery. CAR was available for 79 patients (34 hips and 46 knees) with 61 successful two-stage\nrevisions and 18 failures.The average CAR for patients with successful reimplantation was 1.2 (0.2, 3.0) compared to 1.0 (0.4, 3.2)\nfor treatment failure. However, this was not statistically significant (p=0.766). Therefore, CAR is not applicable in predicting the\nprognosis of two-stage revisions for PJI in total arthroplasty but other preoperative inflammatory-based prognostic scores should be\nexplored.
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