BACKGROUND This study identified risk factors associated with
reinfection and created a scoring system designed for patients with periprosthetic joint
infection (PJI) who have undergone prosthetic resection and spacer implantation. MATERIAL AND METHODS Patients who underwent 2-stage revision for PJI from January 2010 to December 2017 were retrospectively analyzed in this study. Patients were divided into 2 groups:
infection recurrence and
infection cure. Demographic and clinical information, laboratory test results, and radiological images that were potentially associated with
infection were obtained and analyzed. RESULTS Seven independent risk (protective) factors for
infection recurrence in patients with PJI who underwent 2-stage hip
revision surgery were identified:
C-reactive protein level, type of
bacterial infection, age, immunosuppression,
albumin/
globulin ratio,
glucose level, and magnetic resonance imaging findings. Finally, a weighted scoring system of 100-mark system was established and the area under the curve was 0.965 (95% confidential interval=0.947-0.983). The predictive scores for low risk (≤30%), moderate risk (31-69%), and high risk (≥70%) of
infection recurrence were ≤45, 46-77, and ≥78, respectively. CONCLUSIONS For patients with PJI who had already undergone joint resection and spacer implantation, this newly established scoring system might help determine the accurate risk of
infection recurrence after a definitive new
prosthesis implantation. Patients with scores greater than 78 points would be considered very likely to have an
infection recurrence. Therefore, the second-stage
revision surgery should be changed to an additional anti-
infection treatment or a
debridement surgery instead of a definitive
prosthesis implantation surgery.