{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:23Z","timestamp":1786121363092,"version":"build-2736575974"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic value of platelet-to-CRP ratios for periprosthetic joint infection (PJI) following total joint arthroplasty, and to assess the influence of potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case-control study included 151 PJI patients and 178 with aseptic loosening (AL). CRP, ESR, PLT, PDW, PLT\/CRP, PLT\/ESR, and PDW\/CRP were compared between groups. ROC curves assessed diagnostic performance. Subgroup analyses stratified by joint (hip\/knee) and infection duration (acute\/chronic) were performed. Multivariate regression adjusted for time-related covariates, with pairwise ROC comparisons via DeLong test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Joint distribution, symptom duration, diabetes, and time from arthroplasty differed significantly between groups (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05); sex, age, laterality, revision history, and immunosuppression did not. All seven biomarkers differed significantly between PJI and AL groups (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.0001). PDW\/CRP achieved the highest AUC (0.9047), with 84.3% sensitivity and 84.8% specificity, followed by CRP (AUC\u00a0=\u00a00.9002) and PLT\/CRP (AUC\u00a0=\u00a00.8841). Single platelet markers performed poorly (AUCs &amp;lt; 0.66). No significant joint-specific differences were observed (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). PDW\/CRP showed higher AUC in acute (0.9452) versus chronic PJI (0.8901,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.0407). All seven biomarkers remained significantly associated with PJI after adjustment for time-related variables (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.01). DeLong tests confirmed that PLT\/CRP and PDW\/CRP were comparable to CRP alone (both\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05), while significantly outperforming single platelet parameters (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PLT\/CRP and PDW\/CRP are low-cost adjunctive biomarkers for PJI diagnosis, with PDW\/CRP offering well-balanced sensitivity and specificity. Their diagnostic performance is stable across hip and knee joints and independent of symptom duration or implantation time. External validation in unselected populations is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1871636","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:22:33Z","timestamp":1786076553000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The diagnostic value of platelet-related indicators to CRP ratio in periprosthetic joint infection"],"prefix":"10.3389","volume":"16","author":[{"given":"Runshan","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s, Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Xuan","sequence":"additional","affiliation":[{"name":"Department of Hospital Infection Management, Henan Provincial People\u2019s Hospital, Zhengzhou, University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s, Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s, Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B6","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.idc.2018.06.005","article-title":"Prosthetic joint infection update","volume":"32","author":"Beam","year":"2018","journal-title":"Infect. 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