Introduction & Aim:

Host-related factors influence outcomes in periprosthetic joint infection (PJI). The Controlling Nutritional Status (CONUT) score integrates serum albumin, total lymphocyte count, and total cholesterol, reflecting immunonutritional status. This study aimed to evaluate whether CONUT predicts failure and mortality after surgery for acute PJI.

Methods:

We performed a single-centre retrospective cohort study of patients surgically treated for acute postoperative or acute haematogenous hip or knee PJI between 2013 and 2024. PJI was defined according to European Bone and Joint Infection Society (EBJIS) criteria. Minimum follow-up was 12 months. Patients were classified as low (<5) or high CONUT (≥5).

Outcomes were assessed using the Musculoskeletal Infection Society Outcome Reporting Tool (MSIS-ORT). Failure was defined as persistent or recurrent infection requiring further treatment (tiers 3B–3F). Total failure additionally included all-cause death within 1 year (tier 4A). Overall mortality at final follow-up was analysed separately.

Results:

Ninety patients were included, of whom 42 (46.7%) had high CONUT. Median follow-up was 46.5 months (range 0–149).