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Background Serum fibrinogen (FI is an acute-phase glycoprotein in the infection response that may stop excessive bleeding. The purposes of this study are to determine the value of FIB that can be used to differentiate between periprosthetic joint infection (PJI) and aseptic loosening of the prosthesis, and to determine the clinical significance of FIB for analyzing infection outcomes after first-stage surgery. Methods This retrospective study included 90 patients undergoing total knee arthroplasty or total hip arthroplasty revision fro