Incidence of periprosthetic joint infection after primary total hip arthroplasty is underestimated: a synthesis of meta-analysis and bibliometric analysis.

The American Musculoskeletal Society updated the diagnostic criteria for periprosthetic joint infection (PJI) in 2011 and 2018. However, the overall incidence of PJI since the introduction of these new standards has not been assessed. In order to fill this knowledge gap, a single-group meta-analysis was conducted using articles obtained from several databases, focusing on the incidence of PJI after primary total hip arthroplasty (THA). Our study revealed a significant difference in the incidence of PJI reported by different national or regional databases. Moreover, most cases of PJI were found to be underestimated. This highlights the crucial need for standardized diagnostic criteria and monitoring methods to accurately identify and track cases of PJI. Furthermore, a bibliometric analysis was conducted to provide a comprehensive overview of the current state of research on PJI after THA. This analysis explored the most productive countries, organizations, journals, and individuals in this research area. Additionally, it identified the research trends and hotspots of the last decade, highlighting the advancements and areas of focus in this field. By conducting these analyses, the study aims to contribute to the understanding of PJI after THA and provide valuable insights for clinicians, researchers, and policymakers involved in the management of this condition.

[Phosphate Removal on Zirconium Alginate/Poly(N-isopropyl acrylamide) Hydrogel Beads with a Semi-interpenetrating Network].

Zirconium alginate/poly(N-isopropyl acrylamide) hydrogel beads with a semi-interpenetrating network (ZA/PNIPAM) were prepared by using the ionic crosslinking and radical polymerization method and investigated for phosphate removal from aqueous solutions. The effects on the adsorption performance of hydrogel beads, including initial pH, adsorbent dose, initial phosphate concentration, and co-existing anions, were evaluated systematically. Results showed that the ZA/PNIPAM could exhibit a maximum uptake capacity of phosphate at pH 2.The uptake capacity of the adsorbent increased with a decrease in the dose or an increase in the initial phosphate concentration. The presence of SO42- had a more negative effect on phosphate removal compared to Cl- and NO3-. The kinetics fitted a pseudo-second-order model and intraparticle diffusion model, suggesting the adsorption rate was mainly controlled by surface adsorption and diffusion into the interior of the hydrogel beads. The isotherm data could be described by the Freundlich model, indicating that the adsorption process was heterogeneous multilayer adsorption. The studies of FTIR, XPS, and zero point of charge with relevant adsorption data revealed that the phosphate adsorption mechanisms could be electrostatic attraction (physical adsorption) and ligand exchange reactions (chemical adsorption). After four cycles of regeneration, ZA/PNIPAM exhibited a stable uptake capacity, indicating favorable reusability.