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Purpose To investigate the patient-reported outcome measures (PROMs) and graft survival of combined anterior cruciate ligament reconstruction (ACLR) and lateral extra-articular tenodesis (ACLR-LET) compared with a matched cohort having ACLR alone. Methods Patients were retrospectively recruited from a consecutive series of primary ACLR-LET, between 1996 and 2015, with a minimum postsurgical time of 4 years. ACLR-LET were matched with isolated ACLR for age, gender, and operation year. The indications for adding lateral extra-articular tenodesis were lateral laxity of grade 1 or 2, hyperextension laxity, and/or increased rotational laxity of 5° to 10°. The technique used involved detaching a strip of iliotibial band proximally, before being passed deep to the lateral collateral ligament, looped through Kaplan’s fibers, and sutured back onto itself at physiological tension. The PROMs used were the Lysholm Knee Scoring Scale, Tegner Activity Scale, Oxford Knee Score, and International Knee Documentation Committee subjective knee form. Failure was defined as graft rupture. Student’s t-test was used to compare the matched groups and Kaplan-Meier analysis for survivorship. Results Eighty-three patients had ACLR-LET between 1996 and 2015. Nine revision cases and 2 with less than 4 years follow-up were excluded. The remaining 72 ACLR-LET patients were matched and included in the survival analysis. Seventy percent of patients completed the PROMs. In both groups, 76% were males, and the mean age was 25 years (standard deviation ± 8.5). The median follow-up was 10 years (interquartile range, 6.7 years). There was no significant change of PROMs (Lysholm Knee Scoring Scale: P = .82, 95% confidence interval (CI) −13 to 11; International Knee Documentation Committee: P = .07, CI −1 to 24; Oxford Knee Score: P = .5, CI −8 to 4; Tegner Activity Scale: P = .5, CI −1 to 3) between the groups. The pre- to postoperative PROMs, except the Tegner Activity Scale, improved significantly, clinically and statistically. There was no statistically significant difference in graft failure between the ACLR-LET group (n = 4, 5%) and the ACLR group (n = 9, 11%) (log-rank P = .099). Conclusion ACLR-LET shows good graft survival and PROMs in a high-risk population. This suggests that lateral extra-articular tenodesis is an effective technique to restore joint stability to a knee with additional features of laxity. Level of Evidence III, matched cohort study.

Peter Myers seeks to shed light on the guttural consonants of Biblical Hebrew underlying transcriptions into Greek in 2 Esdras, the Greek translation of Ezra-Nehemiah in the Septuagint. The article goes about this by examining the vowels that are used where the underlying Hebrew pronunciation would be expected to have a guttural. Myers finds a degree of systematicity in the use of specific Greek vowels for specific Hebrew guttural consonants. The examination also corroborates earlier hypotheses regarding the loss of the velar fricatives /*ḫ/ and /*ġ/ in Hebrew by the time of the writing of Septuagint Ezra-Nehemiah.

To assess mid-term survivorship of meniscal allograft transplantation (MAT) and determine the effect that pre-operative meniscal sizing has upon functional outcome and mechanical survivorship. A prospectively collected database of patients receiving MAT from 2001 to 2017 was analysed. Data include demographics; sizing measurements, complications, further surgery, and patient-reported outcome measures (PROMs). Allografts were fresh frozen, non-irradiated, and sized using the Pollard technique. Seventy-three MATs were performed in 67 patients; mean age at MAT was 34 years (range 14–52 years). 56% were male and 62% were medial. The mean follow-up was 75 months (6.25 years). Mechanical survival at 5 and 10 years was 96% and 89.4%, respectively. There were statistically significant improvements in all PROMs; mean Lysholm score improved by 17.5 points [95% confidence interval (CI) 22.2–12.9, p

Furocoumarin (furo[3,2-c]coumarin) derivatives have been synthesized from single step, high yielding (82–92%) chemistry involving a 4-hydroxycoumarin 4 + 1 cycloaddition reaction. They are characterized by FTIR, 1H-NMR, and, for the first time, a comprehensive UV-Vis and fluorescence spectroscopy study has been carried out to determine if these compounds can serve as useful sensors. Based on the fluorescence data, the most promising furocoumarin derivative (2-(cyclohexylamino)-3-phenyl-4H-furo[3,2-c]chromen-4-one, FH), exhibits strong fluorescence (ФF = 0.48) with long fluorescence lifetime (5.6 ns) and large Stokes’ shift, suggesting FH could be used as a novel fluorescent chemosensor. FH exhibits a highly selective, sensitive and instant turn-off fluorescence response to Fe3+ over other metal ions which was attributed to a charge transfer mechanism. Selectivity was demonstrated against 13 other competing metal ions (Na+, K+, Mg2+, Ca2+, Mn2+, Fe2+, Al3+, Ni2+, Cu2+, Zn2+, Co2+, Pb2+ and Ru3+) and aqueous compatibility was demonstrated in 10% MeOH-H2O solution. The FH sensor coordinates Fe3+ in a 1:2 stoichiometry with a binding constant, Ka = 5.25 × 103 M−1. This novel sensor has a limit of detection of 1.93 µM, below that of the US environmental protection agency guidelines (5.37 µM), with a linear dynamic range of ~28 (~2–30 µM) and an R2 value of 0.9975. As an exemplar application we demonstrate the potential of this sensor for the rapid measurement of Fe3+ in mineral and tap water samples demonstrating the real-world application of FH as a “turn off” fluorescence sensor.

BACKGROUND: Patellofemoral replacements (PFRs) have a higher rate of revision than unicompartmental knee arthroplasty or TKA. However, there is little information regarding why PFRs are revised, the components used for these revisions, or the outcome of the revision procedure. Some contend that PFR is a bridging procedure that can easily be revised to a TKA with similar results as a primary TKA; however, others dispute this suggestion. QUESTIONS/PURPOSES: (1) In the setting of a large national registry, what were the reasons for revision of PFR to TKA and was the level of TKA constraint used in the revision associated with a subsequent risk of rerevision? (2) Is the risk of revision of the TKA used to revise a PFR greater than the risk of revision after a primary TKA and greater than the risk of rerevision after revision TKA? METHODS: Data were obtained from the Australian Orthopaedic Association Joint Replacement Registry through December 31, 2016, for TKA revision procedures after PFR. Because revisions for infection may be staged procedures resulting in further planned operations, for the revision analyses, these were excluded. There were 3251 PFRs, 482 of which were revised to TKA during the 17-year study period. The risk of second revision was calculated using Kaplan-Meier estimates of survivorship for PFRs revised to TKAs, and that risk was compared with the risk of first revision after TKA and also with the risk of a second revision after revision TKA. Hazard ratios (HRs) from Cox proportional hazards models were used to compare second revision rates among the different levels of prosthesis constraint used in the index revision after PFR (specifically, cruciate-retaining versus cruciate-substituting). RESULTS: The main reasons for revising a PFR to TKA were progression of disease (56%), loosening (17%), and pain (12%). With the numbers available for analysis, there was no difference in the risk of a second revision when a PFR was revised to a cruciate-retaining TKA than when it was revised to a cruciate-substituting TKA (HR, 1.24 [0.65-2.36]; p = 0.512). A total of 204 (42%) of the PFR revisions had the patella component revised when the PFR was converted to a TKA. There was no difference in rates of second revision when the patella component was revised or not revised (HR, 1.01 [0.55-1.85]; p = 0.964). When we eliminated the devices that ceased to be used before 2005 (older devices), we found no change in the overall risk of repeat revision. The risk of a PFR that was revised to a TKA undergoing a second revision was greater than the risk of TKA undergoing a first revision (HR, 2.39 [1.77-3.24]; p < 0.001), but it was less than the risk of a revision TKA undergoing a second revision (HR, 0.60 [0.43-0.81]; p = 0.001). CONCLUSIONS: The risk of second revision when a PFR is revised is not altered if cruciate-retaining or posterior-stabilized TKA is used for the revision nor if the patella component is revised or not revised. The risk of repeat revision after revision of a PFR to a TKA was much higher than the risk of revision after a primary TKA, and these findings did not change when we analyzed only devices in use since 2005. When PFR is used for the management of isolated patellofemoral osteoarthritis, patients should be counselled not only about the high revision rate of the primary procedure, but also the revision rate after TKA. Further studies regarding the functional outcomes of these procedures may help clarify the value of PFRs and subsequent revisions. LEVEL OF EVIDENCE: Level III, therapeutic study.

Meniscal allograft transplantation (MAT) is a possible treatment option for patients with joint pain after meniscectomy. It is necessary that the joint be aligned and stable. Current evidence shows that MAT improves pain and mechanical function in the mid to long term with patients reporting significantly improved outcomes at up to 15 years following surgery. Studies on survivorship showed up to 76% graft survival at 10 years. Recent studies have suggested a chondroprotective effect, but there is, at present, no evidence to support MAT in the prevention of osteoarthritis. This review article reported the current evidence for MAT showing support for fresh frozen, nonirradiated allografts. However, further research is required to determine the ideal indications for MAT, the optimal graft fixation method, and the safest rehabilitation protocol.

The international recognition of Jørn Utzon’s professional career is accompanied by a growing interest in the Danish architect’s courtyard housing projects. But previous scholarship had access to limited material from Utzon’s professional career, compared to what is now available in The Utzon Archives. Based on a detailed study of presently accessible archival material and original interviews with Utzon’s family and affiliates, this article shows that the Danish architect’s courtyard housing projects closely reflected both his architectural philosophy in general and his thoughts on modern dwellings in particular. These were in turn cultivated by the ideas and ideals of Lin Yutang, Alvar Aalto, and Osvald Sirén.

Homozygous mutations in the progranulin gene (GRN) are associated with neuronal ceroid lipofuscinosis 11 (CLN11), a rare lysosomal-storage disorder characterized by cerebellar ataxia, seizures, retinitis pigmentosa, and cognitive disorders, usually beginning between 13 and 25 years of age. This is a rare condition, previously reported in only four families. In contrast, heterozygous GRN mutations are a major cause of frontotemporal dementia associated with neuronal cytoplasmic TDP-43 inclusions. We identified homozygous GRN mutations in six new patients. The phenotypic spectrum is much broader than previously reported, with two remarkably distinct presentations, depending on the age of onset. A childhood/juvenile form is characterized by classical CLN11 symptoms at an early age at onset. Unexpectedly, other homozygous patients presented a distinct delayed phenotype of frontotemporal dementia and parkinsonism after 50 years; none had epilepsy or cerebellar ataxia. Another major finding of this study is that all GRN mutations may not have the same impact on progranulin protein synthesis. A hypomorphic effect of some mutations is supported by the presence of residual levels of plasma progranulin and low levels of normal transcript detected in one case with a homozygous splice-site mutation and late onset frontotemporal dementia. This is a new critical finding that must be considered in therapeutic trials based on replacement strategies. The first neuropathological study in a homozygous carrier provides new insights into the pathological mechanisms of the disease. Hallmarks of neuronal ceroid lipofuscinosis were present. The absence of TDP-43 cytoplasmic inclusions markedly differs from observations of heterozygous mutations, suggesting a pathological shift between lysosomal and TDP-43 pathologies depending on the mono or bi-allelic status. An intriguing observation was the loss of normal TDP-43 staining in the nucleus of some neurons, which could be the first stage of the TDP-43 pathological process preceding the formation of typical cytoplasmic inclusions. Finally, this study has important implications for genetic counselling and molecular diagnosis. Semi-dominant inheritance of GRN mutations implies that specific genetic counselling should be delivered to children and parents of CLN11 patients, as they are heterozygous carriers with a high risk of developing dementia. More broadly, this study illustrates the fact that genetic variants can lead to different phenotypes according to their mono- or bi-allelic state, which is a challenge for genetic diagnosis.

Background: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. While noncomparative reports have been described as promising, we were aware of no short or long-term clinical studies showing the superiority of Oxinium on polyethylene as a bearing surface. Using data from a comprehensive national joint replacement registry, we compared the long-term outcomes after cruciate-retaining total knee arthroplasty (TKA) with an Oxinium femoral component and those with the same prosthetic design but with a CoCr femoral component. Methods: The cohorts consisted of 17,577 cemented Genesis-II cruciate-retaining total knee replacements using non-cross-linked polyethylene, which included 11,608 with CoCr femoral components and 5,969 with Oxinium femoral components. The cumulative percent revision and hazard ratio (HR) for revision risk were estimated for the cemented Genesis-II Oxinium and CoCr cruciate-retaining TKAs performed in Australia from September 1, 1999, to December 31, 2013. In addition, the revision diagnoses and the effects of age and patellar resurfacing were examined. Results: No difference in the HR for revision risk was found between the Oxinium and CoCr cohorts for any age category for all causes of revision (HR = 0.92 [95% confidence interval (CI), 0.78 to 1.08]; p = 0.329), loosening or lysis, or aseptic causes, except for loosening or lysis in the group of patients who were >=75 years old (p = 0.033). In these patients, TKA with Oxinium femoral components had a higher rate of revision. Younger patients preferentially received Oxinium femoral components. The revision risk was not affected by patellar resurfacing or nonresurfacing. At 12 years, the cumulative percent revision was 4.8% (95% CI, 4.2% to 5.4%) for the CoCr Genesis-II prosthesis compared with 7.7% (95% CI, 6.2% to 9.5%) for the Oxinium Genesis-II prosthesis. Conclusions: In this cohort study involving the same prosthetic design, Oxinium femoral components did not reduce revision rates for all causes, loosening or lysis, or when infection as a cause of revision was removed compared with the same CoCr femoral component across all age groups including patients who were

In his essay of 1983, ‘Towards a Critical Regionalism’, Kenneth Frampton referred to the Bagsværd Church as a primary exemplar, briefly citing the architect's representation of ‘the Chinese pagoda roof’ in this project, to emphasise the importance of crosscultural inspiration in the creation of ‘critical regionalism’. Peter Myers followed Frampton in his 1993 ‘Une histoire inachevée’, arguing for the significant role that Chinese architecture played as a source for Utzon's Bagsværd Church design and further variations on the theme of Chinese and Japanese exemplars on Utzon's work follows. Françoise Fromonot established the importance of the 1925 edition of the Yingzao-fashi (State Building Standard, first published in 1103 ad) and Johannes Prip-Møller's 1937 Chinese Buddhist Monasteries for Utzon; Philip Drew pointed out the significance of the work of Chinese writer Lin Yutang (1895–1976) and historian Osvald Sirén (1879–1966) as important channels through which Utzon perceived East Asian art and architecture; while in 2002, Richard Weston suggested Das Japanische Wohnhaus (1935), written by Japanese architect Tetsuro Yoshida (1894–1956), as a formational influence in Utzon's early perception of Japanese building culture. However, none of these works attempt to clarify the precise role that Chinese and Japanese precedents play in Utzon's architectural career. Two more recent studies, by Philip Goad and Michael Asgaard Andersen, have confirmed the role of Chinese architecture in Utzon's church design and have introduced new evidence and details, but there are still unanswered questions about the exact nature of these influences. This article attempts to address the detailed process of Utzon's cross-cultural practices for his design of the Bagsværd Church in order to reveal how Utzon interpreted specific ideas, ideals, and artefacts from East Asian building culture.

Both before and after his forced resignation from the charge of the Sydney Opera House (1956–66)in 1966, Danish Architect Jørn Utzon (1918–2008) has cited Chinese architecture as one of the most important inspirational sources of his unfinished masterpiece. However, the significance of Chinese building culture has largely been overlooked in historical accounts of Utzon's Opera House design. This is despite ample evidences suggesting several direct analogies of Chinese architecture in Utzon's design proposals. The evidence also indicates that one of the key Chinese sources for Utzon comes from the written works of Finland-born and Sweden-based art historian Osvald Sirén 喜龍仁 (1879–1966). Accordingly, this paper aims to identify Utzon's perception of Chinese architecture from Sirén's interpretation of this subject, and Utzon's eventual reinterpretation of this notion in his design of the Sydney Opera House.The article poses four questions. First, what were the socio-political contexts both of Sirén and Utzon's approach to Chinese architecture? Second, how did Sirén interpret Chinese architecture in his scholarly work? Third, what was the interrelationship between Sirén and Utzon? And fourth, how did Utzon reinterpret Sirén's concept in his design for the Sydney Opera House? To respond to these questions, the authors surveyed the literature associated with Sirén and Utzon, reviewed their private collections, and undertook interviews with their friends, colleagues and followers. On this basis, the authors constructed a series of ideological analogies between Sirén and Utzon's work, with particular emphasis on Utzon's design for the Sydney Opera House.

Zeolitic imidazolate framework-8 (ZIF-8) is one type of metal-organic framework (MOF) with excellent thermal and solvent stability and has been used extensively in separation, catalysis, and gas storage. Supported ZIF-8 structures can offer additional advantages beyond the MOF-only materials. Here, spheres-on-spheres (SOS) silica microspheres are used as support for the nucleation and growth of ZIF-8 nanocrystals. The surface functionalities (-SH, -COOH, and -NH2) of silica and reaction conditions are investigated for their effects on the ZIF-8 morphology. The use of SOS microspheres results in the formation of highly crystalline ZIF-8 nanostructured shell with varied sizes and shapes, ranging from spherical to cubic and to needle crystals. The SOS@ZIF-8 microspheres are packed into a column and utilized for separation of aromatic molecules on the basis of π-π interaction in high-performance liquid chromatography (HPLC). Furthermore, by thermal treatment in air, ZIF-8 nanocrystals can be transformed into ZnO coating on SOS silica microspheres. The SOS@ZnO microspheres show excellent photocatalytic activity, as measured by degradation of methyl orange in water, when compared to ZnO nanoparticles. This study has demonstrated the facile way of using SOS microspheres to prepare core-shell microspheres and their applications.

Paediatric knee injuries are common, although significant injury is rare and often difficult to identify. It is vital to diagnose these serious injuries in order to allow management in a timely manner. It is important that a high level of suspicion is maintained when reviewing these patients in the emergency department or fracture clinic to ensure none of these injuries are neglected. When managed appropriately, most paediatric knee disorders have an excellent prognosis. Common fractures and soft tissue injuries are discussed in this article along with accepted treatment options.

Objectives: Reporting the clinical outcomes of our cohort of patients who underwent arthroscopic transtibial posterior medial meniscal root tear repair (MMRTr) in those patients who had Outerbridge cartilage degeneration of III or IV. Methods: 29 consecutive patients with isolated MMRT underwent trans-tibial repair with all patients completing pre-operative scoring and 20 patients completing both pre and post-operative questionnaires. Of this there were 18 patients who had Outerbridge III or IV cartilage degeneration in the medial compartment at the time of surgery. Data was collected prospectively to include the Oxford Knee Score (OKS), the Lysholm Score (LS), the Tegner Activity Level Scale (TS) and International Knee Documentation Committee Score (IKDC). Results: In the 18 patient cohort there was a mean age at the time of surgery of 57.22 (range 40 – 71) years and the mean follow up period was 26.77 (7.2 – 94.53) months. There was statistically significant improvement across all scoring measures (OKS p = 5.94e-07, LS p = 2.40e-07, IKDC p = 4.17e-06 and TS p = 0.023) in this cohort. Conclusion: There was a significant improvement in the clinical outcomes of all patients who underwent MMRTr despite the presence of Outerbridge III or IV cartilage injury.

Core-shell particles have a wide range of applications. Most of the core-shell particles are prepared in two or multiple steps. Core-shell silica microspheres, with solid core and porous shell, have been used as novel packing materials in recent years for highly efficient liquid chromatography separation with relatively low back-pressure. These core-shell silica microspheres are usually prepared by the time-consuming layer-by-layer technique. Built on our previous report of one-pot synthesis of core-shell nanospheres-on-microspheres (termed as SOS particles for "spheres-on-spheres"), we describe here a two-stage synthesis for the introduction of shell mesoporosity into SOS particles with tunable shell morphology by co-condensation of tetraethyl orthosilicate (TEOS) with 3-mercaptopropyltrimethoxysilane (MPTMS) in the presence of surfactant in the second stage. With MPTMS as the primary precursor at the first stage, some other silica precursors (apart from TEOS) are also employed at the second stage. Expansion of the surfactant-templated mesopores with swelling agents during the reaction and by hydrothermal postsynthesis treatment is then performed to allow the pore sizes (6 nm) suitable for separation of small molecules in liquid chromatography. Compared to the standard SOS silica (both the nanospheres and microspheres contain nearly no mesopores), the introduction of mesoporosity into the nanosphere shell increases the separation efficiency of small molecule mixtures by 4 times as judged by the height equivalent plate number, while the separation of protein mixtures is not negatively affected.

Symptomatic meniscal tears have, until recently, been treated with partial or total meniscectomy, with the inevitable consequential development of arthritis. After a tear, retaining as much functional meniscus as possible is vital to maintain long-term function and reduce the risk of degeneration within the knee. Advances in instruments and techniques allow meniscal repair to be performed more commonly, and with excellent results. New procedures are evolving to allow repair of tears that would previously have been labelled ‘irreparable’. Meniscal allograft transplant is a viable treatment option for symptomatic patients who have suffered total loss of a meniscus and research continues into the use of synthetic menisci.

Typically, metal–organic frameworks (MOFs) exhibit ordered micropores (

Prevention of musculotendinous injuries is an idealistic goal which, while it may not be possible, is worth striving for. Athletes and individuals engaged in dynamic activity are subject to the risk of sustaining many forms of injury including to the muscles and tendons. While these injuries are not life-threatening and are rarely permanently disabling, they do impose a limitation on the ability of the individual to perform competitively and are frequently recurrent if not managed adequately. There are many anatomical, biomechanical, physical and chemical factors which have been shown to be associated with an increased risk of musculotendinous injury, but few have a direct cause and effect relationship, and even fewer have any proof of efficacy in the role of prevention.

Introduction The status of the lateral compartment of the knee is a determining factor in the long-term outcome of medial unicompartmental arthroplasty (UKA). Various methods of assessing the lateral compartment have been used including stress radiography, radioisotope bone scanning, magnetic resonance imaging and visualisation at the time of surgery. Arthroscopy is another means of directly assessing the integrity of the articular cartilage and the meniscus in the lateral compartment. Purpose This study aims to show that per-operative arthroscopy is a safe and effective means of deciding whether to proceed with UKA or convert to total knee arthroplasty (TKA). Method We have used arthroscopy of the lateral compartment to assess suitability for UKA in 151 knees over 8 years. Results At time of arthroscopy 34 knees underwent a change of surgical plan from UKA to TKA (22.5%). There has been one revision to TKA and 2 bearing exchanges for dislocation. Conclusion Immediate per-operative arthroscopy is a reliable method for assessing the suitability of a knee for UKA, in particular the lateral compartment.

Purpose This study seeks to establish the incidence of pathological medial plicae in a large series and design a clinical classification based on arthroscopic findings.

We report the first development of a novel, planar, microfluidic, graphitic carbon separations column utilizing an array of graphitic micropillars of diamond cross-section as the chromatographic stationary phase. 795 nm femtosecond laser ablation was employed to subtractively machine fluidic architectures and a micropillared array in a planar, graphitic substrate as a monolithic structure. A sample injector was integrated on-chip, together with fluid-flow distribution architectures to minimize band-broadening and ensure sample equi-distribution across the micro-pillared column width. The separations chip was interfaced directly to the ESI probe of a Thermofisher Surveyor mass spectrometer, enabling the detection of test-mixture analytes following their differential retention on the micro-pillared graphitic column, thus demonstrating the exciting potential of this novel separations format. Importantly, unlike porous, graphitic microspheres, the temperature and pressure resilience of the microfluidic device potentially enables use in subcritical H(2)O chromatography.

Femoral nerve block (FNB) is an accepted mode of analgesia for lower limb procedures but has a documented complication rate. This study compared femoral nerve and fascia iliaca regional anesthesia for total knee arthroplasty (TKA), using fentanyl consumption as the primary outcome measure. Ninety-eight primary unilateral TKA patients were blinded and randomized into fascia iliaca block (FIB) (n = 51) or FNB (n = 47) groups. No significant differences were found in analgesia use (fentanyl and tramadol) at 12 and 36 hours in pain, nausea and range of motion between the groups. There was one case of paresthesia in the femoral nerve in the FNB group. Fascia iliaca block is as effective as FNB as part of a multimodal anesthetic regimen for TKA.

Porous nanospheres have a wide range of applications such as in catalysis, separation and controlled delivery. Among these nanospheres, syntheses and applications of porous silica nanospheres have been investigated extensively. Uniform porous silica nanospheres can be synthesized using a modified Stöber method. In the present study, porous silica spheres were prepared in the pre-formed emulsion-templated porous polyacrylamide (PAM). A hierarchical hybrid structure of mesoporous silica spheres was formed in the highly interconnected macroporous polymer. The polymer scaffold could be removed by calcination with porous silica spheres and the macroporous structures retained. This resulted from the close packing or aggregation of small silica nanospheres in the pores and on the surface of pores of PAM. The modified Stöber synthesis was further carried out in pre-formed polymer nanofibres (chitosan and sodium carboxymethyl cellulose). The structure of porous silica spheres on nanofibres was produced in the presence of the polymer or composite fibres. The corresponding inorganic structures were successfully obtained after calcination. The hierarchical structures of porous nanospheres within macroporous structures or on nanofibres are of potential interest to researchers in nanomaterials, porous polymers, supported catalysis and controlled delivery.

Purpose To evaluate the survivorship of meniscal allograft transplantations (MATs), their clinical outcomes, and to compare the effect of perioperative cartilage status on survivorship. Method A consecutive series of MATs with a minimum postsurgical time of 4 years were included from a prospectively collected database from 2001 to 2015. Mechanical failure was defined as transplant removal or knee arthroplasty. The effect of peri-operative cartilage status on survivorship was analyzed using a Kaplan-Meier analysis. Also, pre- and postoperative outcome scores were evaluated. The clinical outcome tools used were the Lysholm Knee Scoring Scale, Tegner Activity Level Scale, Oxford Knee Score (OKS) and International Knee Documentation Committee (IKDC) subjective knee form. Results The mean (±SD) postsurgical follow-up (n = 45 MATs, 43 knees) was 8.6 ± 3.4 years. Among the 45 MATs, 31 had an Outerbridge Cartilage Score (OCS) of 3 to 4. Eight transplants (17.7%) failed at an average of 6.1 ± 4.4 years postoperatively, and all occurred in patients with an OCS of 3 to 4. Functional outcomes showed significant improvement in the Lysholm by 17.7 points (95% confidence interval [CI], 8.5-26.9, P P = .031), and IKDC scores by 15.6 (CI, 6-25.2, P = .001). However, the Tegner score improvement by 0.6 was not statistically significant (CI, 0.3545-1.6212, P = .2). In a subanalysis, the OCS 3-4 group had a significant improvement in all the clinical outcomes except the Tegner score. In the OCS 0-2 group, the Lysholm and Tegner significantly improved, whereas the improvement in the OKS and IKDC was not significant. Conclusions MAT is a viable and effective surgical option for the painful meniscus-deficient knee, with good survivorship and functional outcomes in the medium to long term. Mechanical failure is associated with advanced OCS. Patients with minimal cartilage damage have improved MAT survivorship but both groups benefit clinically. Level of Evidence Level IV, case series.

Porous silica microspheres have wide applications in various areas. It has been a challenge to produce uniform silica microspheres with tunable pore size. In this study, uniform porous silica microspheres were synthesized using a modified Stober method. Cetyltrimethylammonium bromide (CTAB) was used as a cationic surfactant to introduce ordered mesoporosity into silica spheres. Hydrophilic polymers poly(vinyl alcohol) (PVA), polyvinylpyrrolidone (PVP), and poly(ethylene glycol) (PEG) were introduced into the reaction system. It was found that the use of PVA led to the formation of uniform and well-dispersed porous silica microspheres. The effect of the polymers on pore size and particles morphology was also studied. Another cationic surfactant dihexadecyldimethylammonium bromide (DiCTAB) and a nonionic surfactant (Brij-35) were further investigated by replacing CTAB. Uniform nonporous silica nanospheres were formed for Brij-35 and Brij-35/PVA systems. The use of DiCTAB resulted in submicrometer silica sph...

Background The preservation of meniscal tissue is important to protect joint surfaces. Purpose We have an aggressive approach to meniscal repair, including repairing tears other than those classically suited to repair. Here we present the medium- to long-term outcome of meniscal repair (inside-out) in elite athletes. Study Design Case series; Level of evidence, 4. Methods Forty-two elite athletes underwent 45 meniscal repairs. All repairs were performed using an arthroscopically assisted inside-out technique. Eighty-three percent of these athletes had ACL reconstruction at the same time. Patients returned a completed questionnaire (including Lysholm and International Knee Documentation Committee [IKDC] scores). Mean follow-up was 8.5 years. Failure was defined by patients developing symptoms of joint line pain and/or locking or swelling requiring repeat arthroscopy and partial meniscectomy. Results The average Lysholm and subjective IKDC scores were 89.6 and 85.4, respectively. Eighty-one percent of patients returned to their main sport and most to a similar level at a mean time of 10.4 months after repair, reflecting the high level of ACL reconstruction in this group. We identified 11 definite failures, 10 medial and 1 lateral meniscus, that required excision; this represents a 24% failure rate. We identified 1 further patient who had possible failed repairs, giving a worst-case failure rate of 26.7% at a mean of 42 months after surgery. However, 7 of these failures were associated with a further injury. Therefore, the atraumatic failure rate was 11%. Age and size and location of the tears were not associated with a higher failure rate. Medial meniscal repairs were significantly more likely to fail than lateral meniscal repairs, with a failure rate of 36.4% and 5.6%, respectively ( P < .05). Conclusion Meniscal repair and healing are possible, and most elite athletes can return to their preinjury level of activity.

Native, uncoloured, proteins can be focused in a column containing a fluorescent packing material, using hydrodynamic flow and a counteracting non-linear electric field, and imaged along the length of the channel by fluorescence quenching.

Few surgical procedures are suitable for the management of recurrent patellar instability in skeletally immature patients. A combination of 3 soft tissue procedures is described. These include a lateral release, medial transfer of the medial one third of the patellar tendon to the medial collateral ligament, and advancement of the medial static and dynamic stabilizing structures. Good success has been achieved with this procedure over time with no long-term complications.

SAR studies were conducted around lead compound 1 using high-throughput parallel solution and solid phase synthesis. Our lead optimization efforts led to the identification of several CCR2b antagonists with potent activity in both binding and functional assays [Compound 71 CCR2b Binding IC 50 3.2 nM; MCP-1-Induced Chemotaxis IC 50 0.83 nM; Ca 2+ Flux IC 50 7.5 nM].

Large perfusive silica beads (particle size 110 microm, through pore approximately 2 microm) held in place by the keystone effect were used as single-particle frits for the manufacture of particulate packed capillary columns. High-quality capillary electrochromatographic separations of a standard test mixture of alkylbenzenes were obtained over the full voltage range of 5-30 kV, with no requirement for pressurization. Excellent robustness was demonstrated by the reproducibility of migration times, peak efficiencies, and resolution during 100 consecutive runs at the highest voltage (30 kV) without thermostating and pressurization. Superior performance relative to traditional sinter-fritted columns is ascribed to the heat-free fritting process and short frit length of approximately 110 microm.