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Improper healing of a femoral shaft fracture can result in posttraumatic residual multiplanar femoral deformity and limb shortening, which can be restored with a corrective osteotomy. Predominantly in complex posttraumatic circumstances, the use of computer assistance in orthopaedic surgery may facilitate meticulous preoperative planning, and further improve the accuracy and safety of such procedures, potentially resulting in better clinical outcomes. Herein, we present a unique case of electromagnetic navigation assisted patient-personalized femoral osteotomy for acute correction of posttraumatic residual multiplanar femoral deformity with shortening.

Introduction: Leg-length discrepancy (LLD) can cause distinct gait and posture disorders that may lead to lifestyle-limiting disability and premature joint degeneration. The purpose of this study was to describe a novel surgical method for acute femoral lengthening in adults with symptomatic structural LLD using step-cut osteotomy, traction table, and proximal femoral locking plate fixation. Materials and methods: We retrospectively evaluated three consecutive adult patients that underwent the procedure at our institution between 2011 and 2019, describing the surgical technique and presenting a report of three cases, including complications assessment. Results: The average age was 47 years (range 38–58), average BMI was 28.1 kg/m2(range 26.8–29.9), average ASA score was 2 (range 1–3). The mean pre-operative shortening (2 congenital, 1 posttraumatic) was 21 mm (range 20–23). The average elongation achieved was 18 mm (range 15–20). The average surgery duration was 142 min (range 120–165) and the average estimated blood loss was 558 mL (range 375–900). Symptoms were relieved after the lengthening in all three cases. We observed no complications after the mean 68 months (range 22–125) of follow-up. Conclusions: Successful correction of structural LLD is challenging, depends on patient selection, meticulous planning, surgical technique and experience. Therefore, it should be considered case-by-case. In the hands of an experienced surgeon, our method of acute femoral lengthening seems safe and suitable for carefully selected cases of structural LLD correction, where the final lengthening goal remains within the critical limits of one-stage leg lengthening and principles of traction table use.

Background: Mixing and matching components from different manufacturers in total hip arthroplasty is a frequently used off-label praxis. The clinical consequences of this procedure have not been studied in detail.Methods: 860 patients with matched and 1067 patients with mixed primary total hip replacement (THR) components carried out between 1 January 2002 and 31 December 2004, were selected from our Institution registry. The analysis endpoint was set at 1 January 2016. THRs with poorly performing components were excluded from study groups. Kaplan-Meier survival curves for both groups were calculated and compared using the Log-Rank test and the demographic data using the chi-square test. Correlations between demographic data and revisions were calculated using bivariate correlation.Results: 28 revisions were carried out in the matched group and 67 in the mixed group. The 14-year overall survival probability was significantly better in the former (96.0%) than in the mixed group (92.7%) (p= 0.002). Survival, free of aseptic and septic failures, was statistically, significantly higher in the matched group (p= 0.026 and p= 0.007, respectively). The survival of the mixed subgroup with heads and stems from the same manufacturer did not differ statistically from that of the matched group (p= 0.079).Conclusions: In contrast to the results listed in the National Joint Registry and the New Zealand Joint Registry, the survival probability in our study was, statistically, significantly higher in total hip replacements using components of the same manufacturer. Importantly, mixing and matching the components of different manufacturers led to similar survival providing the head and the stem were from the same manufacturer.

The initial reverse shoulder arthroplasty (RSA), designed by Paul Grammont, was intended to treat rotator cuff tear arthropathy in elderly patients. In the early experience, high complication rates (up to 24%) and revision rates (up to 50%) were reported.The most common complications reported were scapular notching, whereas clinically more relevant complications such as instability and acromial fractures were less commonly described.Zumstein et al defined a ‘complication’ following RSA as any intraoperative or postoperative event that was likely to have a negative influence on the patient’s final outcome.High rates of complications related to the Grammont RSA design led to development of non-Grammont designs, with 135 or 145 degrees of humeral inclination, multiple options for glenosphere size and eccentricity, improved baseplate fixation which facilitated glenoid-sided lateralization, and the option of humeral-sided lateralization.Improved implant characteristics combined with surgeon experience led to a dramatic fall in the majority of complications. However, we still lack a suitable solution for several complications, such as acromial stress fracture.Cite this article: EFORT Open Rev2021;6:1097-1108. DOI: 10.1302/2058-5241.6.210039

Early reported complication rates with the Grammont-type reverse shoulder arthroplasty (RSA) were very high, up to 24%.A ‘problem’ is defined as an intraoperative or postoperative event that is not likely to affect the patient’s final outcome, such as intraoperative cement extravasation and radiographic changes. A ‘complication’ is defined as an intraoperative or postoperative event that is likely to affect the patient’s final outcome, including infection, neurologic injury and intrathoracic central glenoid screw placement.Radiographic changes around the glenoid or humeral components of the RSA are very frequently observed and described in the literature.High complication rates related to the Grammont RSA design led to development of non-Grammont designs which led to a dramatic fall in the majority of complications.The percentage of radiological changes after RSA is not negligible and remains unsolved, despite a decrease in its occurrence in the last decade. However, such changes should be now considered as simple problems because they rarely have a negative influence on the patient’s final outcome, and their prevalence has dramatically decreased.With further changes in indications and designs for RSA, it is crucial to accurately track the rates and types of complications to justify its new designs and increased indications.Cite this article: EFORT Open Rev2021;6:1109-1121. DOI: 10.1302/2058-5241.6.210040

Bisphenol S (BPS) is a common, persistent, and mobile chemical found in everyday products such as thermal paper. BPS can easily enter the body by migrating from the paper to the fingers, disrupting the endocrine system by mimicking the oestrogen hormone, thus negatively influencing human health. Assessing BPS levels in daily life is of great importance. This study introduces a rapid and reliable approach for detecting BPS in thermal paper and tap water by developing an electrochemical analytical method. This method allows for in-situ, real-time measurements. We present a simple, low-cost electrochemical sensor for detecting BPS using screen-printed electrodes based on carbon (SPEC) and single-wall carbon-nanotube (SPE-SWCNT) working electrodes. BPS was detected over a wide linear range from 1 to 400 μM. The detection limits were 0.73 μM and 0.87 μM for the SPE-C and SPE-SWCNT electrodes, respectively. Good repeatability was observed for both sensors when using one electrode 16 times, which demonstrates its potential for real-time environmental monitoring. Additionally, traditional chromatographic methods, high-performance liquid chromatography with a diode-array detector (HPLC-DAD), and liquid chromatography-mass spectrometry triple quadrupole (LCMS), were incorporated to enhance analytical capabilities. HPLC-DAD achieved a detection limit of 3 nM after solid-phase extraction preconcentration, while LCMS triple quadrupole demonstrated a detection limit of 10 pM without preconcentration. Electrochemical screen-printed electrodes can be employed for on-site analysis and health-risk assessments in everyday settings, such as shops. However, for detecting very low concentrations where time is not a constraint, LCMS quadrupole remains the preferred technique.

AimsThe diagnosis of periprosthetic joint infection (PJI) can be difficult. All current diagnostic tests have problems with accuracy and interpretation of results. Many new tests have been proposed, but there is no consensus on the place of many of these in the diagnostic pathway. Previous attempts to develop a definition of PJI have not been universally accepted and there remains no reference standard definition.MethodsThis paper reports the outcome of a project developed by the European Bone and Joint Infection Society (EBJIS), and supported by the Musculoskeletal Infection Society (MSIS) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Implant-Associated Infections (ESGIAI). It comprised a comprehensive review of the literature, open discussion with Society members and conference delegates, and an expert panel assessment of the results to produce the final guidance.ResultsThis process evolved a three-level approach to the diagnostic continuum, resulting in a definition set and guidance, which has been fully endorsed by EBJIS, MSIS, and ESGIAI.ConclusionThe definition presents a novel three-level approach to diagnosis, based on the most robust evidence, which will be useful to clinicians in daily practice.Cite this article: Bone Joint J2021;103-B(1):18–25.

Purpose The purpose of this study was to compare the results of revision total hip arthroplasty after fracture of primary ceramic components using different type of revision bearing surfaces.Methods We analysed the results of 16 patients with a follow-up more than 3 years after first revision. 6 were revised to ceramic-on-ceramic (CoC) bearing, 9 to metal-on-polyethylene (MoP) and 1 to ceramic-on-cross-linked polyethylene (CoXLP) bearing.Results The mean follow-up was 87 months. Patients with revision to CoC had higher Harris Hip Score (HHS) of 89 points in comparison to the patients with revision to MoP with 84 points. Radiographic examinations revealed visible eccentric polyethylene wear with osteolysis in 3 out of 9 patients revised to MoP. There were no detrimental x-ray changes in patients revised to CoC components.Conclusions We consider CoC as the best option at revision operation for ceramic component fracture.

Environmental context Various UV-filtering chemicals are added to sunscreens in order to protect humans from the harmful effects of the sun. As a consequence of disinfection processes in swimming pools, sunscreen components may be chlorinated and change their structure and properties, leading to derivatives with higher toxicity. The safety of sunscreen components as well as that of their transformation products during their use requires further study. Abstract In this work is presented a synthesis pathway for the UV filter hexyl 2-(4-diethylamino-2-hydroxybenzoyl)benzoate (DHHB) and its chlorinated by-products in order to investigate the transformation behaviour and toxicity changes of DHHB during chlorination disinfection treatment. Acute toxicity was measured using standardised tests with aquatic model organisms. The potency of DHHB was compared with other benzophenone-like UV filters tested in the same experimental set-up. The toxicity of chlorinated compounds tested with photobacteria was found to be in a similar range to that of the starting compound. Microalgae were more sensitive to DHHB than to its chlorinated by-products, whereas daphnids were affected more by DHHB’s chlorinated products. The comparative toxicity data showed DHHB and even more its chlorinated by-products as more highly biologically potent to daphnids than other tested UV filters. The toxic potential of benzophenone-like UV filters should be interpreted together with data on their chemical properties, chlorination effects and affected organisms.

Infection is becoming the most important as well as the most devastating mechanism of prosthetic joint failure. The incidence is increasing because the absolute number of patients operated is increasing and because more often very sick, debilitated and immunocompromised patients are operated. The trend reveals a further increase in the years to come. Diagnosis may be very easy in case of high grade processes, but also extremely difficult in some other instances. Misdiagnosing infection leads to repeated early failures that are distressing for patients as well as surgeons. To avoid failures related to misdiagnosed prosthetic joint infections a step-wise algorithm of action is proposed and the diagnostic strength of the steps discussed. The key point is to select potential candidates to define the probability of an ongoing infection and then to select the tools to strengthen the suspicion. Further procedures are based on the analysis of the pseudo-synovial fluid obtained by aspiration. Diagnostic conclusions form the basis for treatment decisions.

Transparent TiO2films with a high photodegradation activity towards an azo dye in aqueous solution were prepared by sol–gel processing. Films on soda–lime glass supports protected with a thin silica barrier layer exhibited better crystallization and monodisperse nanoparticles, higher absorption of light below 370 nm, and higher photocatalytic activity than those films deposited on bare glass supports proving the detrimental effect of interdiffused sodium ions on the development of the anatase nanostructure. The effect of substrate was more pronounced in thinner films (300 nm) than in thicker ones (1200 nm), which were achieved by adding a template (i.e.Pluronic F127) to the sol.Transparent TiO2films with a high photodegradation activity towards an azo dye in aqueous solution were prepared by sol–gel processing. Films on soda–lime glass supports protected with a thin silica barrier layer exhibited better crystallization and monodisperse nanoparticles, higher absorption of light below 370 nm, and higher photocatalytic activity than those films deposited on bare glass supports proving the detrimental effect of interdiffused sodium ions on the development of the anatase nanostructure. The effect of substrate was more pronounced in thinner films (300 nm) than in thicker ones (1200 nm), which were achieved by adding a template (i.e.Pluronic F127) to the sol.

Photodegradation of coumaphos and azinphos-methyl in the air, in oxygen, and in nitrogen atmosphere (quartz reactor equipped with six 18-W lamps with the maximum emission intensity at 310 nm) was studied. The fastest reaction occurred with coumaphos in nitrogen atmosphere (complete decomposition in 10 min), where the formation of a new compound was also detected by high-performance liquid chromatography (HPLC). In the case of azinphos-methyl, no additional signals in HPLC chromatogram were observed. The rearrangement mechanism, involving a triplet-state activation complex and the formation of an acetylcholinesterase (AChE)-inhibiting oxo analog of coumaphos was verified and confirmed by laser flash photolysis.

Substituted 2H-1-benzopyran-2-ones are useful synthons and have potential as biologically active compounds. In order to characterize the transformation of benzopyran-2,5 diones with a heterocyclic hydrazine to 2H-1-quinoline-2,5-diones and 5-hydrazono-2H-1-benzopyran-2-ones we have studied structural parameters of the products using 2D NMR techniques in solution combined with computational tools. Molecular modeling based on experimentally determined NOE distance restraints enabled determination of solution structures of two compounds:  N-1,2,5,6,7,8-hexahydro-1-(imidazo1,2-bpyridazin-6-yl)amino-7-methyl-2,5-dioxo-3-quinolinylbenzamide and N-5,6,7,8-tetrahydro-5-(imidazo1,2-bpyridazin-6-yl)hydrazono-7-methyl-2-oxo-2H-1-benzopyran-3-ylbenzamide.

A simple, highly selective transformation of 5,6,7,8tetrahydro2H1benzopyran2,5diones 1–3 and 14 with some phenylhydrazines and heterocyclic hydrazines to 5hydrazono2H1benzopyran2ones 4–12and 15–16is described. Under more severe conditions the hydrazonoquinoline derivative 17 was obtained from the benzopyran derivative 3 and Phenylhydrazine.

Abstract6, 7-Dihydrocyclopenta[b]pyran-2, 5-dione 1was converted with hydrazines to fused pyridine-2(1H)-ones of type a. In contrast, 2H-1-benzopyran-2, 5-diones 2–4gave under the same reaction conditions 5-hydrazonobenzopyrans of type b. Calculated heats of formation matched experimental findings.

The object of our research has been laser-induced photo-oxidation of organophosphorus compounds in aqueous media. A XeCl excimer laser with a pulse energy of up to 150 mJ and wavelength of 308 nm has been used as a light source. The research comprised the influence of irradiation conditions on pesticide degradation (number of laser pulses, pulse energy) and decomposition efficiency. The time between irradiation and sample isolation ranged from 5 min to 24 hrs. Rapid decomposition has been achieved within two hours following the irradiation for the range of concentrations limited by the solubility of pesticide (up to 40 mgL-1). 1 mL samples required less than 120 mJ of total irradiation energy at 308 nm, which was delivered to the sample in time intervals shorter then 1 second when catalysts, such as titanium dioxide and hydrogen peroxide were applied. Similar degradation efficiency was also obtained without the addition of catalysts when higher irradiation energies were used. The compounds detected in the irradiated samples suggest that diazinon is converted directly into 2-isopropyl-4-methyl-6-hydroxypyrimidine without the formation of more toxic diazoxon. This transformation involves oxidation of the sulphur atom to the sulphate anion.