Cementation of a Dual Mobility Cup Into an Existing Well-Fixed Metal Shell: A Reliable Option to Manage Wear-Related Recurrent Dislocation in Patients With High Surgical Risk.

BACKGROUND: During revision total hip arthroplasty (THA), the "double-socket" technique has been proposed as a straightforward solution in order to reduce the overall perioperative morbidity in patients with high surgical risk. However, the option of cementing a dual mobility cup into an existing well-fixed metal shell was sparsely reported. Therefore, this study aimed to evaluate the outcome of a "double-socket" technique performed with a cemented dual mobility cup in revision THA for late instability. METHODS: Twenty-eight revision THAs (28 patients) were performed for wear-related recurrent dislocation using a "double-socket" technique with a cemented dual mobility cup and retrospectively reviewed. The age at revision averaged 82 years (range 74-93). According to the American Society of Anesthesiologists (ASA) physical status classification, 12 patients (43%) were ASA II and 16 patients (57%) were ASA III before revision. RESULTS: At a mean follow-up of 3.5 years (range 2-5), the mean preoperative to postoperative functional outcome improved significantly (P < .01). The mean operative time was 107 minutes (range 75-140). The mean intraoperative bleeding was 200 mL (range 110-420). No postoperative complication, reoperation, or re-revision was reported. Importantly, no dislocation, dissociation of the cemented dual mobility cup construct, or aseptic loosening of the retained metal shell was observed. CONCLUSION: The "double-socket" technique with a dual mobility cup cemented into an existing well-fixed and well-positioned metal shell ensured a straightforward and blood-sparing revision technique that was efficient to restore stability and provide a secure acetabular construct in frail patients with high surgical risk and/or older than their natural life expectancy.

Encapsulation of Emulsion Droplets with Metal Shells for Subsequent Remote, Triggered Release.

A two-step method to encapsulate an oil core with an impermeable shell has been developed. A thin metallic shell is deposited on the surface of emulsion droplets stabilized by metal nanoparticles. This thin shell is shown to prevent diffusion of the oil from within the core of the metal-shell microcapsules when placed in a continuous phase that fully dissolves the oil. The stabilizing nanoparticles are sterically stabilized by poly(vinyl pyrrolidone) chains and are here used as a catalyst/nucleation site at the oil-water interface to grow a secondary metal shell on the emulsion droplets via an electroless deposition process. This method provides the simplest scalable route yet to synthesize impermeable microcapsules with the added benefit that the final structure allows for drastically improving the overall volume of the encapsulated core to, in this case, >99% of the total volume. This method also allows for very good control over the microcapsule properties, and here we demonstrate our ability to tailor the final microcapsule density, capsule diameter, and secondary metal film thickness. Importantly, we also demonstrate that such impermeable microcapsule metal shells can be remotely fractured using ultrasound-based devices that are commensurate with technologies currently used in medical applications, which demonstrate the possibility to adapt these microcapsules for the delivery of cytotoxic drugs.

Reconstruction of acetabular defects with porous tantalum shells and augments in revision total hip arthroplasty at ten-year follow-up.

AIMS: The use of trabecular metal (TM) shells supported by augments has provided good mid-term results after revision total hip arthroplasty (THA) in patients with a bony defect of the acetabulum. The aim of this study was to assess the long-term implant survivorship and radiological and clinical outcomes after acetabular revision using this technique. PATIENTS AND METHODS: Between 2006 and 2010, 60 patients (62 hips) underwent acetabular revision using a combination of a TM shell and augment. A total of 51 patients (53 hips) had complete follow-up at a minimum of seven years and were included in the study. Of these patients, 15 were men (29.4%) and 36 were women (70.6%). Their mean age at the time of revision THA was 64.6 years (28 to 85). Three patients (5.2%) had a Paprosky IIA defect, 13 (24.5%) had a type IIB defect, six (11.3%) had a type IIC defect, 22 (41.5%) had a type IIIA defect, and nine (17%) had a type IIIB defect. Five patients (9.4%) also had pelvic discontinuity. RESULTS: The overall survival of the acetabular component at a mean of ten years postoperatively was 92.5%. Three hips (5.6%) required further revision due to aseptic loosening, and one (1.9%) required revision for infection. Three hips with aseptic loosening failed, due to insufficient screw fixation of the shell in two and pelvic discontinuity in one. The mean Harris Hip Score improved significantly from 55 (35 to 68) preoperatively to 81 points (68 to 99) at the latest follow-up (p < 0.001). CONCLUSION: The reconstruction of acetabular defects with TM shells and augments showed excellent long-term results. Supplementary screw fixation of the shell should be performed in every patient. Alternative techniques should be considered to address pelvic disconinuity. Cite this article: Bone Joint J 2019;101-B:311-316.

BaTiO3-core Au-shell nanoparticles for photothermal therapy and bimodal imaging.

We report sub-100 nm metal-shell (Au) dielectric-core (BaTiO3) nanoparticles with bimodal imaging abilities and enhanced photothermal effects. The nanoparticles efficiently absorb light in the near infrared range of the spectrum and convert it to heat to ablate tumors. Their BaTiO3 core, a highly ordered non-centrosymmetric material, can be imaged by second harmonic generation, and their Au shell generates two-photon luminescence. The intrinsic dual imaging capability allows investigating the distribution of the nanoparticles in relation to the tumor vasculature morphology during photothermal ablation. Our design enabled in vivo real-time tracking of the BT-Au-NPs and observation of their thermally-induced effect on tumor vessels. STATEMENT OF SIGNIFICANCE: Photothermal therapy induced by plasmonic nanoparticles has emerged as a promising approach to treating cancer. However, the study of the role of intratumoral nanoparticle distribution in mediating tumoricidal activity has been hampered by the lack of suitable imaging techniques. This work describes metal-shell (Au) dielectric-core (BaTiO3) nanoparticles (abbreviated as BT-Au-NP) for photothermal therapy and bimodal imaging. We demonstrated that sub-100 nm BT-Au-NP can efficiently absorb near infrared light and convert it to heat to ablate tumors. The intrinsic dual imaging capability allowed us to investigate the distribution of the nanoparticles in relation to the tumor vasculature morphology during photothermal ablation, enabling in vivo real-time tracking of the BT-Au-NPs and observation of their thermally-induced effect on tumor vessels.

Understanding the Mechanisms of Gold Shell Growth onto Polymer Microcapsules to Control Shell Thickness.

Polymer microcapsules have been used commercially for decades, however they have an inherent flaw which renders them impractical as a carrier of small, volatile molecules. The porous nature of the polymer shell allows for diffusion of the encapsulated molecules into the bulk. The use of metal shells is an innovative way to prevent undesired loss of small molecules from the core of microcapsules, however it is important, particularly when using expensive metals to ensure that the resulting shell is as thin as possible. Here we investigate the fundamental mechanisms controlling the gold shell thickness when a fragrance oil is encapsulated in a poly(methyl methacrylate) shell. We consider the distribution of the nanoparticles on the capsule surface, and from quantification of the adsorbed nanoparticle (NP) density and resulting shell thickness, we propose mechanisms to describe the gold shell growth for systems with high and low NP surface coverage. We suggest from our observations that the gold grows to fill in the gaps between NPs. At low NP concentrations, thicker metal shells form. We postulate that this is due to the low NP density on the surface, forcing the gold clusters to grow larger before they meet the adjacent ones. Thus, to grow the thinnest possible shells a densely packed monolayer of platinum nanoparticles is required on the capsule surface.

Long-Term Retention of Small, Volatile Molecular Species within Metallic Microcapsules.

Encapsulation and full retention of small molecular weight active ingredients is a challenging task that remains unsolved by current technologies used in industry and academia. In particular, certain everyday product formulations provide difficult environments in which preventing active leakage through capsule walls is not feasible. For example, a continuous phase that can fully dissolve an encapsulated active will typically force full release over a fraction of the intended lifetime of a product. This is due to the inherent porosity of polymeric membranes typically used as capsule wall material in current technologies. In this study, we demonstrate a method for preventing undesired loss of encapsulated actives under these extreme conditions using a simple threestep process. Our developed methodology, which forms an impermeable metal film around polymer microcapsules, prevents loss of small, volatile oils within an ethanol continuous phase for at least 21 days while polymeric capsules lose their entire content in less than 30 min under the same conditions. Polymer shell-oil core microcapsules are produced using a well-known cosolvent extraction method to precipitate a polymeric shell around the oil core. Subsequently, metallic catalytic nanoparticles are physically adsorbed onto the microcapsule polymeric shells. Finally, this nanoparticle coating is used to catalyze the growth of a secondary metallic film. Specifically, this work shows that it is possible to coat polymeric microcapsules containing a model oil system or a typical fragrance oil with a continuous metal shell. It also shows that the coverage of nanoparticles on the capsule surface can be controlled, which is paramount for obtaining a continuous impermeable metal film. In addition, control over the metal shell thickness is demonstrated without altering the capability of the metal film to retain the encapsulated oils.

Current advances in precious metal core-shell catalyst design.

Precious metal nanoparticles are commonly used as the main active components of various catalysts. Given their high cost, limited quantity, and easy loss of catalytic activity under severe conditions, precious metals should be used in catalysts at low volumes and be protected from damaging environments. Accordingly, reducing the amount of precious metals without compromising their catalytic performance is difficult, particularly under challenging conditions. As multifunctional materials, core-shell nanoparticles are highly important owing to their wide range of applications in chemistry, physics, biology, and environmental areas. Compared with their single-component counterparts and other composites, core-shell nanoparticles offer a new active interface and a potential synergistic effect between the core and shell, making these materials highly attractive in catalytic application. On one hand, when a precious metal is used as the shell material, the catalytic activity can be greatly improved because of the increased surface area and the closed interfacial interaction between the core and the shell. On the other hand, when a precious metal is applied as the core material, the catalytic stability can be remarkably improved because of the protection conferred by the shell material. Therefore, a reasonable design of the core-shell catalyst for target applications must be developed. We summarize the latest advances in the fabrications, properties, and applications of core-shell nanoparticles in this paper. The current research trends of these core-shell catalysts are also highlighted.

Breakage of Metal Shell in Total Hip Replacement using CLS Expansion Press-Fit Cup: A Case Report

Acetabular metal shell breakage is very rare after a total hip replacement. We encountered one case of metal shell breakage at approximately 8 years after the total hip replacement arthroplasty using a CLS expansion cup without a trauma history. Breakage of the metal shell was confirmed during revision surgery. We report this rare case with a review of the relevant literature.

Late dissociation of the polyethylene liner from a modular acetabular metal shell after primary total hip arthroplasty: a report of five cases

Modular designs of hip prostheses have become popular recently. Along with complications inherent in all hip arthroplasty systems, modular systems have the additional potential for dissociation of components. Five male patients underwent total hip arthroplasties, in which all of the acetabular components were Harris-Galante II porous acetabular cups. Many years after the operation, the polyethylene liners were dissociated without any previous trauma or dislocation of the femoral heads, these dissociations and dislodgements were managed with open reduction. This complication can be predicted from clinical symptoms and signs. Roentgenograms must be taken and carefully compared to previous roentgenograms. We postulated two causes for the dissociation. First, the polyethylene liner was not fixed securely within the acetabular metal shell at the time of operation. Second, the locking mechanism of the acetabular metal shell was not strong enough to firmly hold the polyethylene liner within the acetabular metal shell. It does warrant that certain precautions must be taken when implanting modular components. The locking mechanism of the harris-Galante II porous acetabular component is mechanically weak and fails easily, therefore its design must be improved in an attempt to prevent postoperative dissociation of the polyethylene liner.