Composite Photocatalysts with Fe, Co, and Ni Oxides on Supports with Tetracoordinated Ti Embedded into Aluminosilicate Gel during Zeolite Y Synthesis

Ti-aluminosilicate gels were used as supports for the immobilization of Fe, Co, and Ni oxides (5%) by impregnation and synthesis of efficient photocatalysts for the degradation of β-lactam antibiotics from water. Titanium oxide (1 and 2%) was incorporated into the zeolite network by modifying the gel during the zeolitization process. The formation of the zeolite Y structure and its microporous structure were evidenced by X-ray diffraction and N2 physisorption. The structure, composition, reduction, and optical properties were studied by X-ray diffraction, H2-TPR, XPS, Raman, photoluminescence, and UV-Vis spectroscopy. The obtained results indicated a zeolite Y structure for all photocatalysts with tetracoordinated Ti4+ sites. The second transitional metals supported by the post-synthesis method were obtained in various forms, such as oxides and/or in the metallic state. A red shift of the absorption edge was observed in the UV-Vis spectra of photocatalysts upon the addition of Fe, Co, or Ni species. The photocatalytic performances were evaluated for the degradation of cefuroxime in water under visible light irradiation. The best results were obtained for iron-immobilized photocatalysts. Scavenger experiments explained the photocatalytic results and their mechanisms. A different contribution of the active species to the photocatalytic reactions was evidenced.

Co- and Ni-Doped TiO2 Nanoparticles Supported on Zeolite Y with Photocatalytic Properties

Zeolite Y samples with microporous and hierarchical structures containing Ti-Ni and Ti-Co oxides were obtained as active photocatalysts. Different Ti amounts (5, 10% TiO2) were supported, followed by the loading of Ni or Co oxides (5%). X-ray diffraction evidenced the presence of TiO2 as an anatase. N2 adsorption-desorption results showed type IV isotherms for hierarchical zeolite Y samples, and a combination of type IV and I isotherms for zeolite Y samples. UV-Vis diffuse reflectance spectra showed a shift in the absorption band to visible with increasing Ti loading and especially after Co and Ni addition. A significant effect of the support was evidenced for Ti and its interaction with Co/Ni species. The zeolite Y support stabilized Ti in the 4+ oxidation state while hierarchical zeolite Y support favored the formation of Ti3+ species, Ni0 and Ni2+ and the oxidation of Co to 3+ oxidation state. Photocatalytic activity, under UV and visible light irradiation, was evaluated by the degradation of amoxicillin, used as a model test. The photocatalytic mechanism was investigated using ethanol, p-benzoquinone and KI as ·OH and ·O2- radicals and hole (h+) scavengers. The best results were obtained for the immobilized Ni-Ti species on the hierarchical zeolite Y support.

TiO2-SiO2 Self-Standing Materials bearing Hierarchical Porosity: MUB-200(x) Series toward 3D-Efficient VOC Photoabatement Properties

Three-dimensional photoactive self-standing porous materials have been synthesized through the integration of soft chemistry and colloids (emulsions, lyotrope mesophases, and P25 titania nanoparticles). Final multiscale porous ceramics bear 700-1000 m² g^-1 of micromesoporosity depending on the P25 nanoparticle contents. The applied thermal treatment does not affect the P25 anatase/rutile allotropic phase ratio. Photonic investigations correlated with the foams' morphologies suggest that the larger amount of TiO₂ that is introduced, the larger the walls' density and the smaller the mean size of the void macroscopic diameters, with both effects inducing a reduction of the photon transport mean free path (l_t) with the P25 content increase. A light penetration depth in the range of 6 mm is reached, thus depicting real 3D photonic scavenger behavior. The 3D photocatalytic properties of the MUB-200(x) series, studied in a dynamic "flow-through" configuration, show that the highest photoactivity (concentration of acetone ablated and concentration of CO₂ formed) is obtained with the highest monolith height (volume) while providing an average of 75% mineralization. These experimental results validate the fact that these materials, bearing 3D photoactivity, are paving the path for air purification operating with self-standing porous monolith-type materials, which are much easier to handle than powders. As such, the photocatalytic systems can now be advantageously miniaturized, thereby offering indoor air treatment within vehicles/homes while drastically limiting the associated encumbrance. This volumetric counterintuitive acting mode for light-induced reactions may find other relevant advanced applications for photoinduced water splitting, solar fuel, and dye-sensitized solar cells while both optimizing photon scavenging and opening the path for the miniaturization of the processes where encumbrance or a foot-print penalty would be advantageously circumvented.

Site directed confinement of laccases in a porous scaffold towards robustness and selectivity

We immobilized a fungal laccase with only two spatially close lysines available for functionalization into macrocellular Si(HIPE) monoliths for the purpose of continuous flow catalysis. Immobilization (30-45 % protein immobilization yields) was obtained using a covalent bond forming reaction between the enzyme and low glutaraldehyde (0.625 % (w/w)) functionalized foams. Testing primarily HBT-mediated RB5 dye decolorization in continuous flow reactors, we show that the activity of the heterogeneous catalyst is comparable to its homogeneous counterpart. More, its operational activity remains as high as 60 % after twelve consecutive decolorization cycles as well as after one-year storage, performances remarkable for such a material. We further immobilized two variants of the laccase containing a unique lysine: one located in the vicinity of the substrate oxidation site (K157) and one at the opposite side of this oxidation site (K71) to study the effect of the proximity of the Si(HIPE) surface on enzyme activity. Comparing activities on different substrates for monoliths with differentially oriented catalysts, we show a twofold discrimination for ABTS relative to ascorbate. This study provides ground for the development of neo-functionalized materials that beyond allowing stability and reusability will become synergic partners in the catalytic process.

Amorphous mesostructured zirconia with high (hydro)thermal stability

Here, combining the evaporation-induced self-assembly (EISA) method and the liquid crystal templating pathway, mesostructured amorphous zirconium oxides have been prepared by a soft templating method without addition of any heteroelement to stabilize the mesopore framework. The recovered materials have been characterized by SAXS measurements, nitrogen adsorption–desorption analysis and X-ray diffraction (XRD). The obtained mesostructured zirconia exhibits a high thermal stability. An in situ XRD study performed as a function of temperature shows that the amorphous ZrO₂, obtained after removal of the pore templating agent (pluronic P123), begins to crystallize in air from 420 °C. Amorphous mesostructured ZrO₂ also presents a high hydrothermal stability; these materials are not degraded after 72 hours in boiling water.

Amorphous mesostructured zirconia with high thermal stability and hydrothermal stability in boiling water has been obtained without addition of stabilizer.

Nonionic Fluorinated Surfactant Removal from Mesoporous Film Using sc-CO2

Surfactant templated silica thin films were self-assembled on solid substrates by dip-coating using a partially fluorinated surfactant R₈^F(EO)₉ as the liquid crystal template. The aim was 2-fold: first we checked which composition in the phase diagram was corresponding to a 2D rectangular highly ordered crystalline phase and second we exposed the films to sc-CO₂ to foster the removal of the surfactant. The films were characterized by in situ X-ray reflectivity (XRR) and grazing incidence small angle X-ray scattering (GISAXS) under CO₂ pressure from 0 to 100 bar at 34 °C. GISAXS patterns reveal the formation of a 2-D rectangular structure at a molar ratio R₈^F(EO)₉/Si equal to 0.1. R₈^F(EO)₉ micelles have a cylindrical shape, which have a core/shell structure ordered in a hexagonal system. The core contains the R₈^F part and the shell is a mixture of (EO)₉ embedded in the silica matrix. We further evidence that the extraction of the template using supercritical carbon dioxide can be successfully achieved. This can be attributed to both the low solubility parameter of the surfactants and the fluorine and ethylene oxide CO₂-philic groups. The initial 2D rectangular structure was well preserved after depressurization of the cell and removal of the surfactant. We attribute the very high stability of the rinsed film to the large value of the wall thickness relatively to the small pore size.

Insights into the Formation and Properties of Templated Dual Mesoporous Titania with Enhanced Photocatalytic Activity

The one pot synthesis of dual mesoporous titania (2.3 and 7.7 nm) has been achieved from a mixture of fluorinated and Pluronic surfactants. The small and large mesopore networks are templated, respectively, by a fluorinated-rich liquid crystal and a Pluronic-rich liquid crystal, which are in equilibrium. After calcination at 350 °C, the amorphous walls are transformed into semicrystalline anatase preserving the mesoporous structure. Results concerning the photodegradation of methyl orange using the calcined photocatalysts highlight that the kinetic rate constant (k) determined for the dual mesoporous titania is 2.6 times higher than the k value obtained for the monomodal ones.

Influence of the porous texture of SBA-15 mesoporous silica on the anatase formation in TiO2–SiO2 nanocomposites

TiO₂–SiO₂ composites with 44 wt% of anatase exhibit a better MO degradation rate than those with fully crystallized anatase.

A meso-macro compartmentalized bioreactor obtained through silicalization of “green” double emulsions: W/O/W and W/SLNs/W

We report a straightforward approach for both structuring and entrapping enzymes into hierarchical silica materials with hexagonally ordered mesopores and tailored macroporosity by converting a double emulsion colloidal template into solid lipid nanoparticles.

Formation of nanostructured silica materials templated with nonionic fluorinated surfactant followed by in situ SAXS

The formation of two-dimensional (2D)-hexagonal (p6m) silica-based hybrid materials from concentrated micellar solutions (10 wt %) of two nonionic fluorinated surfactants, R(7)(F)(EO)(8) and R(8)(F)(EO)(9), is investigated in situ using synchrotron time-resolved small angle X-ray scattering (SAXS). The two surfactants form direct micelles with different structures prior to the silica precursor addition as demonstrated by SAXS and SANS. R(8)(F)(EO)(9) gives spherical micelles and R(7)(F)(EO)(8) more complex ones, modeled here as short wormlike micelles. The in situ SAXS experiments reveal that both surfactants form well-ordered 2D-hexagonal hybrid materials after the addition of the silica precursor, in coexistence with an excess of surfactant micelles. The structures of both 2D-hexagonal phases are compared just after precipitation, and it is found that more robust and larger silica walls are formed for R(8)(F)(EO)(9) than for R(7)(F)(EO)(8). This could explain why only the material obtained with R(8)(F)(EO)(9) is stable upon washing, as observed previously. Moreover, it is proposed that in both cases, only a part of the micelles interact with the silica oligomers and undergo structural modifications before forming the 2D-hexagonal mesophase. The obtained results are finally discussed in the more general framework of the templating mechanism for nonionic surfactants.

Triblock siloxane copolymer surfactant: template for spherical mesoporous silica with a hexagonal pore ordering

Ordered mesoporous silica materials with a spherical morphology have been prepared for the first time through the cooperative templating mechanism (CTM) by using a silicone triblock copolymer as template. The behavior of the pure siloxane copolymer amphiphile in water was first investigated. A direct micellar phase (L(1)) and a hexagonal (H(1)) liquid crystal were found. The determination of the structural parameters by SAXS measurements leads us to conclude that in the hexagonal liquid crystal phase a part of the ethylene oxide group is not hydrated as observed for the micelles. Mesoporous materials were then synthesized from the cooperative templating mechanism. The recovered materials were characterized by SAXS measurements, nitrogen adsorption-desorption analysis, and transmission and scanning electron microscopy. The results clearly evidence that one can control the morphology and the nanostructuring of the resulting material by modifying the synthesis parameters. Actually, highly ordered mesoporous materials with a spherical morphology have been obtained with a siloxane copolymer/tetramethoxysilane molar ratio of 0.10 after hydrothermal treatment at 100 °C. Our study also supports the fact that the interactions between micelles and the hydrolyzed precursor are one of the key parameters governing the formation of ordered mesostructures through the cooperative templating mechanism. Indeed, we have demonstrated that when the interactions between micelles are important, only wormhole-like structures are recovered.

Tailored jeffamine molecular tools for ordering mesoporous silica

Herein, we report the formation of organized mesoporous silica materials prepared from a novel nonionic gemini surfactant, myristoyl-end-capped Jeffamine, synthesized from a polyoxyalkyleneamine (ED900). The behavior of the modified Jeffamine in water was first investigated. A direct micellar phase (L(1)) and a hexagonal (H(1)) liquid crystal were found. The structure of the micelles was investigated from the SAXS and the analysis by generalized indirect Fourier transformation, which show that the particles are globular of core-shell type. The myristoyl chains, located at the ends of the amphiphile molecule, are assembled to form the core of the micelles and, as a consequence, the molecules are folded over on themselves. Mesoporous materials were then synthesized from the self-assembly mechanism. The recovered materials were characterized by SAXS measurements, nitrogen adsorption-desorption analysis, and transmission and scanning electron microscopy. The results clearly evidence that by modifying the synthesis parameters, such as the surfactant/silica precursor molar ratio and the hydrothermal conditions, one can control the size and the nanostructuring of the resulting material. It was observed that, the lower the temperature of the hydrothermal treatment, the better the mesopore ordering.

Identification of Ras, Pten and p70S6K homologs in the Pacific oyster Crassostrea gigas and diet control of insulin pathway

Insulin pathways were demonstrated from invertebrates to vertebrates to be involved in the regulation of numerous processes including storage metabolism and reproduction. In addition, insulin system may integrate variations of environmental conditions like dietary restrictions. In the Pacific oyster Crassostrea gigas, reproductive and storage compartments are closely intricated in the gonadal area and their respective development was found to be dependant of trophic conditions. For these reasons, C. gigas is an original and interesting model for investigating the role of insulin control in the balance between storage and reproduction and the integration of environmental parameters. On the basis of sequence conservation, we identified three potential elements of the oyster insulin pathway, Ras, Pten and p70S6K and we investigated their expression levels in various tissues. In the gonadal area, we used laser microdissection in order to precise the targeted contribution of insulin signaling to the restoration of storage tissue and to the control of vitellogenesis. Food deprivation during gametogenesis reinitiation stage led to reduced proliferations of gonia and also to modulate insulin signal by transcriptional activation of insulin pathway elements.

Coexistence of two kinds of fluorinated hydrogenated micelles as building blocks for the design of bimodal mesoporous silica with two ordered mesopore networks

A simple and effective route has been developed for the synthesis of bimodal (3.6 and 9.4 nm) mesoporous silica materials that have two ordered interconnected pore networks. Mesostructures have been prepared through the self-assembly mechanism by using a mixture of polyoxyethylene fluoroalkyl ether and triblock copolymer as building blocks. The investigation of the R(F)(8)(EO)(9)/P123/water phase diagram shows that in the considered surfactant range of concentrations the system is micellar (L(1)). DLS measurements indicate that this micellar phase is composed of two types of micelles; the size of the first one at around 7.6 nm corresponds unambiguously to the pure fluorinated micelles. The second type of micelles at higher diameter consists of fluorinated micelles that have accommodated a weak fraction of P123 molecules. Thus, in this study the bimodal mesoporous silica is really templated by two kinds of micelles.

Water behavior in mesoporous materials as studied by NMR relaxometry

Water in mesoporous materials possessing a two-dimensional hexagonal structure has been studied by the variation of its NMR longitudinal relaxation time T(1) as a function of the static magnetic field value, or equivalently of the NMR measurement frequency. This technique, dubbed relaxometry, has been applied from 5 kHz (measurement frequency) up to 400 MHz with various instruments including a variable-field spectrometer operating between 8 and 90 MHz. Moreover, the range 0-5 kHz could be investigated by transverse relaxation, T(2) denoting the corresponding relaxation time, and relaxation in the rotating frame, T(1ρ) denoting the corresponding relaxation time. Measurements of proton relaxation rates (inverse of relaxation times) have been performed with H(2)O and HOD (residual protons of heavy water) at water volumes of 80%, 60%, and 40% relative to the porous volume. Comparison between H(2)O and HOD shows clearly that, above 1 MHz where both sets of data are superposed, relaxation is purely intermolecular and due to paramagnetic relaxation (dipolar interactions of water protons with unpaired electrons of paramagnetic entities). Below 1 MHz, it is possible to subtract the intermolecular contribution (given by HOD data) from H(2)O data so that one is left with intramolecular relaxation which is solely due to water reorientational motions. The analysis of these low-frequency data (in terms of Lorentzian functions) reveals two types of water within the pores: one interacting strongly with the surface and the other corresponding to a second layer. High-frequency data, which arise from paramagnetic relaxation, exhibit again two types of water. Due to their correlation times, one type is assigned to relatively free water within the pores while the other type corresponds to bulk (interparticular) water. Their proportions, given as a function of the volume fraction, are consistent with the above assignments.

TiO2 thin films self-assembled with a partly fluorinated surfactant template

New TiO(2) films have been self-assembled on solid substrate by dip-coating using TiCl(4) as the titanium source and the partly fluorinated surfactant F(CF(2))(8)C(2)H(4)(OC(2)H(4))(9)OH as the liquid crystal template. By control over the dip-withdrawal speed, film thicknesses from a minimum of 43 nm were produced with rms roughnesses of 0.5-0.7 nm. The films were characterized by X-ray reflectivity, grazing incidence small-angle X-ray scattering, atomic force microscopy, contact angle measurements, and Raman spectroscopy. Their GI-SAXS patterns are characteristic of a 2-D hexagonal structure in which tubular rods of the fluorinated surfactant are packed hexagonally and aligned parallel to the substrate. Reflectivity and contact angle measurements of the as-prepared film indicate that a low-density hydrophilic TiO(2) surface presents to the air.

Relation between the lower consolute boundary and the structure of mesoporous silica materials

In this study, we have shed some light on the relation between the position of the lower consolute boundary of various nonionic surfactants in water and the structure of the mesoporous silica materials synthesized from these surfactants-based systems. In the first part, the lower consolute boundary was shifted by adding salts. Depending on the features of the phase diagram, we have looked for either a salting out or a salting in effect. Mesoporous materials were prepared from a micellar solution of the investigated surfactants. Results clearly evidenced that the cooperative self-assembly mechanism is not favored if the lower consolute boundary is not shifted toward high temperatures. Moreover, the higher the difference between the phase separation temperature and the temperature at which the silica precursor is added to the surfactant solution, the better the mesopore ordering is. In the second part, this tendency has been confirmed by using a hydrogenated surfactant as additive.

Design of ordered bimodal mesoporous silica materials by using a mixed fluorinated-hydrogenated surfactant-based system

Mesoporous silica materials have been prepared using aqueous solutions of hydrogenated-fluorinated surfactant mixtures. The phase behavior of the C18H35(OC2H4)10-C6F15C2H4(OC2H4)11OH [RH18(EO)10-RF6(EO)11] mixture in aqueous solution was first established at the temperature at which the silica source is added, i.e., 20 or 40 degrees C. We have delimited the different phase domains. Concerning the mesostructured silica, whatever the temperature at which the silica source is added, mesoporous material with a hexagonal array of their channel is formed via a cooperative templating mechanism (CTM), if the content of RF6(EO)11 in the surfactant mixture is lower than 50%. Moreover, when the silica source is added at 40 degrees C, the recovered materials exhibit a bimodal pore size distribution. The appearance of this bimodality has been related to the coexistence of hydrogenated micelles with fluorinated wormlike micelles. By contrast, the bimodality is not observed when the silica source is added at 20 degrees C.

Solubilization of Various Fluorocarbons in a Fluorinated Surfactant/Water System: Relation with the Design of Porous Materials

We have investigated the phase behavior of the R(F)(7)(EO)(8) surfactant in water as well as the effect of the solubilization of various fluorocarbons in this system. Results show that the cloud point (CP) curve is shifted to high temperatures upon addition of fluorocarbons, following the sequence 1-bromo-perfluorooctane (PFOB) < perfluorodecalin (PFD) < perfluorooctane (PFO). The values of the phase inversion temperature (PIT) associated with these systems increase in the same order: PFOB approximately 65 degrees C, PFD approximately 82 degrees C, and PFO > 90 degrees C. Starting from these systems, we have prepared mesoporous and hierarchical porous materials. The formation of the ordered mesoporous materials has been related to the CP curve. Indeed, our results show that mesoporous materials with a high degree of ordering are obtained from systems whose CP curve is shifted toward high temperatures. We have also correlated the formation of the hierarchical porous silica to the PIT. It appears that the design of macro-mesoporous materials is favored with systems that exhibit a high value of the PIT.

Mixed fluorinated–hydrogenated surfactant-based system: Preparation of ordered mesoporous materials

We have investigated a mixed fluorinated-hydrogenated surfactant-based system [C8F17C2H4(OC2H4)9-C12H25(OC2H4)8] in water. The phase diagram exhibits that the micellar domain can be divided into three parts: above 80 wt% of water both hydrogenated and fluorinated surfactants are completely miscible and they formed mixed micelles in all proportion. When the water concentration is decreased from 80 to 60 wt% a gap of miscibility appears and two micellar zones, one fluorocarbon-rich micelles and one hydrocarbon-rich micelles are observed. The liquid crystal domain is composed of one fluorocarbon-rich (H(F)(1)) and one hydrocarbon-rich (H(H)(1)) hexagonal phase. The hydrophobic radius and the cross-sectional area remain constant in the H(H)(1) and in the H(F)(1) domains. Moreover, SAXS measurements proved that the hydrophobic chains in the liquid crystal phases adopt rather an extended conformation. Then the mixture of surfactants was used as template for the preparation of mesoporous materials. Mesostructured silicas with a well hexagonal array of their channels were prepared via a cooperative templating mechanism (CTM), if the loading of fluorinated surfactant is larger than 50%. Decreasing the proportion of the fluorinated amphiphile in the mixture leads to the formation of mesoporous silica with a disordered structure. In this case the channel arrangement is no longer governed by the fluorinated surfactant but by the hydrogenated one.

Cloud point curve of nonionic surfactant related to the structures of mesoporous materials

We have investigated the phase behavior of a fluorinated surfactant R(7)(F)(EO)(7) in water. The cloud point is situated at 19 degrees C for 2 wt% of surfactant. Using this surfactant, mesoporous materials have been synthesized with micellar solution prepared either at 10 degrees C (below the cloud point) or at 40 degrees C (above the cloud point). Results show that whatever the syntheses conditions, only wormhole-like structure is recovered. The effect of perfluorodecalin addition on the fluorinated surfactant/water system was also investigated. Swollen micelles, microemulsion, and lamellar (L(alpha)) liquid crystals were identified. When perfluorodecalin is added, the cloud point is shifted toward higher temperature. As regards the mesoporous syntheses, perfluorodecalin plays a dual role. First, incorporation of perfluorodecalin leads to the formation of well ordered materials. Secondly, the pore size enlargement occurs when perfluorodecalin is added. Our results evidence that the ratio between the volume of the hydrophilic headgroup (V(H)) and the hydrophobic part (V(L)) of the surfactant is not an efficiency parameter to explain the ordering improvement of mesoporous materials and that we should rather consider the existence of the cloud point curve, which disturbs the cooperative templating mechanism (CTM).

Nonionic fluorinated surfactant: investigation of phase diagram and preparation of ordered mesoporous materials

The behavior of fluorinated surfactant F(CF2)8C2H4(OC2H4)9OH in water solution was investigated, and the preparation ofmesoporous molecular sieves was achieved. A direct micellar phase (L1) and a hexagonal (H1) liquid crystal were found. Small-angle X-ray scattering measurements proved that the hydrophobic chains are completely extended and that the cross sectional area remains constant in H1. At 80 degrees C, materials with a hexagonal array of their channel are prepared via a cooperative templating type mechanism in a wide range of surfactant concentrations (5-20 wt %). Decreasing the hydrothermal temperature leads to the formation ofwormhole-like structure. In this case the channel arrangement is no longer governed by the surfactant behavior but by the silica condensation and polymerization. An increase of the mean pore diameter with heating temperature is noted. This result is associated with changes of aggregation number with temperature. A comparison of the characteristics of the materials obtained with both hydrogenated and fluorinated surfactants is also made.

One-pot surfactant assisted synthesis of aluminosilicate macrochannels with tunable micro- or mesoporous wall structure

A one-step surfactant assisted synthesis pathway was developed leading to novel hierarchical macro-meso- (or micro-)porous aluminosilicates made of an assembly of macrochannels with openings between 0.5 and 2.0 microm and wormhole-like amorphous walls with tunable pore sizes.

Design of bimodal mesoporous silicas with interconnected pore systems by ammonia post-hydrothermal treatment in the mild-temperature range

Bimodal (4 and 8 nm) mesoporous silicas with interconnected three-dimensional structure were synthesized by mild-temperature post-synthesis hydrothermal treatment of MCM-41 mesoporous materials in ammonia solution.

Arthroscopic treatment of pigmented villonodular synovitis of the shoulder

Pigmented villonodular synovitis (PVNS) rarely affects the shoulder. Fewer than 30 cases have been reported in the English and French language literature. In those patients, PVNS was treated by open surgery involving total or local synovectomy, sometimes associated with total shoulder replacement, cuff tear repair, or arthroplastic head resection. The authors report 2 cases of PVNS of the shoulder treated arthroscopically and discuss the advantages and limitations of this technique in the treatment of shoulder PVNS.

[Arthroscopic meniscectomy with Ho-Yag laser versus mechanical meniscectomy. Mid-term results of a randomized prospective study of 80 meniscectomies]

INTRODUCTION

The theoretical advantages of the Ho-Yag laser make it the ideal instrument for current use in arthroscopic meniscectomy. Short term results showed less patient discomfort, rapid recovery and less post operative pain and swelling. The purpose of this single blind prospective randomized study was to compare the results of arthroscopic meniscectomy performed mechanically to those obtained with the Ho-Yag laser, with a minimum follow up of one year.

MATERIALS AND METHODS

Eighty meniscectomies in 76 patients were included with a mean follow up of 19.5 months (extremes 12-35 months). The mean age was 42.5 years (extremes 18-65 years). The laser group included 39 patients while the mechanical group included 37 patients. In the Ho-Yag laser group, energy never exceeded 30 watts. During arthroscopic meniscectomy, no other surgical procedure was allowed i.e. chondroplasty, ligament surgery. Prior to arthroscopy, all patients underwent a clinical evaluation including: Pain and Lysholm score assessment. This was repeated in the post operative period at the 10th, 30th day and at last follow up. 37 patients also had a standard X ray at last follow up (anterior-posterior, lateral, and schuss views).

RESULTS

No statistically significant difference was observed in global clinical results between both techniques. Even if mechanical meniscectomy showed better results, the laser remained best when used in degenerative medial meniscal tears with minimal cartilaginous lesions. In degenerative medial meniscal tears with severe cartilaginous lesions, mechanical meniscectomy showed significantly better results (p = 0.048). X ray control was normal in 47 p. 100 of the laser group and in 80 p. 100 of the mechanical group. The difference was statistically significant (p = 0.038). Narrowing of the joint space was observed in 45 p. 100 of laser group and in 18 p. 100 of mechanical group. Iterative arthroscopy was necessary in 4 cases (3 laser and 1 mechanical) for residual pain. Severe chondrolysis was present in 2 cases following laser meniscectomy. In the 2 other cases a complement of meniscectomy for residual lesions allowed good results. No bony necrosis was observed after laser meniscectomy.

CONCLUSION

According to the results of this study and the high cost of the laser, we do not recommend the laser as a routine technique for arthroscopic meniscectomy.

Wrist arthroscopy and dislocation of the radiocarpal joint without fracture

The authors report a rare case of dorsal dislocation of the radiocarpal joint without any bony lesion associated. The traumatic cause was a high energy motorbike accident. Fractures of the other limbs were associated. The authors report the clinical, radiological, and arthroscopic features. Wrist arthroscopy showed a complete tear of all the extrinsic ligaments, a radial avulsion of the triangular fibrocartilage complex, and the integrity of the intracarpal ligaments, which guided the treatment. The dislocation was treated by closed reduction and radiocarpal pinning. The authors propose wrist arthroscopy in radiocarpal dislocation for diagnosis of soft tissue and cartilaginous lesions to guide the treatment (close or open).

[Osteosynthesis under arthroscopic control of separated tibial plateau fractures. 26 case reports]

PURPOSE OF THE STUDY

Arthroscopic treatment of tibial plateau fractures may reduce morbidity compared to open articular surgery. But bony fixation is necessarily percutaneous and minimal. The purpose of our study was not only to assess immediate results but also long term functional and anatomic results after arthroscopic treatment of tibial plateau fractures, with special reference to radiographical results.

MATERIAL AND METHODS

Twenty-six patients (mean age 42 years, range 18 to 70 years, 17 men, 9 women) were arthroscopically treated for a fresh tibial plateau fracture. According to Schatzker classification, there was 2 type I, 17 type II, 6 type III and 1 type IV. No type V or VI were treated in this series. The fixation device was: percutaneous cannulated screw in 23 cases, Kirchner wire in 2 cases, and bone cement filing of the fracture site in 1 case. We did not use cancellous bone graft but we used a hydroxyapatite plug in one case. There were 8 meniscal injuries: 2 underwent arthroscopic suture, 1 had partial meniscectomy and 5 were left in place. Twenty-six cases were suitable for immediate post op follow up. 19 were reviewed at long term. A clinical (Knee Society scoring system) and radiographical examination were done with an average follow-up of 32.7 months.

RESULTS

There were no complications except one immediate postoperative septic osteoarthritis (case with hydroxyapatite plug) and one bony depression of the lateral tibial plateau at the fourth month. Passive motion of the knee started at 1.8 days postop with no pain. Mean flexion at 3 months was 130 degrees. At revision, the average score was: 94.1 for the knee, 94.7 for the function. In two cases we found early signs of osteoarthrosis. There were no secondary bony depression or significant valgus deformity on X-rays.

CONCLUSION

Arthroscopic management of tibial plateau fractures allows a complete articular screening. Rapid rehabilitation, short hospital stay, and low rate of complications reduce morbidity. The long term results are as good as those with open surgical technique for the types of fracture that we have treated (type III and IV). A minimal, percutaneous osteosynthesis which was the only possibility under arthroscopic control, did not modify the anatomical results.

[Arthroscopic management of recurrent anterior shoulder dislocation by combining a labrum suture with antero-inferior holmium:YAG laser capsular shrinkage]

Current arthroscopic treatments do not address satisfactorily the capsular redundancy frequently associated with the Bankart lesion in recurrent anterior dislocation. Although the Bankart lesion heals, many of the recurrences after arthroscopic procedures are due to capsular redundancy and the laxity of glenohumeral ligaments. We propose that laser-assisted capsular shrinkage (LACS) be combined with arthroscopic labrum reattachment. As shown by Market et al., significant capsular shrinkage can be achieved by the application of non-ablative Ho:YAG laser energy without detrimental effects to the relaxation properties of the tissue. For 1 year we have used LACS together with labrum suture in 18 shoulders in 18 patients (mean age 24.6 years). All patients suffered from chronic anterioinferior recurrent dislocation. The labrum suture was realized by an anterior reattachment (REVO screws, Linvatec, USA) or by transglenoid suture. Two or three sutures were passed through the torn labrum with 2/0 non-absorbable suture material. The LACS procedure was performed with a holmium:YAG laser (VersaPulse, Coherent, USA) at an energy of 10 W (1 J, 10 Hz) with a 30 degrees curved handpiece. All patients were immobilized in a sling for 4 weeks postoperatively. Physical therapy was begun at 1 month with passive and active exercise. To date, none of the patients have had a recurrence. Seven of 18 patients returned to their previous sports activity, and at the same level. None of the patients had an iatrogenic lesion due to the laser application or labrum suture. Compared to the other shoulder, the loss of external rotation with the arm 90 degrees abducted was 30 degrees at 4 weeks and 10 degrees at 4 months. We think that the LACS procedure is a good treatment for the capsular redundancy that is frequently associated with Bankart's lesion in recurrent anterior dislocation and is probably responsible for the high failure rate in current arthroscopic procedures. Our results are short-term results, but we expect the capsular shrinkage associated with the labrum reattachment will provide a long-term success rate that is comparable to open procedures.