The aim of this study was to assess medium term results of patellar resurfacing in total knee arthroplasty, specifically looking at anterior knee pain, patellofemoral function and need for reoperation. A prospective cohort study was conducted with patients undergoing staged bilateral knee arthroplasty with the patella being resurfaced only on one side. This was due to change in the clinical practice of the senior author. Sixty patients were reviewed clinically and radiologically on a regular basis. The surgery was either performed or supervised by the senior author in all cases. All patients received the cemented press-fit condylar© prosthesis. The Knee Society clinical rating system was used. Scores were recorded pre-operatively and post-operatively at three months, one year, two years and three yearly thereafter. The mean age of patients in the study group was 75 years (range: 62-89 years). There were 42 women and 18 men in the study. The mean duration of follow-up was 4.5 years (range: 2-12 years). There was no significant difference in the pre-operative scores in both groups. There were significantly better scores (p < 0.05) on the resurfaced side as compared to the non-resurfaced side at final follow-up. No revision was carried out for patellofemoral complications on the resurfaced side. Four patients required revision in the form of patellar resurfacing on the non-resurfaced side for persistent anterior knee pain. Patellar resurfacing is recommended in total knee arthroplasty for better functional outcome with regards to anterior knee pain and patellofemoral function.
A popliteal block in conjunction with an ankle block provides significantly better pain relief than does an ankle block alone in patients undergoing forefoot surgery.
Lab-on-a-chip devices based on inertial microfluidics have emerged as a promising technique to manipulate particles in a precise way. Here, we study the coupled dynamics of soft-particle pairs.
Flows at moderate Reynolds numbers in inertial microfluidics enable high throughput and inertial focusing of particles and cells with relevance in biomedical applications. In the present work, we consider a viscosity-stratified three-layer flow in the inertial regime. We investigate the interfacial instability of a liquid sheet surrounded by a density-matched but more viscous fluid in a channel flow. We use linear stability analysis based on the Orr–Sommerfeld equation and direct numerical simulations with the lattice Boltzmann method (LBM) to perform an extensive parameter study. Our aim is to contribute to a controlled droplet production in inertial microfluidics. In the first part, on the linear stability analysis we show that the growth rate of the fastest growing mode $$\xi ^{*}$$ ξ ∗ increases with the Reynolds number $$\text {Re}$$ Re and that its wavelength $$\lambda ^{*}$$ λ ∗ is always smaller than the channel width w for sufficiently small interfacial tension $$\Gamma $$ Γ . For thin sheets we find the scaling relation $$\xi ^{*} \propto mt^{2.5}_{s}$$ ξ ∗ ∝ m t s 2.5 , where m is viscosity ratio and $$t_{s}$$ t s the sheet thickness. In contrast, for thicker sheets $$\xi ^{*}$$ ξ ∗ decreases with increasing $$t_s$$ t s or m due to the nearby channel walls. Examining the eigenvalue spectra, we identify Yih modes at the interface. In the second part on the LBM simulations, the thin liquid sheet develops two distinct dynamic states: waves traveling along the interface and breakup into droplets with bullet shape. For smaller flow rates and larger sheet thicknesses, we also observe ligament formation and the sheet eventually evolves irregularly. Our work gives some indication how droplet formation can be controlled with a suitable parameter set $$\{\lambda ,t_{s},m,\Gamma ,\text {Re}\}$$ { λ , t s , m , Γ , Re } . Graphical Abstract
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