Evaluation of unicondylar knee arthroplasty and fibulectomy from a biomechanical viewpoint / 医用生物力学

Varus deformation in knee joint is one of the common symptoms caused by unicompartment knee osteoarthritis. Currently, several operations can be used for correcting such deformation, including high tibial osteotomy, unicondylar knee arthroplasty (UKA) and fibulectomy. UKA has been developed for over 60 years, with the advantage of normal knee kinematics restored, less incision, more bony tissue preserved and larger range of motion than total knee arthroplasty (TKA). Therefore, UKA has become a reliable method for treating unicompartment knee osteoarthritis. Fibulectomy is a new kind of surgical technique for treating varus deformation in knee joint, with the advantage of simple operation, low cost and fast recovery. At present, fibulectomy has been widely applied, but its treatment mechanism is still not clear. In this review, two clinical operations UKA and fibulectomy were summarized, and the possible mechanism of fibulectomy for treating unicompartment knee osteoarthritis was proposed from the viewpoint of biomechanics. The author hypothesized that reduction in lateral muscle force after fibulectomy would cause rebalance of the resultant joint moment, therefore, the change of joint contact position and the decrease in joint contact force might be the cause of fibulectomy to release the pain for knee osteoarthritis patients.

Regularity on change of retinal nerve fiber layer thickness with acute high intraocular pressure / 医用生物力学

Objective To measure the rabbit retinal nerve fiber layer(RNFL) thickness in vivo under different intraocular pressures (IOP) and at different time intervals after acute high IOP, and to obtain the regularity on change of RNFL thickness with acute high IOP. Methods Four groups of acute high IOP model were formed by perfusing the saline water into the anterior chamber of rabbit eyes, then RNFL thickness under different IOPs was measured by optical coherence tomography with radial scanning mode whose center was optical papilla and diameter was 6 mm. Results The absolute change values of RNFL thickness were(-27.16±14.24), (-33.33±6.74), (-48.75±5.24), (-67.29±3.89) μm under different IOPs of (4.50±0.35), (6.07±0.31), (7.74±0.26), (10.71±0.07) kPa, respectively. The linear relationship was found between the relative change of RNFL thickness and IOP. IOP could return to the normal level within two days after acute high IOP, while the RNFL thickness could be restored at the second week, and it was easier to restore if the IOP was lower than 6.65 kPa. Conclusions The acute high IOP could cause RNFL thickness to decrease significantly with the increased acute high IOP, but it will be restored after some time.