［Abstract］　Objective　To study the short-term outcomes of functionally aligned robotic-assisted total knee arthroplasty(FA-RTKA). Methods　A retrospective analysis was conducted on the clinical data of 94 patients(97 knees) who underwent total knee arthroplasty(TKA) in the People′s Hospital of Guangxi Zhuang Autonomous Region from March 2023 to September 2025. All the patients were divided into FA-RTKA group(46 cases, 48 knees) and conventional mechanically aligned total knee arthroplasty(MA-TKA) group(48 cases, 49 knees) according to the surgical techniques. The surgical-related indicators were compared between the two groups, including operative duration, perioperative blood loss, and the extent of soft tissue releases. The imaging evaluations were conducted according to the Coronal Plane Alignment of the Knee(CPAK) classification. The changes in arithmetic hip-knee-ankle angle(aHKA), joint-line inclination(JLO) and CPAK classification were compared between the two groups before and after surgery. The clinical outcomes were evaluated at 1, 3 and 6 months postoperatively using the American Knee Society Score(KSS) and the Forgotten Joint Score-12(FJS-12). Results　Compared with the MA-TKA group, the FA-RTKA group had significantly longer operative duration(P<0.05), less perioperative blood loss(P<0.05), and lower intraoperative soft tissue release rate(P<0.05), and the FA-RTKA group had significantly higher proportions of the patients whose JLO types and CPAK classifications after the operation kept consistent with those before the operation(P<0.05). One month after the operation, the objective KSS and subjective KSS values in the FA-RTKA group were significantly higher than those in the MA-TKA group(P<0.05). Three months after the operation, the subjective KSS and FJS-12 values in the FA-RTKA group were significantly higher than those in the MA-TKA group(P<0.05). Six months after the operation, the FJS-12 values in the FA-RTKA group were significantly higher than those in the MA-TKA group(P<0.05). Conclusion　Compared with MA-TKA, FA-RTKA can reduce perioperative blood loss and soft tissue releases, and has advantages in keeping the knee joint phenotype and JLO, thus leading to better early clinical outcomes.]]> 2026/5/29 19:40:21 SHI Zefeng, QIAN Yongcheng, SUN Ke, JIN Xianyue, WANG Xian, CAI Min 3true ［Abstract］　Objective　To compare the effects of MAKO robotic-assisted and conventional device-assisted total knee arthroplasty(TKA) on joint line(JL) height. Methods　A total of 691 patients who underwent TKA with Stryker prosthesis implantation in Peking University Third Hospital from January 2021 to December 2023 were retrospectively included in this study. The patients who received MAKO robotic-assisted TKA(611 cases) were assigned to the robotic group, and those who received conventional device-assisted TKA(80 cases) were assigned to the conventional group. The propensity score matching at a 1∶1 ratio was used to balance potential biases. After the propensity score matching, a total of 160 patients were included for statistical analysis, including 80 patients in the robotic group and 80 patients in the conventional group. The primary outcome measure was the change of postoperative JL height. The secondary outcome measures included operative duration, anesthesia duration, patellar position and lower limb alignment. Results　The operative duration and the anesthesia duration of the robotic group were longer than those of the conventional group, but there were no statistically significant differences between the two groups(P>0.05). The changes of postoperative JL height and the rate of excessive upward shifts of the postoperative JL in the robotic group were significantly lower than those in the conventional group(P<0.05). The absolute value of the postoperative JL height changes and the rate of abnormal heights in the conventional group were higher than those in the robotic group, but the differences were not statistically significant(P>0.05). There was no statistically significant difference in the incidence of abnormal patellar position between the two groups after the operation(P>0.05). There were no statistically significant differences in the deviation values and abnormal rates of the hip-knee-ankle angle, the lateral distal femoral angle and the medial proximal tibial angle between the two groups after the operation(P>0.05). Conclusion　The MAKO knee system can better restore JL height in TKA.]]> 2026/5/29 19:40:21 1,2, DONG Ziyang^1,2, WANG Xinguang^1,2, LI Yang^1,2, TIAN Hua^1,2]]> ZHENG Yuhang^1,2, DONG Ziyang^1,2, WANG Xinguang^1,2, LI Yang^1,2, TIAN Hua^1,2 2true ［Abstract］　Objective　To evaluate the accuracy of AIJOINT system in predicting component sizes for total knee arthroplasty(TKA) and to analyze the influencing factors. Methods　The clinical data of 412 patients undergoing primary TKA in Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen University from January 2025 to December 2025 were retrospectively analyzed, and artificial intelligence(AI)-based preoperative planning was performed using the AIJOINT system.The primary outcome was prediction accuracy(exact match or within ±1 size). The agreement was assessed using Cohen′s weighted Kappa(κ_w), with 95% confidence interval(CI) calculated by bootstrap resampling. Multivariate logistic regression models were constructed separately for femoral and tibial components whether their sizes were in exact matching as dependent variables, with independent variables showing P<0.10 in univariate analysis entered into the models. The variables were screened by backward stepwise selection. Results　The exact matching prediction accuracy rate was 72.8%(300/412) for femoral components［κ_w=0.752(95%CI: 0.694-0.805)］ and 70.1%(289/412) for tibial components［κ_w=0.721(95%CI: 0.662-0.773)］. The prediction accuracy for the components within ±1 size was 92.0% for femoral components and 91.0% for tibial components. The results of multivariate analysis showed that mild deformity［OR(95%CI)=8.428(4.499-15.789), P<0.001］, moderate deformity［OR(95%CI)=3.106(1.746-5.525), P<0.001］ and female sex［OR(95%CI)=2.581(1.586-4.202), P<0.001］ were independent influencing factors of exact matching prediction accuracy for femoral components, and mild deformity［OR(95%CI)=2.797(1.597-4.899), P<0.001］, moderate deformity［OR(95%CI)=1.898(1.082-3.328), P=0.025］ and female sex［OR(95%CI)=1.635(1.043-2.564), P=0.032］ were independent influencing factors of exact matching prediction accuracy for tibial components. Conclusion　AI-based preoperative planning demonstrates high accuracy in predicting component sizes for TKA in Chinese populations. Deformity severity and gender are independent influencing factors of prediction accuracy. Prediction accuracy is notably reduced in patients with severe deformity, indicating more cautious interpretation of AI predictions in clinical application.]]> 2026/5/29 19:40:21 1, MAO Guping², PAN Baiqi¹, WU Xiaoyu¹, YAO Zeyang¹, TU Yucheng¹, HAN Tieling¹, SHENG Puyi¹, ZHANG Ziji¹, LI Zhiwen¹]]> KANG Yunze¹, MAO Guping², PAN Baiqi¹, WU Xiaoyu¹, YAO Zeyang¹, TU Yucheng¹, HAN Tieling¹, SHENG Puyi¹, ZHANG Ziji¹, LI Zhiwen¹ 1true