Objective:To investigate the precise advantages of robot-assisted total knee arthroplasty(RATKA)in reconstruction of mechanical axis of lower limb,and its influence on early functional rehabilitation.Methods:A prospective cohort design was used.A total of eighty patients with osteoarthritis who underwent total knee arthroplasty(TKA)at the Department of Joint Surgery of The People's Hospital of Suzhou New District between June 2021 and August 2024 were enrolled.According to different surgical method,they were divided into robot-assisted group(n=40)and conventional surgery group(n=40).The deviation angles of mechanical axis were quantified by three-dimensional(3D)imaging under weight-bearing conditions of 3D modeling(EOS)of whole body skeleton at the postoperative 1st week,the 3rd month,and the 6th month.The recovery of function was assessed by using the Hospital for Special Surgery(HSS)knee joint score.Results:The postoperatively average deviation angle of mechanical axis in the robot-assisted group was(1.23±0.67)°,which was significantly lower than the(2.89±1.23)° of the conventional surgery group(t=7.560,P<0.05).The increased extent of angular deviation was smaller with the change of time in the robot-assisted group.The HSS scores at the 6th month after surgery indicated that the score of relieving pain was(28.45±2.34)points in the robot-assisted group,and that was(25.12±3.45)points in the conventional surgery group,and the difference of that between two groups was significant(t=5.12,P<0.05).The score of joint stability was(9.23±0.78)points in the robot-assisted group,and that was(7.89±1.23)points in the conventional surgery group,and the difference of that between two groups was significant(t=5.89,P<0.05).The advantages of the robot-assisted group was significant.The operative time of the robot-assisted group was(98.45±10.23)min,which was significantly longer than the(85.67±9.78)min of the conventional surgery group(t=5.89,P<0.05).However,intraoperative blood loss in the robot-assisted group was(150.34±25.67)mL,which was significantly better than the(220.45±30.12)ml in the conventional surgery group(t=11.23,P<0.05).The total incidence of complication was 5.0%(2/40)in the robot-assisted group,and that was 17.5%(7/40)in the conventional surgery group,and the difference of that between two groups was significant(x2=4.01,P<0.05).Conclusion:RATKA can enhance significantly the reconstructed precision of lower limb alignment through 3D dynamic navigation.The characteristic of its sub-millimeter osteotomy can optimize early functional rehabilitation and reduce risk of postoperative complication.

Objective:To investigate the precise advantages of robot-assisted total knee arthroplasty(RATKA)in reconstruction of mechanical axis of lower limb,and its influence on early functional rehabilitation.Methods:A prospective cohort design was used.A total of eighty patients with osteoarthritis who underwent total knee arthroplasty(TKA)at the Department of Joint Surgery of The People's Hospital of Suzhou New District between June 2021 and August 2024 were enrolled.According to different surgical method,they were divided into robot-assisted group(n=40)and conventional surgery group(n=40).The deviation angles of mechanical axis were quantified by three-dimensional(3D)imaging under weight-bearing conditions of 3D modeling(EOS)of whole body skeleton at the postoperative 1st week,the 3rd month,and the 6th month.The recovery of function was assessed by using the Hospital for Special Surgery(HSS)knee joint score.Results:The postoperatively average deviation angle of mechanical axis in the robot-assisted group was(1.23±0.67)°,which was significantly lower than the(2.89±1.23)° of the conventional surgery group(t=7.560,P<0.05).The increased extent of angular deviation was smaller with the change of time in the robot-assisted group.The HSS scores at the 6th month after surgery indicated that the score of relieving pain was(28.45±2.34)points in the robot-assisted group,and that was(25.12±3.45)points in the conventional surgery group,and the difference of that between two groups was significant(t=5.12,P<0.05).The score of joint stability was(9.23±0.78)points in the robot-assisted group,and that was(7.89±1.23)points in the conventional surgery group,and the difference of that between two groups was significant(t=5.89,P<0.05).The advantages of the robot-assisted group was significant.The operative time of the robot-assisted group was(98.45±10.23)min,which was significantly longer than the(85.67±9.78)min of the conventional surgery group(t=5.89,P<0.05).However,intraoperative blood loss in the robot-assisted group was(150.34±25.67)mL,which was significantly better than the(220.45±30.12)ml in the conventional surgery group(t=11.23,P<0.05).The total incidence of complication was 5.0%(2/40)in the robot-assisted group,and that was 17.5%(7/40)in the conventional surgery group,and the difference of that between two groups was significant(x2=4.01,P<0.05).Conclusion:RATKA can enhance significantly the reconstructed precision of lower limb alignment through 3D dynamic navigation.The characteristic of its sub-millimeter osteotomy can optimize early functional rehabilitation and reduce risk of postoperative complication.

Objective To observe the feasibility of inducible costimulatory(ICOS)target in mice adjuvant-induced arthritis(AIA)models.Methods Twenty BALB/c mice were injected with equal dose of complete Freund's adjuvant(AIA group,n=10)or phosphate buffered saline(control group,n=10)into the right back paws.The second day after injection,ICOS-IRD680 mAb probes were injected in AIA group,while IgG-IRD680 mAb probes were injected in control group through tail vein,respectively.The fluorescent intensity ratio of the right and left paw based on near-infrared fluorescence imaging 24 and 48 h later were compared between groups.The total RNA of mice were extracted for transcriptome sequencing,and differentially expressed genes(DEG)were screened and analyzed.Primary T cells were extracted from the spleen of mice in control group,then magnetic negative T cells were sorted.Activated T cells were stimulated and induced using phoboxylate/ionomycin,the expression level of ICOS protein on the surface of activated T cells were detected,and the safety of probe was also evaluated.Results The expression of ICOS gene in AIA group was significantly up-regulated,and the proportion of T cells was higher than that in control group.ICOS tented to distribute in FoxP3+ regulatory T cells,CD8+T cells and CD4+T cells.The purity of CD3+T cells before and after magnetic negative T cells was 65.31％ and 90.14％,respectively.The proportion of CD4+T cells before and after activated was 7.14％ and 31.20％,respectively,and the mean fluorescent intensity of ICOS protein in activated CD4+T cells(586±25)was significantly higher than that in non-activated CD4+T cells(161±31)(t=25.390,P＜0.001).Twenty-four and 48 h after probe injection,the fluorescent intensity ratio of the right paw/left paw in AIA group was higher than that in control group(t=34.600,P＜0.001;t=23.380,P＜0.001).Compared with control group,no significant pathological change of heart,liver nor kidney tissues of mice in AIA group was detected,while no significant difference of glutamic-pyruvic transaminase,glutamic-oxaloacetic transaminase nor creatinine was found between groups(all P＞0.05).Conclusion ICOS target was safe and feasible for mice AIA models.