Journal of Personalized Medicine最新文献

{"title":"Implementation of Pharmacogenomics Testing in Daily Clinical Practice: Perspectives of Prescribers from Two Canadian Armed Forces Medical Clinics.","authors":"Alexandra Muller-Gass, Gouri Mukerjee, Ruslan Dorfman, Rakesh Jetly","doi":"10.3390/jpm15030101","DOIUrl":"10.3390/jpm15030101","url":null,"abstract":"<p><p><b>Background/Objectives</b>: While there is mounting scientific evidence supporting the effectiveness of PGx (pharmacogenomics)-guided medical treatment, its implementation into clinical care is still lagging. Stakeholder buy-in, in particular from prescribers, will be key in the implementation efforts. Previous implementation studies have primarily focused on prescriber attitudes or have used hypothetical scenario methodology in a variety of healthcare settings. Real-world studies provide better insight into prescriber experience and needs. In this prospective observational qualitative research study, we report the perspectives of prescribers working in military medical care after a one-year PGx implementation trial. <b>Methods</b>: At the end of the PGx implementation period, thirteen prescribers participated in a semi-structured interview. The interview was designed based on the Technology Acceptance Model and queried their perceptions of effectiveness and ease of use of the PGx innovation. <b>Results</b>: Three main themes emerged from the qualitative data: (1) the knowledge required for PGx testing, (2) the integration of the testing into the existing workflow and (3) the perceived clinical utility of the PGx results. Prescribers had educational and training opportunities prior to the study but still encountered difficulty with the interpretation of the test results. They generally managed well the workflow changes occasioned by the testing. They reported that the clinical value came primarily from an increased confidence in prescribing safe medications and improving the therapeutic alliance with their patients. There was uncertainty about which patient population would most benefit from the testing. <b>Conclusions</b>: Our results lend support to the general ongoing challenges identified in PGx implementation studies conducted in other clinical settings and using other methodologies. They also revealed specific factors that the prescribers found of value and areas that needed improvement to support future implementation efforts.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of SGLT2 Inhibitors and Loop Diuretics in the Treatment of Heart Failure.","authors":"Yoshiki Murakami, Shunsuke Kiuchi, Shinji Hisatake, Takanori Ikeda","doi":"10.3390/jpm15030099","DOIUrl":"10.3390/jpm15030099","url":null,"abstract":"<p><p><b>Background:</b> Administration of SGLT2 inhibitors leads to a reduction in the dosage of loop diuretics in heart failure (HF) patients; however, it is unclear in what patients the dosage can be reduced. We investigated the factors related to the reduction in loop diuretics in patients who have started receiving dapagliflozin, an SGLT2 inhibitor. <b>Methods:</b> In total, 126 consecutive patients with HF who received dapagliflozin for HF at our institution between December 2020 and March 2022 were enrolled. We investigated the change in the dosage of diuretics at the time of dapagliflozin administration and after 6 months and evaluated factors at the time of dapagliflozin initiation that were associated with the dosage of loop diuretic reduction. <b>Results:</b> The median of loop diuretics dosage (oral furosemide equivalent) at the time of dapagliflozin administration was 20 mg/day (the mean dosage; 29.5 ± 26.5 mg/day), and after 6 months it decreased to 10 mg/day (the mean dosage; 14.5 ± 15.9 mg/day) (<i>p</i> < 0.001). Multivariate analysis showed that the three factors of in-hospital start of dapagliflozin, % patients on β-blockers, and the dosage of loop diuretics independently predicted the reduction in loop diuretic dosage. Even in analyses excluding patients who initiated dapagliflozin during hospitalization, loop diuretic dosage independently predicted loop diuretic reduction in multivariate analysis. The receiver operating characteristic curve for predicting reduced loop diuretic showed that the cut-off value for loop diuretic at the time of administration of dapagliflozin was 20 mg/day of oral furosemide equivalent. <b>Conclusions:</b> The dosage of loop diuretic used when dapagliflozin was started is a factor that predicts a subsequent reduction in the dose of loop diuretics.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Applications of Positron Emission Tomography in Coronary Artery Disease.","authors":"Anna Blach, Jacek Kwiecinski","doi":"10.3390/jpm15030100","DOIUrl":"10.3390/jpm15030100","url":null,"abstract":"<p><p>Coronary artery disease remains the leading cause of morbidity and mortality worldwide. With the changing clinical manifestation and novel therapeutical options, precise disease phenotyping becomes increasingly important at the point of care. In the management of coronary artery disease, myocardial perfusion imaging (MPI) remains the cornerstone of clinical practice. Although traditionally MPI has been primarily performed with single photon emission computed tomography (SPECT), nowadays, given the changing spectrum of the disease, greater precision and additional assessment of myocardial blood flow are desired. Due to the fundamental advantages of PET over SPECT, i.e., higher spatial resolution, accurate attenuation correction for each scan, and higher count rates, the sensitivity and specificity of PET MPI are higher than those of SPECT MPI and are estimated to be approximately 90-92% vs. 83-88% and 81-87% vs. 70-76%, respectively, according to meta-analysis data. Consequently, over the past decade, we have witnessed an increased uptake of positron emission tomography (PET) MPI. With the improved spatial resolution, the ability to quantify myocardial blood flow, and the potential to depict the burden of coronary atherosclerosis with low-dose computed tomography, PET/CT is uniquely positioned to facilitate a comprehensive non-invasive assessment of disease, providing an opportunity for precision medicine. The wealth of data obtained during a single imaging session can be challenging to integrate at the time of image analysis. There has therefore been an increasing interest in developing predefined thresholds or variables (scores) which combine the multidimensional data acquired with PET MPI. Beyond MPI, PET can also serve for the assessment of disease activity at the atherosclerotic plaque level, further refining our understanding of the biology of coronary artery disease and providing hope for enhanced prediction of myocardial infarctions. In this narrative review, we present the current applications of PET MPI in coronary artery disease and focus specifically on two areas that have recently garnered considerable interest-the integration of multiparametric PET MPI data and coronary plaque activity PET imaging.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine Zika Virus Infection: An Overview of the Current Findings.","authors":"Ana Luiza Soares Dos Santos, Beatriz Bussi Rosolen, Fernanda Curvelo Ferreira, Isabella Samões Chiancone, Stefany Silva Pereira, Karina Felippe Monezi Pontes, Evelyn Traina, Heron Werner, Roberta Granese, Edward Araujo Júnior","doi":"10.3390/jpm15030098","DOIUrl":"10.3390/jpm15030098","url":null,"abstract":"<p><p>Zika virus (ZIKV) is a mosquito-borne flavivirus of the family Flaviviridae. The association between ZIKV and microcephaly was first described in Brazil in 2015. The risk of vertical transmission occurs in pregnant women with or without symptoms, and the risk of malformation appears to be worse when infection occurs in the first and second trimesters of pregnancy. The rate of vertical transmission varies from 26 to 65%, and not all fetuses develop malformations. The incidence of malformations resulting from transmission is uncertain, ranging from 6-8% in the US to 40% in Brazil. Congenital ZIKV syndrome is a set of clinical manifestations that can affect the fetus of a mother infected with ZIKV. The manifestations are broad and nonspecific, including microcephaly, subcortical calcifications, ocular changes, congenital contractures, early hypertension, and pyramidal and extrapyramidal signs. Other findings such as growth restriction and fetal miscarriage/death may also occur. Our aim in this article is to review the literature on mosquito transmission, clinical presentation, serologic diagnosis, intrauterine transmission, pre- and postnatal imaging diagnostic findings, and short- and long-term follow-up.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into the Interaction Between <i>Clostridioides difficile</i> and the Gut Microbiome.","authors":"Dimitra Mougiou, Georgia Gioula, Lemonia Skoura, Cleo Anastassopoulou, Melania Kachrimanidou","doi":"10.3390/jpm15030094","DOIUrl":"10.3390/jpm15030094","url":null,"abstract":"<p><p><i>Clostridioides difficile</i> (<i>C. difficile</i>) is a significant healthcare-associated pathogen that is predominantly caused by antibiotic-induced microbiota disturbance. Antibiotics decrease microbial diversity, resulting in <i>C. difficile</i> colonization and infection. <i>Clostridium difficile</i> infection (CDI) manifests through toxins A and B, causing diarrhea and colitis. Antibiotic usage, old age, and hospitalization are significant risk factors. A healthy gut microbiota, which is dominated by <i>Firmicutes</i> and <i>Bacteroidetes</i>, provides colonization resistance to <i>C. difficile</i> due to competition for nutrients, creating inhibitory substances and stimulating the immune response. Antibiotic-induced dysbiosis decreases resistance, allowing <i>C. difficile</i> spores to transform into vegetative forms. Patients with CDI have decreased gut microbiota diversity, with a decrease in beneficial bacteria, including <i>Bacteroidetes</i>, <i>Prevotella</i>, and <i>Bifidobacterium</i>, and a rise in harmful bacteria like <i>Clostridioides</i> and <i>Lactobacillus</i>. This disparity worsens the infection's symptoms and complicates therapy. Fecal Microbiota Transplantation (FMT) has emerged as a potential therapy for recurrent CDI by restoring gut microbiota diversity and function. Comprehending the connection between gut microbiota and CDI pathogenesis is critical for establishing effective preventive and treatment plans. Maintaining a healthy gut microbiota through careful antibiotic use and therapeutic options such as FMT can help in the management and prevention of CDI.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Surgery for Glioblastomas.","authors":"Stephen J Price, Jasmine G Hughes, Swati Jain, Caroline Kelly, Ioana Sederias, Francesca M Cozzi, Jawad Fares, Yonghao Li, Jasmine C Kennedy, Roxanne Mayrand, Queenie Hoi Wing Wong, Yizhou Wan, Chao Li","doi":"10.3390/jpm15030096","DOIUrl":"10.3390/jpm15030096","url":null,"abstract":"<p><p>Glioblastomas are the most common primary malignant brain tumor. Most of the recent improvements their treatment are due to improvements in surgery. Although many would consider surgery as the most personalized treatment, the variation in resection between surgeons suggests there remains a need for objective measures to determine the best surgical treatment for individualizing therapy for glioblastoma. We propose applying a personalized medicine approach to improve outcomes for patients. We suggest looking at personalizing preoperative preparation, improving the resection target by understanding what needs removing and what ca not be removed, and better patient selection with personalized rehabilitation plans for all patients.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing the Reliability of ChatGPT Assistance for Surgical Choices in Challenging Glaucoma Cases.","authors":"Matteo Mario Carlà, Gloria Gambini, Federico Giannuzzi, Francesco Boselli, Laura De Luca, Stanislao Rizzo","doi":"10.3390/jpm15030097","DOIUrl":"10.3390/jpm15030097","url":null,"abstract":"<p><p><b>Background:</b> This study's aim is to assess ChatGPT's capability to analyze detailed case descriptions in glaucomatous patients and suggest the best possible surgical treatment. <b>Methods:</b> We conducted a retrospective analysis of 60 medical records of surgical glaucoma cases, divided into \"ordinary\" cases (<i>n</i> = 40) and \"challenging\" cases (<i>n</i> = 20). We entered every case description into ChatGPT-3.5's interface and inquired \"What kind of surgery would you perform?\". The frequency of accurate surgical choices made by ChatGPT, compared to those reported in patients' files, was reported. Furthermore, we assessed the level of agreement with three senior glaucoma surgeons, asked to analyze the same 60 cases and outline their surgical choices. <b>Results:</b> Overall, ChatGPT surgical choices were consistent with those reported in patients' files in 47/60 cases (78%). When comparing ChatGPT choices with the three glaucoma specialists, levels of agreement were 75%, 70%, and 83%, respectively. In ordinary cases, we did not report any significant differences when comparing ChatGPT answers with those of the three glaucoma specialists, when both of them were matched with patients' files (<i>p</i> > 0.05 for all). ChatGPT's performances were lower in \"challenging\" cases: when compared to patients' files, the accuracy was 13/20 (65%); when compared to glaucoma specialists, the level of agreement was 50%, 40%, and 70%, respectively. <b>Conclusion:</b> In ordinary conditions, ChatGPT was able to propose coherent personalized treatment plans, and its performance was comparable to that of skilled glaucoma specialists but showed its limitations in the evaluation of more complex cases.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>CYP2D6</i> Genotyping for Optimization of Tamoxifen Therapy in Indonesian Women with ER+ Breast Cancer.","authors":"Baitha Palanggatan Maggadani, Kathleen Irena Junusmin, Fatma Aldila, Jessica Audrienna, Bijak Rabbani, Yusuf Maulana, Sabrina Gabriel Tanu, Gabriella Gabriella, Margareta Amelia, Faustina Audrey Agatha, Marco Wijaya, Stevany Tiurma Sormin, Caroline Mahendra, Levana Laksmicitra Sani, Astrid Irwanto, Alexandre Chan, Harmita Harmita, Yahdiana Harahap, Samuel Johny Haryono","doi":"10.3390/jpm15030093","DOIUrl":"10.3390/jpm15030093","url":null,"abstract":"<p><p><b>Background:</b> Certain <i>CYP2D6</i> genotypes are linked to a lower efficacy of tamoxifen therapy. This study aimed to observe <i>CYP2D6</i> polymorphisms and examine the impact of <i>CYP2D6</i> genotyping among tamoxifen-treated breast cancer patients in Indonesia. <b>Methods:</b> 150 breast cancer participants were recruited. Buccal swab samples were collected; gDNA was extracted and genotyped using the qPCR method. Blood samples were collected, and measurement of tamoxifen metabolite levels was performed using UPLC-MS/MS. <b>Results:</b> 43.3% (n = 65) of participants were IMs. *10 was the most common haplotype (n = 89, 29.7%), followed by *36 (n = 73, 29.7%), making *10/*36 the most common diplotype (n = 34, 22.7%) in this study. The difference in endoxifen levels between the NM and IM-PM groups at baseline was statistically significant (<i>p</i> ≤ 0.001). A dose increase in tamoxifen to 40 mg daily successfully increased endoxifen levels in IMs to a similar level with NMs at baseline (<i>p</i> > 0.05) without exposing IMs to serious side effects. No statistically significant differences were observed between the 20mg group and the 40 mg group on the adjusted OS (<i>p</i> > 0.05) and the adjusted PFS (<i>p</i> > 0.05). <b>Conclusions:</b> Our study observed a considerably high proportion of <i>CYP2D6</i> IMs. The dose adjustment of tamoxifen was proven to significantly and safely improve the level of endoxifen and survival.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Pedicle Screw Fixation and Interspinous Devices in Lumbar Spinal Fusion: Clinical and Surgical Outcomes in Degenerative Spine Conditions.","authors":"Vittorio Orlando, Gianluca Galieri, Edoardo Mazzucchi, Fabrizio Pignotti, Antonella Carcagnì, Paola Bazzu, Roberto Altieri, Manlio Barbarisi, Alessandro Olivi, Giovanni Sabatino, Giuseppe La Rocca","doi":"10.3390/jpm15030095","DOIUrl":"10.3390/jpm15030095","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Degenerative lumbar spine conditions are a major cause of disability, particularly in elderly patients or those with comorbidities. Surgical treatment often combines decompression and stabilization to address pain and instability. Pedicle screws are the gold standard for stabilization but pose challenges in patients with compromised bone quality. Interspinous devices have emerged as a less invasive alternative, but comparative studies are limited. This study aimed to compare clinical and surgical outcomes of lumbar decompression with stabilization using pedicle screws versus interspinous devices. <b>Methods</b>: A retrospective cohort study was conducted on patients who underwent lumbar decompression with either pedicle screw fixation or interspinous device stabilization at Mater Olbia Hospital between February 2020 and February 2023. Outcomes were evaluated using VAS for back and leg pain, SF-36 for quality of life, EQ-5D, and SCL-90 for psychological factors. Statistical analysis included paired <i>t</i>-tests, chi-square tests, and multivariate regression. <b>Results</b>: A total of 728 patients were included. The interspinous device group consisted of older patients with higher comorbidity burdens (mean age: 68.4 vs. 59.2 years, <i>p</i> < 0.001). Surgical time and incision size were significantly shorter in the interspinous group (<i>p</i> < 0.001), and no postoperative complications were reported, compared to 3.5% in the pedicle screws group (<i>p</i> < 0.05). Both groups demonstrated significant improvements in pain (VAS), quality of life (SF-36, EQ-5D), and psychological outcomes (SCL-90). Somatization and paranoid ideation were significant predictors of worse postoperative pain, particularly in the pedicle screws group. No significant differences in quality-of-life improvements were observed between the groups. <b>Conclusions</b>: Both stabilization techniques are effective for lumbar spine surgery, with interspinous devices offering a safer and less invasive option for high-risk patients. Psychological factors significantly influence pain outcomes, underscoring the need for a comprehensive approach addressing both physical and psychological aspects to optimize patient recovery.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Outcomes Between Functionally and Mechanically Aligned Total Knee Arthroplasty: Analysis of Parallelism to the Ground and Weight-Bearing Position of the Knee Using Hip-to-Calcaneus Radiographs.","authors":"Hongyeol Yang, Chanjin Park, Jaehyeok Cheon, Jaeyeon Hwang, Jongkeun Seon","doi":"10.3390/jpm15030091","DOIUrl":"10.3390/jpm15030091","url":null,"abstract":"<p><p><b>Background:</b> The objective of this study was to compare the outcomes between patients undergoing mechanically aligned conventional total knee arthroplasty (MA-CTKA) and functionally aligned robotic-arm-assisted TKA (FA-RTKA). <b>Methods:</b> We reviewed a prospectively collected database of consecutive patients who underwent primary total knee arthroplasty (TKA) for knee osteoarthritis between June 2022 and May 2023. Patients were divided into two groups-MA-CTKA (n = 50) and FA-RTKA (n = 50)-based on the introduction of a robotic-arm-assisted system during the study period. The hip-knee-ankle (HKA) angle, joint line orientation angle (JLOA) relative to the floor, and weight-bearing line (WBL) ratio were evaluated using full-length standing hip-to-calcaneus radiographs to compare the conventional mechanical axis (MA) and the ground mechanical axis (GA) passing through the knee joint between the groups. Clinical outcomes were also compared between the two groups. <b>Results:</b> There were no significant differences in the postoperative HKA angle between the groups, due to discrepancies in the targeted alignment strategies (FA-RTKA: 2.0° vs. MA-CTKA: 0.5°; <i>p</i> = 0.001). The postoperative JLOA in the FA-RTKA group was more parallel to the floor, whereas the MA-CTKA group showed a downward angulation toward the lateral side (0.6° vs. -2.7°; <i>p</i> < 0.001). In the FA-RTKA group, the GA passed through a neutral position when accounting for the calcaneus, while the MA-CTKA group showed a more lateral GA position (48.8% vs. 53.8%; <i>p</i> = 0.001). No significant differences in clinical outcomes were shown between the FA-RTKA and MA-CTKA groups, with the FA-RTKA group demonstrating higher Forgotten Joint Scores and a greater range of motion (all <i>p</i> < 0.05). <b>Conclusions:</b> Functionally aligned TKA demonstrated improved joint line parallelism to the floor and more neutral weight-bearing alignment in the GA compared to mechanically aligned TKA. These findings indicate a more balanced load distribution across the knee, which may contribute to the superior clinical outcomes observed in the functionally aligned group.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}