Publications by authors named "Ken N Kuo"

Background: Hip dysplasia (HD) at skeletal maturity can result from residual developmental dysplasia of the hip (DDH) treated in childhood or from primary adolescent-onset HD (AOHD). This study aims to compare the pathomorphology of these two HD subtypes with that of a normal control group.

Methods: This retrospective study reviewed patients who underwent periacetabular osteotomy for symptomatic HD between 2013 and 2020.

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Background: Reoperation is a major adverse event following surgical treatment but has yet to be used as a primary outcome measure in population studies to assess current treatments for developmental dysplasia of the hip (DDH). The purpose of the present study was to explore the risk factors associated with reoperations following procedures under anesthesia ("operations") for DDH in patients between the ages of 1 and 3.00 years, with the goal of deriving treatment recommendations.

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Article Synopsis
  • A 12-year-old boy with Klippel-Trenaunay-Weber syndrome had surgery for a condition called unstable slipped capital femoral epiphysis and later developed a pulmonary embolism.
  • The text highlights the rarity but severity of pulmonary embolism in children, especially when they have risk factors.
  • Emphasizes the need for early intervention for slipped capital femoral epiphysis to reduce immobility and the importance of monitoring for potential complications like femoral head osteonecrosis.
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Background: Multiple epiphyseal dysplasia (MED) is a rare congenital bone dysplasia. Patients with MED develop secondary hip osteoarthritis as early as the third to the fourth decade. Currently, there is no consensus on the prevention of the progressive hip osteoarthritis secondary to MED.

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Article Synopsis
  • This study investigates how the structure of the acetabulum (part of the hip joint) is affected by hip disorders, particularly in children with cerebral palsy, by analyzing the relationship between structural changes and migration percentage.
  • Researchers reviewed clinical data from 70 children with spastic cerebral palsy and used advanced imaging techniques to measure the acetabular index.
  • Findings indicate a significant correlation between increased migration percentage and acetabular index changes, identifying a 30% migration percentage as a critical threshold for the onset of hip disorders.
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Background: In children with severe hereditary multiple exostoses (HME), coxa valga, and hip subluxation are common deformities. The literatures related to surgical management and prevention of hip joint subluxation in HME are scarce. In this study, we aimed to investigate the efficacy of guided growth procedure to correct coxa valga and hip subluxation in HME patients.

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Submuscular plating and osteotomy using power saw have shown the benefits in certain situations of limb lengthening. However, no previous studies combining both procedures have been conducted for acute tibial deformity correction and limb lengthening. Nineteen cases were enrolled in this study.

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Aims: The aim of this study was to compare outcomes of guided growth and varus osteotomy in treating Kalamchi type II avascular necrosis (AVN) after open reduction and Pemberton acetabuloplasty for developmental dysplasia of the hip (DDH).

Methods: This retrospective study reviewed patients undergoing guided growth or varus osteotomy for Kalamchi type II AVN between September 2009 and January 2019. All children who had undergone open reduction and Pemberton acetabuloplasty for DDH with a minimum two-year follow-up were enrolled in the study.

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Background: Evidence of metformin-associated lactic acidosis (MALA) in advanced chronic kidney disease (CKD) has been limited due to high mortality rate but rare incidence rate. The mechanism of increased MALA in advanced CKD is mainly based on the hypothesis of decreased drug elimination, which might also be confounded by increased comorbidities as CKD progresses. The goal of the study is to analyze the incidence and associated factors of lactic acidosis between metformin user and non-user with advanced CKD.

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Proximal femoral varus osteotomy (PFVO) is a common procedure performed in children with developmental dysplasia of the hip (DDH) and Legg-Calvé-Perthes disease (LCPD). However, the long-term effect on angular deformities of the knees and ankles following PFVO remains controversial. This study investigated the relationship between PFVO and alignment changes in the knee and ankle after the procedure.

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Variable techniques in periacetabular osteotomy have been formulated for the treatment of acetabular dysplasia. However, few studies have compared the radiographic outcomes between different osteotomy types. This study compared modified triple innominate (MTI) osteotomy and Ganz osteotomy with respect to radiographic outcomes.

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Objective: Health literacy (HL) is the degree of individuals' capacity to access, understand, appraise and apply health information and services required to make appropriate health decisions. This study aimed to establish a predictive algorithm for identifying community-dwelling older adults with a high risk of limited HL.

Design: A cross-sectional study.

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Background: Newborn hip screening aims to prevent the late diagnosis of and subsequent surgical procedures for developmental dysplasia of the hip (DDH). Weather may affect how parents swaddle their babies in early life, but weather has never been formally regarded as a risk factor in hip screening. This study investigates the association between the incidence of surgically treated DDH and the outdoor temperature.

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Background: Among musculoskeletal disorders, lumbar degenerative disease (LDD) is the leading cause of total disability-adjusted life years globally. Clinical guidelines for LDD describe multiple treatment options in which shared decision making becomes appropriate.

Objectives: To explore the relationships among measures of decision antecedents, process, and outcomes in patients with LDD.

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Purpose of this letter was to explore the trends regarding methodological flaws of systematic review and meta-analyses (SRMAs) based on retraction notes in the past decades, and the categories of reasons for the retractions. Content analysis with descriptive statistics, Cochran Q test, and multinomial logistic regression were used. Based on 187 records of retracted SRMAs, retraction announcements can be categorized into academic ethical violation, methodological flaw, and writing or reporting problem.

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Background: Genu valgum results in lower limb malalignment and altered joint mechanics. The study aimed to identify the effects of genu valgum on balance control and muscular work at the joints during gait in children.

Research Question: Would bilateral genu valgum affect balance control and muscular work at the joints during gait in children?

Methods: Thirteen children with genu valgum and thirteen healthy peers walked at their preferred speed while the body's motions and ground reaction forces were measured to calculate the inclination angles (IA) and the rates of change of IA (RCIA) of the body's center of mass (COM) relative to the center of pressure (COP), as well as the muscular work done at the joints.

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Objective: To evaluate the efficacy of shared decision-making (SDM) intervention among patients with lumbar degenerative diseases (LDDs) in terms of decision self-efficacy, control preferences, SDM process, decision satisfaction, and conflict.

Methods: A total of 130 outpatients with LDDs recruited from orthopedic or rehabilitation clinics were randomly assigned to the SDM intervention (n = 67) or comparison (n = 63) groups. Patients in the intervention group received decision aids (DAs) with decision coaching and those in controlled group received standard educational materials from a health educator.

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Biomechanical deviations at individual joints are often identified by gait analysis of patients with cerebral palsy (CP). Analysis of the control of joint and leg stiffness of the locomotor system during gait in children with spastic diplegic CP has been used to reveal their control strategy, but the differences between before and after surgery remain unknown. The current study aimed to bridge the gap by comparing the leg stiffness-both skeletal and muscular components-and associated joint stiffness during gait in 12 healthy controls and 12 children with spastic diplegic CP before and after tendon release surgery (TRS).

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Article Synopsis
  • Many experts suggest delaying orthopedic surgery for children with cerebral palsy, but this study examines how delaying surgery may lead to worse outcomes due to age-related musculoskeletal issues.
  • The study observed two groups of children (younger and older than 10) who underwent myofascial release surgery and measured their motor function and physical capacity before and after the procedure.
  • Results showed that older children had more severe motion limitations and experienced less improvement in their motor skills and physical capacity post-surgery compared to younger children, indicating the need for timely intervention.*
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Aims: Guided growth has been used to treat coxa valga for cerebral palsy (CP) children. However, there has been no study on the optimal position of screw application. In this paper we have investigated the influence of screw position on the outcomes of guided growth.

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Background: Critical care nurses are in the best position to detect and monitor delirium in critically ill patients. Therefore, an optimum delirium assessment tool with strong evidence should be identified with critical care nurses to perform in the daily assessment.

Aim: To evaluate and compare the diagnostic performance of delirium assessment tools in diagnosing delirium in critically ill patients.

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To investigate the health literacy (HL) among older adults in Taiwan, we referenced an existing integrated model of HL to confirm the influencing factors of HL in older adults. We propose this study to examine the personal, situational, and socioenvironmental factors influencing HL among older adults. : A cross-sectional survey was conducted at a district hospital and affiliated community center in northern Taiwan from August 2016 to May 2017.

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Article Synopsis
  • The study investigates how altered trunk shape and body alignment in adolescents with Lenke 1 thoracic idiopathic scoliosis (AIS) affect balance control during walking, focusing on the center of mass (COM) and center of pressure (COP) dynamics.
  • Sixteen adolescents with AIS and sixteen healthy peers were assessed for balance through kinematic measurements during level walking, analyzing inclination angles (IA), rate of change of IA (RCIA), and jerk index.
  • Results indicated that AIS patients exhibited less smooth motion of COM relative to COP, increased jerkiness, and significant differences in IA and RCIA compared to healthy controls, with moderate to strong correlations existing between these balance metrics and the degree of spinal curvature (Cobb angle).
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