422 results on '"Chin Youb Chung"'
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2. Association of Weight Change and Physical Activity with Knee Pain and Health-Related Quality of Life in East Asian Women Aged 50 Years and Older with Knee Osteoarthritis: A Population-Based Study
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Chong Bum Chang, Young Choi, Seung Baik Kang, Chin Youb Chung, Moon Seok Park, and Kyoung Min Lee
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health-related quality of life ,knee pain ,osteoarthritis ,physical activity weight change ,Medicine (General) ,R5-920 - Abstract
Objectives This study aimed to investigate the association of self-reported weight change and physical activity with the level of knee pain and health-related quality of life in East Asian women with knee osteoarthritis using population-based data. Methods A total of 564 women (mean age, 68.2 years, standard deviation, 8.9 years) aged 50 years or older with knee osteoarthritis (Kellgren-Lawrence (K-L) grade ≥ 2) were included in the data analyses from the fifth Korea National Health and Nutrition Examination Survey. Data regarding the radiographic grade, self-reported weight change during the past year, physical activity, level of knee pain, and health-related quality of life (EuroQOL five-dimension (EQ-5D) index) were collected. Multiple regression analysis was performed to identify factors significantly associated with the level of knee pain and health-related quality of life in subgroups according to the body mass index (BMI) range (≤ 22.5, between 22.6 and 27.5, and > 27.5 kg/m2). Results In the whole group, the level of knee pain was significantly associated with K-L grade (P < 0.001), and EQ-5D was negatively associated with age (P < 0.001), the level of knee pain (P < 0.001), and weekly hours of vigorous-intensity activity (P = 0.026). In the subgroup analysis, weight gain showed significant association with the level of knee pain only in women with 22.5 kg/m2 < BMI ≤ 27.5 kg/m2 (P = 0.006). Weight gain showed significant association with EQ-5D in women with BMI ≤ 22.5 kg/m2 (P = 0.047) whereas weekly hours of moderate-intensity activity was negatively associated with EQ-5D in women with BMI > 27.5 kg/m2. Conclusions The association of weight change and physical activity with knee pain and health-related quality of life might be different according to BMI ranges. Well-designed interventions to improve both knee pain and health-related quality of life need to be investigated in future studies that would strictly control physical activity, diet, and weight changes.
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- 2021
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3. Differences in responses to English and Korean versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD)
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Ki Hyuk Sung, Soon-Sun Kwon, Gyeong Hee Cho, Chin Youb Chung, Clarissa Encisa, Huroy Menal, Unni G. Narayanan, and Moon Seok Park
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Cerebral palsy ,Questionnaire ,Social environment ,Korean ,English ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background The purpose of this study was to identify differences in caregiver responses to Korean-language and English-language versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD) questionnaire. Methods Patient data were acquired from the Cerebral Palsy Hip Outcomes Project database, which was established to run a large international multicenter prospective cohort study of the outcomes of hip interventions in cerebral palsy. Thirty-three children whose caregivers had completed the Korean version of CPCHILD were matched by propensity scoring with 33 children whose parents completed the English version. Matching was performed on the basis of 12 covariates: age, gender, gross motor function classification system level, migration percentage of right and hip, seizure status, feeding method, tracheostomy status, pelvic obliquity, spinal deformity, parental report of hip pain and contracture interfering with care. Results There were no significant differences in CPCHILD scores for section 4 (Communication and Social Interaction), and section 5 (Health) between two groups. Korean-language CPCHILD scores were significantly lower than English-language CPCHILD scores for section 1 (Personal Care/Activities of Daily Living), section 2 (Positioning, Transferring and Mobility), section 3 (Comfort and Emotions) and section 6 (Overall Quality of Life) as well as in terms of total score. Conclusions Cultural influences, and the community or social environment may impact the caregivers’ perception of the health-related quality of life of their children. Therefore, physicians should consider these differences when interpreting the study outcomes across different countries.
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- 2020
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4. Transcultural adaptation and validation of a Korean version of the Oxford Ankle Foot Questionnaire for children
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Seong Hee Cho, Chin Youb Chung, Moon Seok Park, Kyoung Min Lee, and Ki Hyuk Sung
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Oxford ankle foot questionnaire for children ,Korean ,Translation ,Transcultural adaptation ,validation ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background The purpose of this study was to translate and transculturally adapt the original English version of the Oxford Ankle Foot Questionnaire (OAFQ) into a Korean version, and to evaluate its psychometric properties. Methods A Korean OAFQ for children was developed according to established guidelines. To test validity, 169 consecutive patients with foot and ankle problems and their caregivers each completed the OAFQ. The children also completed a Korean version of the KIDSCREEN-52 health related quality of life questionnaire (KIDSCREEN-52 HRQOL). To validate the Korean version of the OAFQ, reliability (child–parent agreement and internal consistency), feasibility (floor and ceiling effects), and construct validity were evaluated, and factor analysis was performed. Results In terms of reliability, Cronbach’s α values were > 0.7 in all subscales of the OAFQ (0.765 to 0.901). Child–parent agreement was confirmed by high intraclass correlation coefficients for all subscales (0.791 to 0.863). In terms of construct validity, there were moderate correlations between the subscales of the OAFQ and the subscales of the KIDSCREEN-52 HRQOL. Factor analysis revealed a three-component solution for both the child/adolescent and parent-proxy version, by combining the school and play, and footwear items into one subscale. In terms of feasibility, no floor effects were found for all subscales. However, ceiling effects were observed for the school and play, and emotional subscales for child/adolescent and parent-proxy versions. Conclusions The OAFQ was successfully translated and transculturally adapted into the Korean language; the Korean version of the OAFQ represents a reliable and valid instrument for evaluating children’s foot or ankle problems. However, factor analysis suggested the use of a three-subscale questionnaire.
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- 2020
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5. Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity
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Ki Hyuk Sung, Chin Youb Chung, Kyoung Min Lee, Ki Bum Kwon, Jeong Hyun Lee, and Moon Seok Park
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Planovalgus ,Ankle dorsiflexion ,Physical examination ,3-dimensional gait analysis ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background In planovalgus deformity with triceps contracture, a midfoot break happens, and ankle dorsiflexion (ADF) occurs at the mid-tarsal joint during gait. Results of standard 3D gait analysis may misinterpret the true ankle dorsiflexion because it recognizes the entire foot as a single rigid segment. We performed this study to investigate whether the severity of planovalgus deformity is associated with the discrepancy between the value of ADF evaluated by physical examination and 3-dimensional (3D) gait analysis. In addition, we aimed to identify the radiographic parameters associated with this discrepancy and their relationships. Methods Consecutive 40 patients with 65 limbs (mean age, 11.7 ± 5.5 years) with planovalgus foot deformity and triceps surae contracture were included. All patients underwent 3D gait analysis, and weightbearing anteroposterior (AP) and lateral (LAT) foot radiographs. ADF with knee extension was measured using a goniometer with the patient’s foot in an inverted position. Results Twenty-one limbs underwent operation for planovalgus foot deformity, and 56 limbs underwent operation for equinus deformity. The difference between ADF on physical examination and ADF at initial contact on gait analysis was 17.5 ± 8.4°. Differences between ADF on physical examination and ADF at initial contact on gait analysis were significantly associated with the LAT talus-first metatarsal angle (p = 0.008) and calcaneal pitch angle (p = 0.006), but not associated with the AP talus-first metatarsal angle (p = 0.113), talonavicular coverage angle (p = 0.190), talocalcaneal angle (p = 0.946), and naviculocuboid overlap (p = 0.136). Conclusion The discrepancy between ADF on physical examination and 3D gait analysis was associated with the severity of planovalgus deformity, which was evaluated on weightbearing LAT foot radiographs. Therefore, physicians should be cautious about interpreting results from 3D gait analysis and perform a careful physical examination to assess the degree of equinus deformity in patients with planovalgus foot deformity.
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- 2020
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6. Overgrowth of the lower limb after treatment of developmental dysplasia of the hip: incidence and risk factors in 101 children with a mean follow-up of 15 years
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Chan Yoon, Chang Ho Shin, Dong Ook Kim, Moon Seok Park, Won Joon Yoo, Chin Youb Chung, In Ho Choi, and Tae-Joon Cho
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Orthopedic surgery ,RD701-811 - Abstract
Background and purpose — There are few studies on overgrowth of the affected limb after treatment of developmental dysplasia of the hip (DDH). We investigated the incidence of overgrowth and its risk factors in DDH patients. Patients and methods — 101 patients were included in this study. Overgrowth was defined by 2 criteria: when the height of the femoral head of the affected side was higher than that of the contralateral side by more than 10 mm, or by more than 15 mm. The potential risk factors of distinct overgrowth were retrospectively examined using multivariable analysis. Results — When overgrowth was defined as femoral head height difference (FHHD) > 10 mm, its incidence was 44%, and only femoral osteotomy was identified as a significant risk factor with a relative risk (RR) of 1.6 (95% confidence interval [CI] 1.0–2.5). When overgrowth was defined as FHHD > 15 mm, its incidence was 23%, and femoral osteotomy was identified as the only significant risk factor with an RR of 2.3 (CI 1.2–4.5). Overgrowth developed more frequently in patients who underwent femoral osteotomy at the age of 2 to 4 years (87%) than in the others (46%) (p = 0.04). Interpretation — Overgrowth of the affected limb is common in DDH patients. Patients who underwent femoral osteotomy, especially at the age of 2 to 4 years, may require careful follow-up because of the substantial risk for overgrowth.
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- 2020
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7. Progression of planovalgus deformity in patients with cerebral palsy
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Jae Jung Min, Soon-Sun Kwon, Ki Hyuk Sung, Kyoung Min Lee, Chin Youb Chung, and Moon Seok Park
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Pes planovalgus ,Talo-first metatarsal angle ,Talo-second metatarsal angle ,Progression ,Cerebral palsy ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Analyzing radiographic changes of pes planovalgus(PV) deformity of cerebral palsy(CP) patients according to age and influencing factors. Methods CP patients with PV deformity younger than 18 years old who had undergone more than a year of follow-up with at least two standing foot radiographs were included. Anteroposterior and lateral talo-first metatarsal(talo-1stMT), talo-second metatarsal(talo-2ndMT), and hallux valgus(HV) angles were measured on the radiographs. The rate of progression was adjusted by multiple factors using the linear mixed model, with the Gross Motor Function Classification System(GMFCS) level as the fixed effect and age and each subject as random effects. Results Overall, 194 patients were enrolled in this study, and 1272 standing foot radiographs were evaluated. The AP talo-2ndMT angle progressed by 0.59° (p
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- 2020
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8. Effects of soft tissue surgery on transverse kinematics in patients with cerebral palsy
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Byeong-Seop Park, Chin Youb Chung, Moon Seok Park, Kyoung Min Lee, Seong Hee Cho, and Ki Hyuk Sung
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Soft tissue surgery ,Cerebral palsy ,Gait analysis ,Transverse kinematics ,Multilevel surgery ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Gait disturbances, including flexed knee gait, stiff knee gait, and tip-toeing gait, are common in patients with cerebral palsy (CP). There has been no reports regarding kinematic changes in the transverse plane after soft tissue surgeries, such as distal hamstring lengthening (DHL), rectus femoris transfer (RFT), and tendo-Achilles lengthening (TAL). This study aimed to evaluate changes in the transverse plane after soft tissue surgery in patients with CP by assessing the effects of the DHL, RFT, and TAL. Methods The study enrolled 156 consecutive patients (mean age, 8.4 years; range, 4.4 to 20.9), representing 213 operated limbs, who underwent soft tissue surgery including DHL with semitendinosus transfer, RFT, and TAL. All patients were assessed by preoperative and 1-year postoperative three-dimensional gait analysis. Changes in transverse plane kinematics after soft tissue surgery and affecting factors were analyzed. Results Sagittal kinematics including knee flexion at initial contact, ankle dorsiflexion at initial contact, and mean ankle dorsiflexion in the stance phase were significantly improved after single event multilevel surgery (all p
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- 2019
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9. Lengthening and deformity correction in vascularized fibular autograft for a patient with Ewing sarcoma
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Ki Bum Kwon, Chin Youb Chung, Moon Seok Park, Kyoung Min Lee, and Ki Hyuk Sung
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Orthopedic surgery ,RD701-811 - Abstract
We report the case of a pediatric patient with Ewing’s sarcoma of the tibia treated with vascularized fibular autograft where the resulting limb deformity and leg length discrepancy (LLD) were corrected using Ilizarov external fixator. A 14-year-old girl presented to our outpatient clinic with a deformity of the right proximal and distal tibia and an 11.7 cm of LLD after tumor reconstruction surgery. Deformity correction and limb lengthening were simultaneously performed using double corticotomy on the right proximal and distal tibia. One year postoperatively, the union of the right proximal tibia had progressed, but nonunion was observed at the right distal corticotomy site. To address this, osteosynthesis with tricortical iliac bone allograft was performed after the removal of the Ilizarov external fixator. After 6 months, the union of the distal tibia was confirmed, and the varus deformity of proximal and distal tibia improved. The LLD was also decreased, but the left lower limb was still longer by 3 cm. This report shows that vascularized fibular autografts can potentially be used for the gradual correction of LLD and deformities. However, for the treatment of multiple deformities in bones previously reconstructed with vascularized fibular graft, the possibility of impaired bone forming potential of the fibular graft should be considered.
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- 2021
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10. Use of iliac crest allograft for Dega pelvic osteotomy in patients with cerebral palsy
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Ki Hyuk Sung, Soon-Sun Kwon, Chin Youb Chung, Kyoung Min Lee, Jaeyoung Kim, and Moon Seok Park
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Dega osteotomy ,Iliac crest allograft ,Cerebral palsy ,Goldberg score ,Aceteabular dysplasia ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Dega pelvic osteotomy is commonly performed procedure in patients with cerebral palsy (CP) undergoing hip reconstructive surgery for hip displacement. However, there has been no study investigating the outcomes after Dega pelvic osteotomy using allograft in patients with CP. This study investigated the outcomes of Dega pelvic osteotomy using iliac crest allograft in CP with hip displacement and the factors affecting allograft incorporation. Methods This study included 110 patients (150 hips; mean age 8y7mo; 68 males, 42 females) who underwent hip reconstructive surgeries including Dega pelvic osteotomy using iliac crest allograft. To evaluate the time of allograft incorporation, Goldberg score was evaluated according to the follow-up period on all postoperative hip radiographs. The acetabular index, migration percentage, and neck-shaft angle were also measured on the preoperative and postoperative follow-up radiographs. Results The mean estimated time for allograft incorporation (Goldberg score ≥ 6) was 1.1 years postoperatively. All hips showed radiographic union at the final follow-up and there was no case of graft-related complications. Patients with Gross Motor Function Classification System (GMFCS) level V had 6.9 times higher risk of radiographic delayed union than those with GMFCS level III and IV. Acetabular index did not increase during the follow-up period (p = 0.316). Conclusions Dega pelvic osteotomy using iliac crest allograft was effective in correcting acetabular dysplasia, without graft-related complications in patients with CP. Furthermore, the correction of acetabular dysplasia remained stable during the follow-up period.
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- 2018
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11. Radiographic differences in the concomitant deformities in two types of medial ankle osteoarthritis.
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Wooyoung Choi, Chin Youb Chung, Moon Seok Park, Sanghoon Lee, and Kyoung Min Lee
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Medicine ,Science - Abstract
ObjectivesMotion preserving surgeries could be unsuccessful because of underestimation of deformities of the foot and knee in ankle osteoarthritis. This study aimed to investigate the concomitant deformities in medial ankle osteoarthritis and the difference between the two types, varus angulation and medial translation.MethodsA retrospective study was conducted using medical records and radiographic data. Patients with medial ankle osteoarthritis that underwent weight-bearing X ray imaging and radiographic measurements including tibial plafond inclination (TPI), tibiotalar tilt angle (TT), lateral talo-first metatarsal angle, naviculo-cuboid overlap, and mechanical tibiofemoral angle (mTFA) were studied. The patients were categorized into two groups, the varus angulation group (TT ≥4°) and medial translation group (TT ResultsA total of 102 patients (male = 44; female = 58) were included; the mean age was 64.9 years (SD 8.3 years). The varus rotation group (N = 66) showed a significantly smaller lateral talo-first metatarsal angle (pConclusionsVarus angulation of the ankle was correlated with knee alignment and foot deformity. Radiographic indices were different between the varus angulation and medial translation groups. The role of concomitant deformities needs to be further investigated in terms of a causal relationship. Surgeons need to pay attention to concomitant deformities in the treatment of medial ankle osteoarthritis.
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- 2021
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12. Genu varum deformity due to premature epiphyseal closure after treatment with isotretinoin for neuroblastoma: A case report
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Won Keun Park, Hyoung Soo Choi, Chin Youb Chung, Moon Seok Park, and Ki Hyuk Sung
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Orthopedic surgery ,RD701-811 - Abstract
Isotretinoin, a vitamin A derivative, is known to induce premature epiphyseal closure. We report the case of a 9-year-old boy with neuroblastoma who demonstrated premature epiphyseal closure after 1 year of isotretinoin treatment (72.3 mg/m 2 /day). A bone bridge developed on the bilateral proximal tibial growth plate resulting in genu varum. We performed hemiepiphysiodesis on the bilateral proximal tibia in anticipation of the spontaneous resolution of the bone bridge. Genu varum on the left side was corrected with the resolution of bone bridge. For the remaining bone bridge on the right side, arthroscopy-assisted physeal bar resection was performed, and genu varum on the right lower extremity was also corrected. A regular review of the alignment of the upper and lower limbs is necessary to provide timely intervention in patients using isotretinoin, considering the possibility of premature epiphyseal closure.
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- 2020
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13. Fate of stable hips after prophylactic femoral varization osteotomy in patients with cerebral palsy
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Ki Hyuk Sung, Soon-Sun Kwon, Chin Youb Chung, Kyoung Min Lee, Jaeyoung Kim, Seung Yeol Lee, and Moon Seok Park
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Prophylactic femoral varization osteotomy ,Stable hip ,Displaced hip ,Cerebral palsy ,Hip reconstructive surgery ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Concurrent prophylactic femoral varization osteotomy (FVO) for stable hips has been performed in patients with cerebral palsy (CP) undergoing hip reconstructive surgery for the contralateral displaced hip. However, there is currently a lack of studies investigating the outcome after the prophylactic FVO in stable hip. This study investigated the outcomes after FVO in stable hips with CP and influencing factors. In addition, this study compared the outcomes with those after hip reconstructive surgery in the contralateral displaced hip. Methods This study included 119 CP patients with 224 hips (80 stable, 144 displaced) undergoing hip reconstructive surgery including FVO. Migration percentage (MP), neck-shaft angle (NSA), and head-shaft angle (HSA) were measured through preoperative and follow-up hip radiographs. All hips were divided into the stable (MP ≤ 33%) and displaced hip groups (MP > 33%) according to the preoperative radiographs, and the annual changes in the radiographic indices after FVO were analyzed. Results In stable hip group, MP did not significantly increase over time (p = 0.057) after prophylactic FVO. In displaced hip group, MP significantly increased over time (1.6%/year, p
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- 2018
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14. Influence of surgery involving tendons around the knee joint on ankle motion during gait in patients with cerebral palsy
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Seung Yeol Lee, Soon-Sun Kwon, Chin Youb Chung, Kyoung Min Lee, Ki Hyuk Sung, Sangwoo Kim, and Moon Seok Park
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Cerebral palsy ,Gait analysis ,Ankle kinematics ,Distal hamstring lengthening ,Rectus femoris transfer ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Simultaneous motion of the knee and ankle joints is required for many activities including gait. We aimed to evaluate the influence of surgery involving tendons around the knee on ankle motion during gait in the sagittal plane in cerebral palsy patients. Methods We included data from 55 limbs in 34 patients with spastic cerebral palsy. Patients were followed up after undergoing only distal hamstring lengthening with or without additional rectus femoris transfer. The patients’ mean age at the time of knee surgery was 11.2 ± 4.7 years, and the mean follow-up duration was 2.2 ± 1.5 years (range, 0.9–6.0 years). Pre- and postoperative kinematic variables that were extracted from three-dimensional gait analyses were then compared to assess changes in ankle motion after knee surgery. Outcome measures included ankle dorsiflexion at initial contact, peak ankle dorsiflexion during stance, peak ankle dorsiflexion during swing, and dynamic range of motion of the ankle. Various sagittal plane knee kinematics were also measured and used to predict ankle kinematics. A linear mixed model was constructed to estimate changes in ankle motion after adjusting for multiple factors. Results Improvement in total range of motion of the knee resulted in improved motion of the ankle joint. We estimated that after knee surgery, ankle dorsiflexion at initial contact, peak ankle dorsiflexion during stance, peak ankle dorsiflexion during swing, and dynamic range of motion of the ankle decreased, respectively, by 0.4° (p = 0.016), 0.6° (p
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- 2018
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15. Factors influencing outcomes after medial hamstring lengthening with semitendinosus transfer in patients with cerebral palsy
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Ki Hyuk Sung, Jaebong Lee, Chin Youb Chung, Kyoung Min Lee, Byung Chae Cho, Seung Jun Moon, Jaeyoung Kim, and Moon Seok Park
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Distal hamstring lengthening ,Cerebral palsy ,Flexed knee gait ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Background Although several studies have investigated the outcomes after distal hamstring lengthening (DHL), no study has undertaken an approach that included all or most of the important factors that could influence the results. This study was performed to evaluate the outcomes after DHL and analyze the factors that influence the improvement and serial change in knee motion after surgery in patients with cerebral palsy (CP), using a linear mixed model (LMM). Methods The study included 314 ambulatory CP patients (594 limbs) with spsastic diplegia who were followed up after undergoing DHL as part of a single-event multilevel surgery and who underwent preoperative and postoperative 3-dimensional (3D) gait analyses. Relevant kinematic values, including knee flexion at initial contact, minimum knee flexion in the stance phase, knee range of motion (ROM), mean pelvic tilt and gait deviation index (GDI) score, were the outcome measures. Changes in knee motion and the GDI score were adjusted for multiple factors, such as sex, the Gross Motor Function Classification System (GMFCS) level, and concomitant surgeries as fixed effects, and follow-up duration, laterality, and each subject as random effects, using a LMM. Results We found significant improvements in knee flexion at initial contact, minimum knee flexion in the stance phase, knee ROM, and GDI score 2 years after DHL. In patients with GMFCS level I and II, improvement in all sagittal knee kinematics was maintained during follow-up. In addition, GDI score, which represents overall gait pathology, consistently improved throughout the follow-up duration (1.2 per year, p = 0.008). Conclusion Medial hamstring lengthening with semitendinosus transfer, as a part of a SEMLS, was effective procedure in treating flexed knee gait with regard to sagittal knee kinematics and GDI score in spastic CP with flexed knee gait.
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- 2017
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16. Effects of walking speed and slope on pedobarographic findings in young healthy adults.
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Seungbum Koo, Moon Seok Park, Chin Youb Chung, Ji Soo Yoon, Chulhee Park, and Kyoung Min Lee
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Medicine ,Science - Abstract
BackgroundThis study aimed to investigate the effects of walking speed and slope on foot pressure changes in young healthy adults.MethodsTwenty young healthy adults (mean age 22.4 years, SD 1.2 years; 10 male and 10 female) participated in the study. Dynamic pedobarographic data during treadmill walking were obtained for combinations of three different walking speeds (3.2 km/hr, 4.3 km/hr, and 5.4 km/hr) and 5 different slopes (downhill 8 degrees, downhill 4 degrees, ground walking (0 degree), uphill 4 degrees, and uphill 8 degrees). Pedobarographic data such as the peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. Maximum ankle dorsiflexion was also recorded using the Plug in Gait marker set.ResultsAll participants maintained heel-toe gait in all walking conditions. The peak pressure on the MFF during downhill slope walking was lower than that during ground and uphill walking, whereas the peak pressure on the MFF during uphill slope walking was similar to that during ground walking at each walking speed. The peak pressures on the heel were similar for different walking slopes at each walking speed. The peak pressures on the MFF and heel increased with an increase in walking speed. The pressure-time integral of the MFF did not show significant changes at different walking speeds and slopes. The pressure-time integral of the heel increased with an increase in walking slope and decrease in walking speed.ConclusionsDifferent walking speeds and slopes affected the pedobarographic characteristics of young healthy adults. Downhill walking with slower speed appeared to be beneficial to reduce or optimize MFF pressures, while downhill walking at a comfortable speed would be helpful to reduce or optimize heel pressures. The findings of this study have clinical implications in recommending activities to patients with foot pressure-related symptoms and disorders.
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- 2019
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17. Correction: Effects of walking speed and slope on pedobarographic findings in young healthy adults.
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Seungbum Koo, Moon Seok Park, Chin Youb Chung, Ji Soo Yoon, Chulhee Park, and Kyoung Min Lee
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Medicine ,Science - Abstract
[This corrects the article DOI: 10.1371/journal.pone.0220073.].
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- 2019
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18. Factors associated with knee pain in 5148 women aged 50 years and older: A population-based study.
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Kyoung Min Lee, Seung-Baik Kang, Chin Youb Chung, Moon Seok Park, Dong-Wan Kang, and Chong Bum Chang
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Medicine ,Science - Abstract
This study was performed to investigate the factors associated with the level of knee pain in a nationally representative sample of noninstitutionalized women aged 50 years or older.Women aged 50 years or older were selected and included in the data analyses from the Korean National Health and Nutrition Examination Surveys (2010-2013). Those having malignant diseases or using osteoarthritis medication were excluded. Significant factors associated with the level of knee pain were analyzed using multivariate regression analysis.A total of 5148 women (average age, 62.9 years; standard deviation, 9.3 years) were included. For women without knee osteoarthritis, level of hip pain (p
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- 2018
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19. Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician's Round at Seoul National University Bundang Hospital
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Sooyoung Yoo, Seok Kim, Taegi Kim, Jon Soo Kim, Rong-Min Baek, Chang Suk Suh, Chin Youb Chung, and Hee Hwang
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mobile hospitals ,hospital information systems ,electronic health records ,empirical research ,patient satisfaction ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
ObjectivesThe cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study.MethodsEmpirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey.ResultsImplementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital.ConclusionsMobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation.
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- 2012
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20. Measurement of Urinary N-Telopeptides and Serum C-Telopeptides from Type I Collagen Using a Lateral Flow-Based Immunoassay
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Kyoung Min Lee, Min Ho Lee, Chin Youb Chung, Woo Kyeong Seong, Sang Dae Lee, and Moon Seok Park
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osteoporosis ,urine N-telopeptide ,serum C-telopeptide ,lateral flow immunoassay ,bone turnover marker ,Chemical technology ,TP1-1185 - Abstract
Measuring bone turnover markers could detect early stages of osteoporosis and early responses to anti-osteoporotic treatments. Currently, commonly used bone turnover markers, N-telopeptides (NTx) and C-telopeptides (CTx), are measured using ELISA tests, which demands time and increases cost. Bone turnover markers need to be measured more easily for general use. Lateral flow-based immunoassay would be an appropriate method for this context. This study was performed to investigate the precision of a newly developed lateral flow-based immunoassay for measuring the urinary NTx and serum CTx, and their correlations with ELISA measurements. Urine NTx and serum CTx concentrations were determined by photoscan of newly developed strips, using a lateral flow-based immunoassay for 36 subjects (mean age 66.2 years, SD 7.5 years; four males and 32 females). Repeated measurement of urinary NTx and serum CTx were performed three times, using this technology for a precision test. The correlation of the lateral flow-based immunoassay with the ELISA measurements was analyzed. Precision of the newly developed lateral flow based immunoassay was 0.974 (ICC, 95% confidence interval, 0.955 to 0.986) and 0.995 (ICC, 95% confidence interval, 0.991 to 0.997) for urinary NTx and serum CTx, respectively. The correlation of lateral flow based immunoassay with ELISA was 0.913 for urinary NTx and 0.872 for serum CTx. These results suggest that measuring the urinary NTx and serum CTx, using a lateral flow-based immunoassay, is a relevant method for point-of-care testing and screening of bone resorption markers.
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- 2012
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21. Seoul National University Bundang Hospital's Electronic System for Total Care
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Sooyoung Yoo, Kee Hyuck Lee, Hak Jong Lee, Kyooseob Ha, Cheong Lim, Ho Jun Chin, Jonghoar Yun, Eun-Young Cho, Eunja Chung, Rong-Min Baek, Chin Youb Chung, Won Ryang Wee, Chul Hee Lee, Hai-Seok Lee, Nam-Soo Byeon, and Hee Hwang
- Subjects
hospital information systems ,electronic health records ,quality of health care ,patient safety ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
ObjectivesSeoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS).MethodsSNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status.ResultsThe BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail.ConclusionsBeyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value.
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- 2012
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22. Repeatability of a multi‐segment foot model with 15‐marker set in normal adults
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Sang Gyo Seo, Dong Yeon Lee, Ji‐Beom Kim, Seong Hyun Kim, Hye Sun Park, Hyo Jeong Yoo, Sung Ju Kim, Jihyeung Kim, Kyoung Min Lee, Chin Youb Chung, and In Ho Choi
- Subjects
Narrow Range ,Sagittal Plane ,Healthy Adult ,Plane Motion ,Transverse Plane ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2014
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23. Temporal pattern in segmental motions of the foot in healthy senile adults: comparison between young and senile healthy adults
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Sang Gyo Seo, Dong Yeon Lee, Ji‐Beom Kim, Seong Hyun Kim, Hye Sun Park, Hyo Jeong Yoo, Sung Ju Kim, Jihyeung Kim, Kyoung Min Lee, Chin Youb Chung, and In Ho Choi
- Subjects
Public Health ,Young Adult ,Temporal Pattern ,Healthy Adult ,Segmental Motion ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2014
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24. Gender differences in segmental foot motions during gait using 3D multi‐segment foot model
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Sang Gyo Seo, Dong Yeon Lee, Ji‐Beom Kim, Seong Hyun Kim, Hye Sun Park, Hyo Jeong Yoo, Sung Ju Kim, Jihyeung Kim, Kyoung Min Lee, Chin Youb Chung, and In Ho Choi
- Subjects
Gender Difference ,Reference Data ,Healthy Adult ,Segmental Motion ,Arch Data ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2014
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25. Repeatability of a multi‐segment foot model with a 15‐marker set in healthy adults
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Sang Gyo Seo, Dong Yeon Lee, Hyuk Ju Moon, Sung Ju Kim, Jihyeung Kim, Kyoung Min Lee, Chin Youb Chung, and In Ho Choi
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Gait analysis ,Repeatability ,Multi‐segment foot model ,Foot 3D ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Several 3D multi‐segment foot models (MFMs) have been introduced for the in vivo analysis of dynamic foot kinematics. However, reproducibility of a model should be checked and ascertained before clinical utilization of a MFM. The purpose of this study was to determine the reliability of recently introduced MFM with a 15‐marker set by assessing the participant's stride‐to‐stride (intra‐session) and visit‐to‐revisit (inter‐session) repeatability. Methods Twenty healthy adults with a mean age of 28.9 years (10 males and 10 females) were tested. Three representative strides from five separate trials were used for analysis from each session. Kinematic data of foot segmental motion was collected and tracked using the Foot3D Multi‐Segment Software (Motion Analysis Co., Santa Rosa. CA). A retest was performed in the same manner at an interval of 4 weeks. Coefficients of multiple correlation (CMC) and intra‐class correlation coefficient (ICC) were calculated in order to assess the intra‐session and inter‐session repeatability. Results Inter‐segment foot angles from healthy adults from a MFM with 15‐marker set showed a narrow range of variability during the gait cycle. The mean intra‐session ICC was 0.981 (±0.010), which was interpreted as excellent. The mean intra‐session CMC was 0.948 (±0.027), which was interpreted as very good repeatability. The mean inter‐session ICC was 0.886 (±0.047) and the mean inter‐session CMC was 0.801 (±0.077), which were interpreted as excellent and good repeatability, respectively. Conclusion We demonstrated a MFM with a 15‐marker set had high intra‐session and inter‐session repeatability, especially in sagittal plane motion. We thought this MFM would be applicable to evaluation of the segmental foot motion during gait.
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- 2014
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26. Post-traumatic avascular necrosis of tibial plafond following an ankle fracture
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Kyoung Min Lee, Ki Hyuk Sung, Ki Bum Kwon, Moon Seok Park, and Chin Youb Chung
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medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Fracture (geology) ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,Avascular necrosis ,Ankle ,business ,Tibial plafond ,medicine.disease - Published
- 2022
27. When to Combine Acetabular Osteotomy in Patients With Proximal Femoral Deformity Causing Residual Hip Dysplasia/Subluxation After Reduction of Developmental Dysplasia of the Hip.
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Yoon Joo Cho, Ihn Seok Chae, Mi Hyun Song, Chang Ho Shin, Chin Youb Chung, In Ho Choi, and Tae-Joon Cho
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- 2023
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28. What happens to the patella height in patients with cerebral palsy as they age
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Chin Youb Chung, Kyoung Min Lee, Jae Jung Min, Soon Sun Kwon, Hansang Lee, Moon Seok Park, and Ki Hyuk Sung
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medicine.medical_specialty ,business.industry ,Cerebral Palsy ,Retrospective cohort study ,Gross Motor Function Classification System ,Patella ,medicine.disease ,Cerebral palsy ,Radiography ,Child, Preschool ,Reference values ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Bone Diseases ,business ,Retrospective Studies - Abstract
OBJECTIVE We aimed to investigate the progression of patella alta (PA) in patients with cerebral palsy (CP) using the Koshino-Sugimoto (KS) index and assess associated risk factors. METHOD Participants in our retrospective study met the following inclusion criteria: patients with CP who visited our institute from May 2003 to December 2019, were ≤18 years of age, were followed up for >2 years and had at least two lateral knee radiographs. KS indices of both knee radiographs were measured for each patient. A linear mixed model was implemented. RESULTS Our participants included 222 CP patients. KS index values were measured via 652 knee radiographs. Reference values of the KS index for those between 4 and 18 years of age were determined according to Gross Motor Function Classification System (GMFCS) levels. In all GMFCS levels, the KS index decreased with patients' ages (P < 0.0001). In groups where the KS index increased, GMFCS levels IV (P = 0.0045) and V (P = 0.0040) were statistically significant. CONCLUSIONS Change in the KS index values indicates that PA improves as patients age within all GMFCS levels. However, in patients with GMFCS levels of IV and V, progressive PA is expected.
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- 2021
29. Remodelling of femoral head deformity after hip reconstructive surgery in patients with cerebral palsy
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Ki Hyuk Sung, Soon Sun Kwon, Kyoung Min Lee, Moon Seok Park, Chin Youb Chung, and Jae Jung Min
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Male ,Reconstructive surgery ,medicine.medical_specialty ,Mose hip ratio ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Femoral Head Deformity ,Femoral head deformity ,Annular ligament reconstruction ,Hip Dislocation ,Humans ,Medicine ,Hip reconstructive surgery ,Orthopedics and Sports Medicine ,Displacement (orthopedic surgery) ,In patient ,030212 general & internal medicine ,Child ,Retrospective Studies ,030222 orthopedics ,business.industry ,Cerebral Palsy ,Open reduction ,Femur Head ,Children’s Orthopaedics ,Plastic Surgery Procedures ,medicine.disease ,Ulnar osteotomy ,Osteotomy ,Surgery ,CP hip displacement ,Chronic Monteggia ,Female ,Bone Remodeling ,business - Abstract
Aims Hip displacement, common in patients with cerebral palsy (CP), causes pain and hinders adequate care. Hip reconstructive surgery (HRS) is performed to treat hip displacement; however, only a few studies have quantitatively assessed femoral head sphericity after HRS. The aim of this study was to quantitatively assess improvement in hip sphericity after HRS in patients with CP. Methods We retrospectively analyzed hip radiographs of patients who had undergone HRS because of CP-associated hip displacement. The pre- and postoperative migration percentage (MP), femoral neck-shaft angle (NSA), and sphericity, as determined by the Mose hip ratio (MHR), age at surgery, Gross Motor Function Classification System level, surgical history including Dega pelvic osteotomy, and triradiate cartilage status were studied. Regression analyses using linear mixed model were performed to identify factors affecting hip sphericity improvement. Results A total of 108 patients were enrolled. The mean preoperative MP was 58.3% (SD 31.7%), which improved to 9.1% (SD 15.6%) at the last follow-up. NSA and MHR improved from 156.5° (SD 11.5°) and 82.3% (SD 8.6%) to 126.0° (SD 18.5°) and 89.1% (SD 9.0%), respectively. Factors affecting the postoperative MHR were preoperative MP (p = 0.005), immediate postoperative MP (p = 0.032), and history of Dega osteotomy (p = 0.046). Conclusion We found that hip sphericity improves with HRS. Preoperative MP, reduction quality, and acetabular coverage influence femoral head remodelling. We recommend that surgeons should consider intervention early before hip displacement progresses and that during HRS, definite reduction and coverage of the femoral head should be obtained. Cite this article: Bone Joint J 2021;103-B(1):198–203.
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- 2021
30. Measurement of Urinary N-Telopeptides and Serum C-Telopeptides from Type I Collagen Using a Lateral Flow-Based Immunoassay.
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Kyoung-Min Lee, Min Ho Lee, Chin Youb Chung, Woo Kyeong Seong, Sang Dae Lee, and Moon Seok Park
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- 2013
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31. Patients’ perspectives on the conventional synthetic cast vs a newly developed open cast for ankle sprains
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Kyoung Min Lee, Chin Youb Chung, Ji Soo Yoon, Byung Cho Min, Moon Seok Park, and Ki Hyuk Sung
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030222 orthopedics ,medicine.medical_specialty ,business.industry ,education ,030229 sport sciences ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Physical therapy ,Medicine ,Orthopedics and Sports Medicine ,Ankle ,business ,Ankle sprain ,human activities - Abstract
Patients’ perspectives on the conventional synthetic cast vs a newly developed open cast for ankle sprains
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- 2020
32. Development and impact of radio-frequency identification-based workflow management in health promotion center: using interrupted time-series analysis.
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Ju Young Kim, Hak Jong Lee, Nam-Soo Byeon, Hyun-Chul Kim, Kyooseob Ha, and Chin Youb Chung
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- 2010
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33. Factors Affecting Subjective Symptoms in Children with Pes Planovalgus Deformity
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Jae Jung Min, Moon Seok Park, Kyoung Min Lee, Ki Hyuk Sung, Soon Sun Kwon, and Chin Youb Chung
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Male ,medicine.medical_specialty ,Adolescent ,Radiography ,Severity of Illness Index ,Diagnostic Self Evaluation ,Deformity ,Humans ,Medicine ,Orthopedics and Sports Medicine ,In patient ,Child ,Retrospective Studies ,biology ,business.industry ,Forefoot ,General Medicine ,biology.organism_classification ,Flatfoot ,body regions ,Valgus ,medicine.anatomical_structure ,Physical therapy ,Female ,Surgery ,Self Report ,Ankle ,medicine.symptom ,business ,Foot (unit) ,Pes planovalgus - Abstract
BACKGROUND Idiopathic pes planovalgus is one of the most common foot deformities in children and adolescents. However, there is a discrepancy between subjective symptoms and radiographic severity in idiopathic planovalgus deformity, and very few studies have investigated this aspect. Further, the assessment of subjective symptoms in patients with pes planovalgus requires a quantitative scoring system for making meaningful comparisons, such as the Oxford Ankle Foot Questionnaire for Children (OxAFQ-c) and that for parents (OxAFQ-p). Therefore, the purpose of this study was to evaluate the factors affecting the symptoms of idiopathic planovalgus using the OxAFQ. METHODS All patients who were ≤18 years of age, had visited our clinic for the evaluation of pes planovalgus deformity, and had completed the OxAFQ were included in this study. The anteroposterior talo-first metatarsal, lateral talo-first metatarsal, and hallux valgus angles were measured on weight-bearing radiographs. The data were analyzed using a multiple regression model, with age, sex, and radiographic indices as explanatory variables. RESULTS Overall, 123 patients were enrolled in this study, and 246 standing foot radiographs were evaluated along with scores in each domain of the OxAFQ. The factors affecting physical domain scores in the OxAFQ-c were female sex (p = 0.047) and the anteroposterior talo-first metatarsal angle (p = 0.033). Age of ≥10 years was a significant factor (p < 0.05) affecting all domains in both the OxAFQ-c and OxAFQ-p other than the physical domain score. CONCLUSIONS Although pes planovalgus deformity is 3-dimensional, the forefoot abduction component of the deformity should be carefully assessed as it is closely related to subjective symptoms. Further, in female patients with a more severe anteroposterior talo-first metatarsal angle, an aggravation of symptoms with aging should be expected when managing pes planovalgus deformity. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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- 2020
34. Transcultural adaptation and validation of a Korean version of the Oxford Ankle Foot Questionnaire for children
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Ki Hyuk Sung, Seong Hee Cho, Chin Youb Chung, Kyoung Min Lee, and Moon Seok Park
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Cross-Cultural Comparison ,Male ,Translation ,Adolescent ,Intraclass correlation ,Korean ,Test validity ,lcsh:Computer applications to medicine. Medical informatics ,Foot Diseases ,03 medical and health sciences ,0302 clinical medicine ,Cronbach's alpha ,Quality of life ,Surveys and Questionnaires ,Republic of Korea ,medicine ,Humans ,Translations ,Child ,Reliability (statistics) ,030203 arthritis & rheumatology ,Foot (prosody) ,validation ,Research ,030503 health policy & services ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,Construct validity ,Transcultural adaptation ,General Medicine ,medicine.anatomical_structure ,Quality of Life ,Oxford ankle foot questionnaire for children ,lcsh:R858-859.7 ,Female ,Ankle ,Factor Analysis, Statistical ,0305 other medical science ,Psychology ,Clinical psychology - Abstract
Background The purpose of this study was to translate and transculturally adapt the original English version of the Oxford Ankle Foot Questionnaire (OAFQ) into a Korean version, and to evaluate its psychometric properties. Methods A Korean OAFQ for children was developed according to established guidelines. To test validity, 169 consecutive patients with foot and ankle problems and their caregivers each completed the OAFQ. The children also completed a Korean version of the KIDSCREEN-52 health related quality of life questionnaire (KIDSCREEN-52 HRQOL). To validate the Korean version of the OAFQ, reliability (child–parent agreement and internal consistency), feasibility (floor and ceiling effects), and construct validity were evaluated, and factor analysis was performed. Results In terms of reliability, Cronbach’s α values were > 0.7 in all subscales of the OAFQ (0.765 to 0.901). Child–parent agreement was confirmed by high intraclass correlation coefficients for all subscales (0.791 to 0.863). In terms of construct validity, there were moderate correlations between the subscales of the OAFQ and the subscales of the KIDSCREEN-52 HRQOL. Factor analysis revealed a three-component solution for both the child/adolescent and parent-proxy version, by combining the school and play, and footwear items into one subscale. In terms of feasibility, no floor effects were found for all subscales. However, ceiling effects were observed for the school and play, and emotional subscales for child/adolescent and parent-proxy versions. Conclusions The OAFQ was successfully translated and transculturally adapted into the Korean language; the Korean version of the OAFQ represents a reliable and valid instrument for evaluating children’s foot or ankle problems. However, factor analysis suggested the use of a three-subscale questionnaire.
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- 2020
35. Surgical outcomes after single event multilevel surgery in cerebral palsy patients with mid-stance knee hyperextension
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Ki Hyuk Sung, Moon Seok Park, Chin Youb Chung, Kyoung Min Lee, and Soon Sun Kwon
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Male ,musculoskeletal diseases ,medicine.medical_specialty ,Adolescent ,Knee Joint ,Biophysics ,Hyperextension ,Multilevel surgery ,Hamstring Muscles ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Postoperative Period ,Child ,Muscle, Skeletal ,Retrospective Studies ,business.industry ,Cerebral Palsy ,Rehabilitation ,030229 sport sciences ,musculoskeletal system ,medicine.disease ,Sagittal plane ,Biomechanical Phenomena ,Surgery ,Tenotomy ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,Gait analysis ,Standing Position ,Female ,Ankle ,Gait Analysis ,business ,Ankle Joint ,030217 neurology & neurosurgery ,Hamstring lengthening - Abstract
Background Some patients with cerebral palsy (CP) exhibit excessive knee flexion at initial contact followed by knee hyperextension (KE) in mid-stance. Research question This study investigated the change in sagittal kinematics after distal hamstring lengthening (DHL) and triceps surae lengthening procedures in CP patients with KE, and compared it to those without KE. In addition, the risk factors for the worsening of postoperative KE were analyzed. Methods Consecutive 312 patients (596 limbs) with CP who underwent DHL and triceps surae lengthening were included. All patients underwent preoperative and 1-year postoperative three-dimensional gait analysis. Patients’ limbs were divided into the KE and knee flexion (KF) groups, according to preoperative minimum knee flexion in stance. KE was defined as minimum knee flexion in stance less than 0°. Results The KE and KF groups included 130 and 466 limbs, respectively. Knee and ankle sagittal kinematics significantly improved after surgery in both groups. Minimum knee flexion in stance significantly increased from -6.6˚ to 0.5˚ in the KE group, but decreased from 14.6˚ to 7.8˚ in the KF group. Among the KE group, minimum knee flexion in stance improved in 103 limbs (79.2 %), but worsened in 27 limbs (20.8 %). Degree of preoperative KE was the only factor significantly associated with postoperative worsening of KE (p=0.002). The cutoff value for the worsening of KE was -5.8˚ of preoperative minimum knee flexion in stance. Significance This study demonstrated that the sagittal kinematics of the knee and ankle joints improved after DHL and triceps surae lengthening procedures in CP patients with and without KE. Preoperative degree of KE was a risk factor for the worsening of KE after surgery. Therefore, careful selection for indication of DHL is required to prevent postoperative KE due to overlengthening of the hamstrings, particularly in patients with severe preoperative KE.
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- 2020
36. Radiographic changes of the mid-tarsal joint after calcaneal lengthening for planovalgus foot deformity
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Moon Seok Park, Ki Hyuk Sung, Chin Youb Chung, Soon Sun Kwon, and Kyoung Min Lee
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Foot Deformities ,musculoskeletal diseases ,medicine.medical_specialty ,Adolescent ,Radiography ,Arthritis ,Tarsal Joints ,Young Adult ,Risk Factors ,Deformity ,medicine ,Humans ,Orthopedics and Sports Medicine ,Child ,Foot deformity ,Retrospective Studies ,Subluxation ,business.industry ,Tarsal Joint ,Surgical correction ,medicine.disease ,Surgery ,Calcaneus ,Child, Preschool ,Female ,sense organs ,medicine.symptom ,business - Abstract
Background This study evaluate the radiographic changes in the mid-tarsal joint, including the calcaneocuboid and talonavicular (TN) joints after calcaneal lengthening for planovalgus deformity in children. Methods This study included 38 patients (68 feet) who underwent calcaneal lengthening for planovalgus deformity. Radiographic osteoarthritic changes at the CC or TN joint were defined as modified Kellgren–Lawrence grade of ≥1. Results Among the 68 feet, 31 feet (45.6%) showed radiographic osteoarthritic changes at the CC joint and 20 (29.4%) showed changes at the TN joint. Risk of radiographic osteoarthritic changes at the CC joint was associated with increased age at surgery (OR = 1.2, p = 0.038). Risk of radiographic osteoarthritic changes at the TN joint was associated with increased age at surgery (OR = 2.2; p = 0.002), preoperative AP talus-1st metatarsal angle (OR = 1.1; p = 0.044), and degree of CC subluxation (OR = 2.1; p = 0.007). Conclusions Surgeons should consider the risk factors in the surgical correction of planovalgus deformity to prevent mid-tarsal arthritis.
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- 2020
37. Development and Validation of a Mobile Application for Measuring Femoral Anteversion in Patients With Cerebral Palsy
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Jae Jung Min, Hendra Cahya Kumara, Chin Youb Chung, Muhammad Ihsan Kitta, Ki Hyuk Sung, Jehee Lee, Moon Seok Park, and Kibeom Youn
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Male ,validity ,Adolescent ,Intraclass correlation ,Radiography ,Concurrent validity ,Validity ,03 medical and health sciences ,0302 clinical medicine ,Bone Anteversion ,Imaging, Three-Dimensional ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Femur ,Child ,Reliability (statistics) ,030222 orthopedics ,Contouring ,business.industry ,Cerebral Palsy ,3D reconstruction ,Reproducibility of Results ,computed tomography ,General Medicine ,mobile application ,Mobile Applications ,femoral anteversion ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,business ,Nuclear medicine ,Algorithms - Abstract
Supplemental Digital Content is available in the text., Background: Computed tomography (CT) provides benefits for 3-dimensional (3D) visualization of femur deformities. However, the potential adverse effects of radiation exposure have become a concern. Consequently, a biplanar imaging system EOS has been proposed to enable reconstruction of the 3D model of the femur. However, this system requires a calibrated apparatus, the cost of which is high, and the area occupied by it is substantial. The purpose of this study was to develop a mobile application that included a new method of 3D reconstruction of the femur from conventional radiographic images and to evaluate the validity and reliability of mobile the application when measuring femoral anteversion. Methods: The statistical shape model, graph-cut algorithm, and iterative Perspective-n-Point algorithm were utilized to develop the application. The anteroposterior and lateral images of a femur can be input using the embedded camera or by file transfer, and the touch interface aids accurate contouring of the femur. Regarding validation, the CT scans and conventional radiographic images of 36 patients with cerebral palsy were used. To evaluate concurrent validity, the femoral anteversion measurements on the images reconstructed from the mobile application were compared with those from the 3D CT images. Three clinicians assessed interobserver reliability. Results: The mobile application, which reconstructs the 3D image from conventional radiographs, was successfully developed. Regarding concurrent validity, the correlation coefficient between femoral anteversion measured using 3D CT and the mobile application was 0.968 (P
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- 2019
38. Effects of soft tissue surgery on transverse kinematics in patients with cerebral palsy
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Seong Hee Cho, Moon Seok Park, Byeong Seop Park, Kyoung Min Lee, Ki Hyuk Sung, and Chin Youb Chung
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Male ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Adolescent ,Transverse kinematics ,Cerebral palsy ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Multilevel surgery ,Rheumatology ,Internal medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Child ,Retrospective Studies ,Gait Disturbance ,business.industry ,Soft tissue ,030229 sport sciences ,medicine.disease ,Gait ,Sagittal plane ,Surgery ,Biomechanical Phenomena ,medicine.anatomical_structure ,Treatment Outcome ,Gait analysis ,Child, Preschool ,Orthopedic surgery ,Female ,lcsh:RC925-935 ,business ,Soft tissue surgery ,030217 neurology & neurosurgery ,Research Article - Abstract
Background Gait disturbances, including flexed knee gait, stiff knee gait, and tip-toeing gait, are common in patients with cerebral palsy (CP). There has been no reports regarding kinematic changes in the transverse plane after soft tissue surgeries, such as distal hamstring lengthening (DHL), rectus femoris transfer (RFT), and tendo-Achilles lengthening (TAL). This study aimed to evaluate changes in the transverse plane after soft tissue surgery in patients with CP by assessing the effects of the DHL, RFT, and TAL. Methods The study enrolled 156 consecutive patients (mean age, 8.4 years; range, 4.4 to 20.9), representing 213 operated limbs, who underwent soft tissue surgery including DHL with semitendinosus transfer, RFT, and TAL. All patients were assessed by preoperative and 1-year postoperative three-dimensional gait analysis. Changes in transverse plane kinematics after soft tissue surgery and affecting factors were analyzed. Results Sagittal kinematics including knee flexion at initial contact, ankle dorsiflexion at initial contact, and mean ankle dorsiflexion in the stance phase were significantly improved after single event multilevel surgery (all p p = 0.004 and − 9.5°, p p = 0.010) and the foot progression angle was significantly improved to a more external angle by TAL (− 3.9°, p = 0.028). Conclusions This study found that the transverse kinematics were improved to a more external angle after soft tissue surgery in patients with CP. Therefore, clinicians should consider that soft tissue surgery can affect the transverse plane kinematics in patients with CP. To confirm our findings, further research regarding the natural history of femoral and tibial torsion in children with CP is needed.
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- 2019
39. Analysis of three-dimensional computed tomography talar morphology in relation to pediatric pes planovalgus deformity
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Moon Seok Park, Seungbum Koo, Soon Do Wang, Ki Hyuk Sung, Kyoung Min Lee, Ki Jin Jung, Chin Youb Chung, and Sang Il Moon
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Male ,Radiography ,Pes planus ,Talus ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Deformity ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Child ,Retrospective Studies ,Orthodontics ,030222 orthopedics ,business.industry ,Cerebral Palsy ,Biomechanics ,Flatfoot ,Sagittal plane ,body regions ,Tarsal Bone ,medicine.anatomical_structure ,Coronal plane ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,Ankle ,Tomography, X-Ray Computed ,business ,human activities ,030217 neurology & neurosurgery - Abstract
Intraosseous alignment of the tarsal bone has not been investigated in relation to various foot deformities. This study aimed to investigate three-dimensional computed tomography (3D CT) talar morphology in children with idiopathic and neuromuscular pes planovalgus. Eleven children [nine boys, two girls; mean (SD) age: 10.5 (2.8) years] with idiopathic pes planovalgus and 15 children [three boys, 12 girls; mean (SD) age: 10.8 (3.4) years] with neuromuscular pes planovalgus were included. All patients underwent 3D CT and weight-bearing anteroposterior, lateral, and axial radiography. Demographic data and talar 3D CT and radiographic measurements were compared between both groups. The correlation between the measurements was also analyzed. The neuromuscular group showed significantly more severe deformity than the idiopathic group in the radiographic and 3D sagittal talus measurements. The 3D coronal talus measurement showed a significant negative correlation with the axial hindfoot alignment in the idiopathic group while the 3D transverse talus measurement was significantly correlated with the lateral talocalcaneal angle in the neuromuscular group. 3D intraosseous alignment of the talus is correlated with pes planus deformity. Longitudinal and biomechanical studies including a control group are necessary to elucidate the role of 3D talar morphology on a dynamic imbalance in pes planovalgus.
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- 2019
40. Lengthening and deformity correction in vascularized fibular autograft for a patient with Ewing sarcoma
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Kyoung Min Lee, Moon Seok Park, Ki Hyuk Sung, Ki Bum Kwon, and Chin Youb Chung
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musculoskeletal diseases ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Nonunion ,Sarcoma, Ewing ,Bone Lengthening ,Deformity ,medicine ,Humans ,Outpatient clinic ,Tibia ,Autografts ,Child ,Varus deformity ,Orthopedic surgery ,Osteosynthesis ,business.industry ,medicine.disease ,musculoskeletal system ,Surgery ,Treatment Outcome ,surgical procedures, operative ,Fibula ,Distraction osteogenesis ,Female ,medicine.symptom ,business ,RD701-811 ,Corticotomy - Abstract
We report the case of a pediatric patient with Ewing’s sarcoma of the tibia treated with vascularized fibular autograft where the resulting limb deformity and leg length discrepancy (LLD) were corrected using Ilizarov external fixator. A 14-year-old girl presented to our outpatient clinic with a deformity of the right proximal and distal tibia and an 11.7 cm of LLD after tumor reconstruction surgery. Deformity correction and limb lengthening were simultaneously performed using double corticotomy on the right proximal and distal tibia. One year postoperatively, the union of the right proximal tibia had progressed, but nonunion was observed at the right distal corticotomy site. To address this, osteosynthesis with tricortical iliac bone allograft was performed after the removal of the Ilizarov external fixator. After 6 months, the union of the distal tibia was confirmed, and the varus deformity of proximal and distal tibia improved. The LLD was also decreased, but the left lower limb was still longer by 3 cm. This report shows that vascularized fibular autografts can potentially be used for the gradual correction of LLD and deformities. However, for the treatment of multiple deformities in bones previously reconstructed with vascularized fibular graft, the possibility of impaired bone forming potential of the fibular graft should be considered.
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- 2021
41. Radiographic differences in the concomitant deformities in two types of medial ankle osteoarthritis
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Kyoung Min Lee, Sang Hoon Lee, Woo Young Choi, Chin Youb Chung, and Moon Seok Park
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Male ,Knee Joint ,Radiography ,Knees ,Health Care Providers ,Osteoarthritis ,Tibial plafond ,0302 clinical medicine ,Skeletal Joints ,Medicine and Health Sciences ,Biomechanics ,Medical Personnel ,Arthrography ,Musculoskeletal System ,Orthodontics ,030222 orthopedics ,Multidisciplinary ,Feet ,Middle Aged ,Ankle Joints ,Professions ,medicine.anatomical_structure ,Medicine ,Legs ,Female ,Anatomy ,Research Article ,Ankle osteoarthritis ,Science ,Surgical and Invasive Medical Procedures ,03 medical and health sciences ,Rheumatology ,Physicians ,medicine ,Humans ,Foot deformity ,Skeleton ,Aged ,030203 arthritis & rheumatology ,Surgeons ,business.industry ,Arthritis ,Ankles ,Biology and Life Sciences ,medicine.disease ,Health Care ,Concomitant ,Body Limbs ,Logistic analysis ,People and Places ,Population Groupings ,Ankle ,business ,Ankle Joint - Abstract
Objectives Motion preserving surgeries could be unsuccessful because of underestimation of deformities of the foot and knee in ankle osteoarthritis. This study aimed to investigate the concomitant deformities in medial ankle osteoarthritis and the difference between the two types, varus angulation and medial translation. Methods A retrospective study was conducted using medical records and radiographic data. Patients with medial ankle osteoarthritis that underwent weight-bearing X ray imaging and radiographic measurements including tibial plafond inclination (TPI), tibiotalar tilt angle (TT), lateral talo-first metatarsal angle, naviculo-cuboid overlap, and mechanical tibiofemoral angle (mTFA) were studied. The patients were categorized into two groups, the varus angulation group (TT ≥4°) and medial translation group (TT Results A total of 102 patients (male = 44; female = 58) were included; the mean age was 64.9 years (SD 8.3 years). The varus rotation group (N = 66) showed a significantly smaller lateral talo-first metatarsal angle (p Conclusions Varus angulation of the ankle was correlated with knee alignment and foot deformity. Radiographic indices were different between the varus angulation and medial translation groups. The role of concomitant deformities needs to be further investigated in terms of a causal relationship. Surgeons need to pay attention to concomitant deformities in the treatment of medial ankle osteoarthritis.
- Published
- 2021
42. Differences in responses to English and Korean versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD)
- Author
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Chin Youb Chung, Soon Sun Kwon, Clarissa Encisa, Huroy Menal, Moon Seok Park, Unni G. Narayanan, Ki Hyuk Sung, and Gyeong Hee Cho
- Subjects
Adult ,Cross-Cultural Comparison ,Male ,Parents ,Gerontology ,Activities of daily living ,Adolescent ,Psychological intervention ,Korean ,lcsh:Computer applications to medicine. Medical informatics ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,English ,Surveys and Questionnaires ,Republic of Korea ,medicine ,Humans ,Disabled Persons ,Prospective Studies ,030212 general & internal medicine ,Child ,Language ,Questionnaire ,Research ,030503 health policy & services ,Public Health, Environmental and Occupational Health ,Social environment ,Gross Motor Function Classification System ,General Medicine ,Middle Aged ,medicine.disease ,Social relation ,Caregivers ,Child, Preschool ,Propensity score matching ,Quality of Life ,lcsh:R858-859.7 ,Female ,0305 other medical science ,Psychology - Abstract
Background The purpose of this study was to identify differences in caregiver responses to Korean-language and English-language versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD) questionnaire. Methods Patient data were acquired from the Cerebral Palsy Hip Outcomes Project database, which was established to run a large international multicenter prospective cohort study of the outcomes of hip interventions in cerebral palsy. Thirty-three children whose caregivers had completed the Korean version of CPCHILD were matched by propensity scoring with 33 children whose parents completed the English version. Matching was performed on the basis of 12 covariates: age, gender, gross motor function classification system level, migration percentage of right and hip, seizure status, feeding method, tracheostomy status, pelvic obliquity, spinal deformity, parental report of hip pain and contracture interfering with care. Results There were no significant differences in CPCHILD scores for section 4 (Communication and Social Interaction), and section 5 (Health) between two groups. Korean-language CPCHILD scores were significantly lower than English-language CPCHILD scores for section 1 (Personal Care/Activities of Daily Living), section 2 (Positioning, Transferring and Mobility), section 3 (Comfort and Emotions) and section 6 (Overall Quality of Life) as well as in terms of total score. Conclusions Cultural influences, and the community or social environment may impact the caregivers’ perception of the health-related quality of life of their children. Therefore, physicians should consider these differences when interpreting the study outcomes across different countries.
- Published
- 2020
43. Aggravation of Ankle Varus Incongruency Following Total Knee Replacement Correcting ≥10° of Genu Varum Deformity: A Radiographic Assessment
- Author
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Kyoung Min Lee, Chong Bum Chang, Moon Seok Park, Chin Youb Chung, Jong Seop Kim, and Ji Hye Choi
- Subjects
musculoskeletal diseases ,Male ,Knee Joint ,Radiography ,Total knee replacement ,Genu varum ,Osteoarthritis ,Genu Varum ,Deformity ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Ankle pain ,Arthroplasty, Replacement, Knee ,Child ,Orthodontics ,Tibia ,business.industry ,Osteoarthritis, Knee ,medicine.disease ,medicine.anatomical_structure ,Female ,medicine.symptom ,Ankle ,business ,Ankle Joint - Abstract
Background This study aimed to investigate the change in ankle varus incongruencies following total knee replacement (TKR) in patients with preoperative genu varum deformity of ≥10°. Methods The study cohort was composed of patients who underwent TKR in a single institution for knee osteoarthritis with preoperative genu varum deformity of ≥10° and concomitant varus ankle incongruencies. Eight radiographic measurements were evaluated preoperatively and postoperatively: mechanical tibiofemoral angle, mechanical lateral distal femoral angle, medial proximal tibial angle, lateral distal tibial angle, tibial plafond inclination, talar inclination, tibiotalar tilt angle (TTTA), and tibia-mechanical axis angle. Of these, TTTA represented the quantitative degree of ankle joint incongruency. Results A total of 110 patients (male = 2; female = 108) were included in the analysis. The mean patient age was 68.9 (standard deviation [SD] 7.2) years at the time of TKR. All radiographic measurements showed significant changes postoperatively, representing the appropriate correction of genu varum deformity and restoration of the mechanical axis. Nineteen patients (17.3%) showed postoperative decrease in TTTA, 2 (1.8%) remained the same, and 89 (80.9%) showed increase. Overall, mean preoperative and postoperative TTTA were 3.3° (SD 2.2°) and 4.7° (SD 2.9°), respectively (P Conclusion Varus ankle incongruencies showed aggravation following TKR despite correction of genu varum deformity and restoration of the mechanical axis. This could be an important cause of postoperative increase or development of ankle pain following TKR. Therefore, patients with preoperative varus ankle incongruencies need to be warned of possible aggravation of ankle symptoms and be evaluated before TKR. Level of Evidence Prognostic level III.
- Published
- 2020
44. Patients' perspectives on the conventional synthetic cast
- Author
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Byung Cho, Min, Ji Soo, Yoon, Chin Youb, Chung, Moon Seok, Park, Ki Hyuk, Sung, and Kyoung Min, Lee
- Subjects
Cast material ,Randomized Controlled Trial ,Conventional cast ,Comparison ,Clinical utility ,Open cast ,Ankle sprain - Abstract
BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured. There have been no significant structural changes or advances in synthetic casts since the development of the modern cast. The Opencast® is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related complications. Although this novel cast appears to have more benefits than the conventional synthetic cast, its clinical efficacy and advantages have not been established. AIM To investigate the clinical efficacy and advantages of the newly developed Opencast® based on patients’ perspectives in those with ankle inversion injury. METHODS A specifically designed questionnaire consisting of 19 items was used to compare patients’ opinions and concerns of the Opencast® and the conventional synthetic cast. The items were focused on subjective patient satisfaction, discomfort, and adverse effects while wearing the cast. Patients with an ankle inversion injury diagnosed as a high-grade ankle sprain were enrolled. The subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast® for 2 wk. They were then required to fill the questionnaire again, after switching to the alternative type of cast for 2 more weeks. RESULTS A total of 22 subjects participated in the study. The synthetic cast appeared to be more rigid and stable than the Opencast®, but there was no significant difference in the amount of pain relief. The likelihood of adverse effects when wearing the synthetic cast was significantly higher. Patient satisfaction tended to be rated higher after wearing the Opencast®. Opencast® showed more subjective vulnerability than the synthetic cast, but there was no significant difference in the redo rate. Patients were more anxious about removal of the synthetic cast than of the Opencast®. CONCLUSION The results indicate that the Opencast® could replace the conventional synthetic cast as it offers increased patient satisfaction, which would in turn increase compliance to treatment.
- Published
- 2020
45. Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity
- Author
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Kyoung Min Lee, Ki Bum Kwon, Jeong Hyun Lee, Chin Youb Chung, Moon Seok Park, and Ki Hyuk Sung
- Subjects
Male ,lcsh:Diseases of the musculoskeletal system ,Sports medicine ,Severity of Illness Index ,Weight-Bearing ,0302 clinical medicine ,Gait (human) ,Ankle dorsiflexion ,Medicine ,Orthopedics and Sports Medicine ,Child ,Gait ,Orthodontics ,030222 orthopedics ,medicine.diagnostic_test ,Biomechanical Phenomena ,Child, Preschool ,Female ,medicine.symptom ,Gait Analysis ,Research Article ,Adult ,Foot Deformities ,medicine.medical_specialty ,Adolescent ,Physical examination ,macromolecular substances ,03 medical and health sciences ,Young Adult ,Rheumatology ,3-dimensional gait analysis ,Deformity ,Humans ,Foot deformity ,Retrospective Studies ,business.industry ,Foot ,Cerebral Palsy ,Foot Bones ,030229 sport sciences ,medicine.disease ,Radiography ,Planovalgus ,Gait analysis ,Orthopedic surgery ,Contracture ,lcsh:RC925-935 ,Ankle ,business ,human activities ,Ankle Joint - Abstract
Background In planovalgus deformity with triceps contracture, a midfoot break happens, and ankle dorsiflexion (ADF) occurs at the mid-tarsal joint during gait. Results of standard 3D gait analysis may misinterpret the true ankle dorsiflexion because it recognizes the entire foot as a single rigid segment. We performed this study to investigate whether the severity of planovalgus deformity is associated with the discrepancy between the value of ADF evaluated by physical examination and 3-dimensional (3D) gait analysis. In addition, we aimed to identify the radiographic parameters associated with this discrepancy and their relationships. Methods Consecutive 40 patients with 65 limbs (mean age, 11.7 ± 5.5 years) with planovalgus foot deformity and triceps surae contracture were included. All patients underwent 3D gait analysis, and weightbearing anteroposterior (AP) and lateral (LAT) foot radiographs. ADF with knee extension was measured using a goniometer with the patient’s foot in an inverted position. Results Twenty-one limbs underwent operation for planovalgus foot deformity, and 56 limbs underwent operation for equinus deformity. The difference between ADF on physical examination and ADF at initial contact on gait analysis was 17.5 ± 8.4°. Differences between ADF on physical examination and ADF at initial contact on gait analysis were significantly associated with the LAT talus-first metatarsal angle (p = 0.008) and calcaneal pitch angle (p = 0.006), but not associated with the AP talus-first metatarsal angle (p = 0.113), talonavicular coverage angle (p = 0.190), talocalcaneal angle (p = 0.946), and naviculocuboid overlap (p = 0.136). Conclusion The discrepancy between ADF on physical examination and 3D gait analysis was associated with the severity of planovalgus deformity, which was evaluated on weightbearing LAT foot radiographs. Therefore, physicians should be cautious about interpreting results from 3D gait analysis and perform a careful physical examination to assess the degree of equinus deformity in patients with planovalgus foot deformity.
- Published
- 2020
46. Factors affecting GDI improvement after single event multilevel surgery in patients with cerebral palsy
- Author
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Chin Youb Chung, Soon Sun Kwon, Ki Hyuk Sung, Jae Jung Min, Moon Seok Park, and Kyoung Min Lee
- Subjects
Male ,Gait deviation ,Adolescent ,medicine.medical_treatment ,Biophysics ,Multilevel surgery ,Osteotomy ,Cerebral palsy ,Quadriceps Muscle ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Femur ,Postoperative Period ,Child ,Gait Disorders, Neurologic ,Retrospective Studies ,business.industry ,Cerebral Palsy ,Rehabilitation ,Gross Motor Function Classification System ,030229 sport sciences ,medicine.disease ,Gait ,Treatment Outcome ,Anesthesia ,Child, Preschool ,Female ,Level iii ,business ,Gait Analysis ,030217 neurology & neurosurgery - Abstract
Background Pathologic gait is common in patients with cerebral palsy (CP). Single-event multilevel surgery (SEMLS) is a combination of surgical procedures to improve pathologic gait in patients with CP. However, the effect of each procedure is difficult to predict. The gait deviation index (GDI) is useful in comparing pre- and postoperative improvement. Research question In this study, we evaluated the degree of GDI improvement in patients with CP and analyzed factors related to surgical outcomes. Methods We screened patients seen between May 2003 and December 2019 via a clinical data warehouse to identify those with CP who had been followed up for >1 year and who had undergone SEMLS. The inclusion criteria were (1) CP patients with GMFCS levels I, II and III, (2) patients who underwent SEMLS, (3) and patients who underwent 3D gait analyses preoperatively and at least 1 year postoperatively. A linear mixed model was used to model GDI improvement, assess effects of covariates, and examine factors that contributed to improvement. Results Overall, 544 patients were included. The average improvement in overall GDI was 8.9 ± 12.3, 9.6 ± 12.0, and 6.4 ± 8.6 in Gross Motor Function Classification System (GMFCS) levels I, II, and III, respectively. In GMFCS level II patients, GDI improvement decreased by 0.26 points with a 1-year delay in surgery (p = 0.0022). Within each group of GMFCS levels, femoral derotation osteotomy (FDO) was a significant factor in GDI improvement in GMFCS levels I and II. Rectus femoris transfer (RFT) and supracondylar extension osteotomy (SCO) were significant factors in GMFCS level II. No single procedure was shown to affect improvement in GMFCS level III. Significance Postoperative GDI improved in all levels of GMFCS. Particular procedures especially affected postoperative improvement in GDI in levels I and II. Our data do not mean to set an indication for particular procedures; however, in GMFCS levels I, II patients, particular procedures, such as FDO, yielded a greater GDI improvement in our data set.
- Published
- 2020
47. Effect of metallic tools on scattered radiation dose during the use of C-arm fluoroscopy in orthopaedic surgery
- Author
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Kisung Lee, Hyemi Cha, Young Jun Jung, Chin Youb Chung, Moon Seok Park, and Ki Hyuk Sung
- Subjects
medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,Radiation Dosage ,Imaging phantom ,03 medical and health sciences ,scattered radiation dose ,C-arm fluoroscopy ,0302 clinical medicine ,Regular Paper ,Medicine ,Fluoroscopy ,metallic tool ,Radiology, Nuclear Medicine and imaging ,Orthopedic Procedures ,Biology ,Pelvis ,Hip surgery ,Radiation ,Dosimeter ,medicine.diagnostic_test ,Drill ,business.industry ,Phantoms, Imaging ,Radiation dose ,equipment and supplies ,body regions ,medicine.anatomical_structure ,Metals ,Organ Specificity ,030220 oncology & carcinogenesis ,Orthopedic surgery ,radiosensitive organ ,business ,Nuclear medicine - Abstract
This study investigated the effect of metallic tools on the scattered radiation dose delivered to surgeons’ radiosensitive organs while simulating hip surgery using C-arm fluoroscopy. Two phantoms, a pelvis and a Rando phantom, were used to simulate a patient and a surgeon in this study. Photoluminescence dosimeters were inserted into the Rando phantom in the positions of the eye, thyroid and gonad. A drill was positioned above the hip of the pelvis phantom or beside the pelvis phantom of the same height. For each drill location, the scattered radiation dose was measured when the angle to the operator phantom was 45°; this was repeated when the angle was 90°. The scattered radiation doses to the eye, thyroid and gonad when the drill was placed beside the pelvis phantom with 90° angulation to the operator phantom were significantly lower than the reference values and those when the drill was placed beside the pelvis phantom at a 45° angulation to the operator phantom. The scattered radiation doses to the eye and thyroid when the drill was placed above the hip were significantly lower than the references values. Of the four different scenarios, the scattered radiation doses to the eye, thyroid and gonad were lowest when the drill was placed beside the pelvis phantom with 90° angulation. This study showed that the scattered radiation doses to radiosensitive organs were affected by the location and angle of the metallic tools in relation to the operator. Therefore, orthopedic surgeons should consider the effect of metallic tools on the scattered radiation dose during intraoperative use of C-arm fluoroscopy.
- Published
- 2018
48. Characteristics of and Factors Contributing to Immediate Postoperative Pain After Ankle Fracture Surgery
- Author
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Chin Youb Chung, Sung Hun Won, Seung Yeol Lee, Kyoung Min Lee, Moon Seok Park, and You Sung Suh
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Postoperative pain ,Ankle Fractures ,Fracture Fixation, Internal ,03 medical and health sciences ,0302 clinical medicine ,Pain control ,Risk Factors ,Rating scale ,medicine ,Humans ,Orthopedics and Sports Medicine ,Ankle pain ,Aged ,Retrospective Studies ,Pain, Postoperative ,030222 orthopedics ,business.industry ,Analgesia, Patient-Controlled ,030208 emergency & critical care medicine ,Middle Aged ,Pain management ,Ankle fracture surgery ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Linear Models ,Female ,Ankle ,business - Abstract
To build an appropriate strategy of pain management after ankle fracture surgery, surgeons need to know the characteristics of postoperative ankle pain and its contributing factors. The aim of the present study was to investigate the maximum pain period after ankle fracture surgery and the factors affecting postoperative pain using a linear mixed model when patient-controlled analgesia (PCA) was used as a basic modality. A total of 219 adult patients (108 males and 111 females; mean age 51.2 ± 15.9 years) who had undergone operative treatment for ankle fractures were included. Data on fracture severity, causes of injury, interval between injury and surgery, anesthesia method, American Society of Anesthesiologists classification, and operative time were collected. Pain intensity was measured using an 11-point pain intensity numerical rating scale preoperatively and postoperatively every 8 hours. Intravenous PCA was prescribed to all patients. The chronologic pattern of postoperative pain and factors affecting it were statistically analyzed using a linear mixed model. Maximum postoperative pain was observed at 8 hours postoperatively, and the maximum pain numerical rating scale score was 3.92, measured at 8-hour intervals. The severity of fracture ( p = .01) was the only significant factor contributing to postoperative pain after ankle fracture surgery on multivariate analysis. Clinicians should consider the chronologic pattern of postoperative pain after ankle fracture surgery during postoperative pain management. Interventions for pain control, in addition to PCA, might be needed at ~8 hours postoperatively, especially for those with severe ankle fractures.
- Published
- 2018
49. Overgrowth of the lower limb after treatment of developmental dysplasia of the hip: incidence and risk factors in 101 children with a mean follow-up of 15 years
- Author
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Chin Youb Chung, In Ho Choi, Chan Yoon, Chang Ho Shin, Won Joon Yoo, Tae Joon Cho, Moon Seok Park, and Dong Ook Kim
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,MEDLINE ,Lower limb ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,lcsh:Orthopedic surgery ,Risk Factors ,Medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Femur ,Hip Dislocation, Congenital ,030222 orthopedics ,business.industry ,Developmental dysplasia ,Incidence (epidemiology) ,Incidence ,Follow up studies ,Infant ,Femur Head ,General Medicine ,Articles ,Leg Length Inequality ,Osteotomy ,body regions ,lcsh:RD701-811 ,Child, Preschool ,Surgery ,Female ,business ,After treatment ,Follow-Up Studies - Abstract
Background and purpose — There are few studies on overgrowth of the affected limb after treatment of developmental dysplasia of the hip (DDH). We investigated the incidence of overgrowth and its risk factors in DDH patients. Patients and methods — 101 patients were included in this study. Overgrowth was defined by 2 criteria: when the height of the femoral head of the affected side was higher than that of the contralateral side by more than 10 mm, or by more than 15 mm. The potential risk factors of distinct overgrowth were retrospectively examined using multivariable analysis. Results — When overgrowth was defined as femoral head height difference (FHHD) > 10 mm, its incidence was 44%, and only femoral osteotomy was identified as a significant risk factor with a relative risk (RR) of 1.6 (95% confidence interval [CI] 1.0–2.5). When overgrowth was defined as FHHD > 15 mm, its incidence was 23%, and femoral osteotomy was identified as the only significant risk factor with an RR of 2.3 (CI 1.2–4.5). Overgrowth developed more frequently in patients who underwent femoral osteotomy at the age of 2 to 4 years (87%) than in the others (46%) (p = 0.04). Interpretation — Overgrowth of the affected limb is common in DDH patients. Patients who underwent femoral osteotomy, especially at the age of 2 to 4 years, may require careful follow-up because of the substantial risk for overgrowth.
- Published
- 2019
50. Long-term outcomes over 10 years after femoral derotation osteotomy in ambulatory children with cerebral palsy
- Author
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Moon Seok Park, Soon Sun Kwon, Gyeong Hee Cho, Chin Youb Chung, Kyoung Min Lee, and Ki Hyuk Sung
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Biophysics ,Osteotomy ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Long term outcomes ,Deformity ,Humans ,Orthopedics and Sports Medicine ,Femur ,Postoperative Period ,Range of Motion, Articular ,Child ,Gait ,Gait Disorders, Neurologic ,Retrospective Studies ,030222 orthopedics ,Foot ,business.industry ,Cerebral Palsy ,Rehabilitation ,medicine.disease ,Surgery ,Prone position ,Treatment Outcome ,Child, Preschool ,Gait analysis ,Ambulatory ,Female ,Hip Joint ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Femoral derotation osteotomy (FDO) is generally reported to be excellent for correcting the hip rotation and foot progression angles in children with cerebral palsy (CP). However, it is unclear how long the favorable outcomes are maintained.This study was performed to evaluate the long-term outcomes at more than 10 years after FDO in children with CP.FDO, as part of single event multilevel surgery to improve gait function, was performed at the intertrochanteric level with the patient in the prone position. The goal of the index surgery was femoral anteversion of 15°, measured using a modified trochanteric prominence angle test intraoperatively. All patients underwent three-dimensional gait analysis preoperatively and at 1 year and over 10 years postoperatively.Thirty-four ambulatory patients (53 hips) with CP undergoing FDO were included. The mean age at surgery was 7.8 years (SD = 3.0 years) and mean follow-up duration was 12.9 years (SD = 2.7 years). The mean hip rotation decreased significantly from 9.6° preoperatively to 3.1° at 1 year postoperatively (p = 0.004), and decreased significantly to -5.9° at the final follow-up (p 0.001). The mean foot progression in stance decreased from 7.9° preoperatively to -7.4° at 1 year postoperatively (p 0.001), and was maintained at -10.9° at the final follow-up. The GDI significantly improved from 68.2 preoperatively to 83.4 1 year postoperatively (p 0.001), and was maintained at 82.3 at the final follow-up. No patients underwent revision surgery due to recurrence of rotation deformity.Proximal FDO performed in the prone position provides favorable long-term outcomes at more than 10 years postoperatively, without recurrence of rotation deformity. To avoid under-correction or recurrence due to insufficient derotation, surgeons should consider not only dynamic gait analysis findings but also the measurement of anatomic femoral anteversion during intraoperative derotation.
- Published
- 2018
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