Kenneth M C Cheung

The University of Hong Kong | HKU · Department of Orthopaedics and Traumatology

[This corrects the article DOI: 10.1016/j.bioactmat.2021.08.027.].

Extrapulmonary complications of different organ systems have been increasingly recognized in patients with severe or chronic Coronavirus Disease 2019 (COVID-19). However, limited information on the skeletal complications of COVID-19 is known, even though inflammatory diseases of the respiratory tract have been known to perturb bone metabolism and c...

Multidrug‐resistant (MDR) bacteria are emerging and disseminating rapidly, undoubtedly posing an urgent threat to global public health. One particular concern is that MDR Gram‐negative bacteria are immunized to available antibiotics owing to a series of biogenetic effects, including the β‐barrel assembly machine (BAM complex) in the outer membrane,...

Purpose The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. Methods On September 17–18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recomm...

In addition to helping individuals with spinal cord injury (SCI) regain the ability to ambulate, the rapidly evolving capabilities of robotic exoskeletons provide an array of secondary biophysical benefits which can reduce the complications resulting from prolonged immobilization. The proposed benefits of increased life-long over-ground walking cap...

Purpose: Vertebral body tethering (VBT) continues to grow in interest from both a patient and surgeon perspective for the treatment of scoliosis. However, the data are limited when it comes to surgeon selection of both procedure type and instrumented levels. This study sought to assess surgeon variability in treatment recommendation and level sele...

Purpose: Operative and postoperative management of early onset scoliosis (EOS) patients with programmable implanted devices has not been well characterized in the literature. The aim of this study was to describe current practices for pediatric spine surgeons who operate on patients with these devices. Methods: An electronic survey was distribut...

Bone formation induced by divalent metal cations has been widely reported; however, the underlying mechanism is unclear. Here we report that these cations stimulate skeleton interoception by promoting prostaglandin E2 secretion from macrophages. This immune response is accompanied by the sprouting and arborization of calcitonin gene-related polypep...

PurposeTo compare the outcomes of anterior Vertebral Body Tethering (AVBT) surgery between overweight and non-overweight patients.MethodsAIS/JIS patients with AVBT with 2-year follow-up from a multi-center pediatric spine database were evaluated pre-operatively, 1st post-operative erect, and 2 years post-operatively. ANOVA was used to compare 3 cat...

Study Design Systematic review and meta-analysis Objectives The present review aimed to summarize the evidence regarding differences in proprioception between children with and without adolescent idiopathic scoliosis (AIS). Methods Seven electronic databases were searched from their inception to April 10, 2021. Articles were included if they invo...

The most critical factor determining the success of biodegradable bone implants is the host tissue response, which greatly depends on their degradation behaviors. Here, a new magnesium‐based implant, namely magnesium–silicon–calcium (Mg–0.2Si–1.0Ca) alloy, that coordinates its biodegradation along with the bone regenerative process via a self‐assem...

IntroductionNeurologic complications after complex adult spinal deformity (ASD) surgery are important, yet outcomes are heterogeneously reported, and long-term follow-up of actual lower extremity motor function is unknown.Objective To prospectively evaluate lower extremity motor function scores (LEMS) before and at 5 years after surgical correction...

Background Lumbar disc degeneration (LDD) may be related to aging, biomechanical and genetic factors. Despite the extensive work on understanding its etiology, there is currently no automated tool for accurate prediction of its progression.PurposeWe aim to establish a novel deep learning-based pipeline to predict the progression of LDD-related find...

Regardless of the advancement of synthetic bone substitutes, allograft-derived bone substitutes still dominate in the orthopaedic circle in the treatments of bone diseases. Nevertheless, the stringent devitalization process jeopardizes their osseointegration with host bone and therefore prone to long-term failure. Hence, improving osseointegration...

Although efforts have been devoted to develop new antibacterial agents and techniques, the challenge of bacterial infection remains unresolved and is even increasing. Sonodynamic therapy (SDT) driven by ultrasound (US) has demonstrated effectiveness in terms of penetration and it can help to clinically address the problem of deep tissue bacterial i...

Extrapulmonary complications of different organ systems have been increasingly recognized in patients with severe or chronic Coronavirus Disease 2019 (COVID-19). However, limited information on the skeletal complications of COVID-19 is known, even though inflammatory diseases of the respiratory tract have been known to perturb bone metabolism and c...

Sagittal alignment of the spine is a common measure for assessing the prognosis and various spinal interventions in adolescent idiopathic scoliosis (AIS). The implementation of 3D sensors (inertial measurement units, IMUs) in medical applications as a non-invasive measurement method such as gait and posture analysis has seen rapid growth. This pilo...

Adolescent idiopathic scoliosis (AIS) is generally considered as a multifactorial disease, while literature has evidenced proprioceptive deficits (PD) may contribute to the development of AIS. The present study aimed to identify the proportion of patients with AIS who experienced PD.

Proprioceptive deficit (PD) of peripheral joints was evidenced in patients with adolescent idiopathic scoliosis (AIS), but there is a lack of knowledge on studying the spinal proprioception in AIS. The present study aimed to compare examine spinal proprioception in AIS subjects that exhibit peripheral joint PD.

BACKGROUND CONTEXT Severity of deformity, preoperative disability, and surgical strategies are variable between, and within, centers performing reconstructive surgery for spinal deformity. However, geographic variation in how surgeons manage ASD patients worldwide is unknown. PURPOSE The purpose of this study was to compare the surgical approach a...

Study Design Modified Delphi study. Objective Adult spinal deformity (ASD) is an increasingly recognized condition, comprising a spectrum of pathologies considerably impacting patients’ health and functional status. Patients present with a combination of pain, disability, comorbidities and radiological deformity. The study aims to propose a system...

Methicillin‐resistant Staphylococcus aureus (MRSA) biofilm infections after orthopedic implant increase the risk of failure and potentially cause amputation of limbs or life‐threatening sepsis in severe cases. Additionally, satisfactory bone‐implant integration is another important indicator of an ideal implant. Here, an antibiotic‐free antibacteri...

The design of orthopedic biomaterials has gradually shifted from “immune-friendly” to “immunomodulatory,” in which the biomaterials are able to modulate the inflammatory response via macrophage polarization in a local immune microenvironment that favors osteogenesis and implant-to-bone osseointegration. Despite the well-known effects of bioactive m...

Objective: To examine the safety and efficacy of ambulation utilizing a semi-passive and lightweight powered exoskeleton by spinal cord injury (SCI) patients. Methods: This is a multi-center, open-label, prospective cohort study across three facilities. A cohort of 40 individuals with SCI from T4-L5 was recruited into a 20-session training and asse...

Macrophage has been gradually recognized as a central regulator in tissue regeneration, and the study of how macrophage mediates biomaterials-induced bone regeneration through immunomodulatory pathway becomes popular. However, the current understanding on the roles of different macrophage phenotypes in regulating bone tissue regeneration remains co...

Despite the widespread observations on the osteogenic effects of magnesium ion (Mg ²⁺ ), the diverse roles of Mg ²⁺ during bone healing have not been systematically dissected. Here, we reveal a previously unknown, biphasic mode of action of Mg ²⁺ in bone repair. During the early inflammation phase, Mg ²⁺ contributes to an upregulated expression of...

Aims The aim of this study was to determine the differences in spinal imaging characteristics between subjects with or without lumbar developmental spinal stenosis (DSS) in a population-based cohort. Methods This was a radiological analysis of 2,387 participants who underwent L1-S1 MRI. Means and ranges were calculated for age, sex, BMI, and MRI m...

Proper immune responses are critical for successful biomaterial implantation. Here, four scales of honeycomb-like TiO 2 structures were custom made on titanium (Ti) substrates to investigate cellular behaviors of RAW 264.7 macrophages and their immunomodulation on osteogenesis. We found that the reduced scale of honeycomb-like TiO 2 structures coul...

Study design: Prospective cohort. Objective: To prospectively evaluate PROs up to 5-years after complex ASD surgery. Methods: The Scoli-RISK-1 study enrolled 272 ASD patients undergoing surgery from 15 centers. Inclusion criteria was Cobb angle of >80°, corrective osteotomy for congenital or revision deformity, and/or 3-column osteotomy. The f...

The fate of cells and subsequent bone regeneration is highly correlated with temporospatial coordination of chemical, biological, or physical cues within a local tissue microenvironment. Deeper understanding of how mammalian cells react to local tissue microenvironment is paramount important when designing next generation of biomaterials for tissue...

Background Current clinical evidence suggests that a well-planned physiotherapeutic scoliosis specific exercise (PSSE) program is effective for scoliosis regression. Objectives We investigated the effect of curve patterns on Cobb angles with PSSE. Methods This was a non-randomized prospective clinical trial that recruited participants with adoles...

Degenerative cervical myelopathy (DCM) presents insidiously during middle-age with deterioration in neurological function. It accounts for the most common cause of non-traumatic spinal cord injury in developed countries and disease prevalence is expected to rise with the aging population. Whilst surgery can prevent further deterioration, biological...

Intervertebral disc degeneration (IDD), a major cause of low back pain, occurs with ageing. The core of the intervertebral disc, the nucleus pulposus (NP), embedded in a proteoglycan‐rich and gelatinous matrix, is derived from the embryonic notochord. With IDD, the NP becomes fibrous, containing fewer cells, which are fibroblastic and of unknown or...

Aims To investigate metallosis in patients with magnetically controlled growing rods (MCGRs) and characterize the metal particle profile of the tissues surrounding the rod. Methods This was a prospective observational study of patients with early onset scoliosis (EOS) treated with MCGRs and undergoing rod exchange who were consecutively recruited...

Study Design Prospective study. Objectives To study the increasing divergence between targeted and achieved distractions observed with magnetically controlled growing rod (MCGR)lengthening, and the relationship of this reduced rate of achieved lengthening with remaining rod length. Methods Patients with early onset scoliosis (EOS) who underwent M...

High-pressure torsion (HPT) can refine the microstructure and consequently modify the properties, such as mechanical and corrosion properties, of Mg and its alloys. Biodegradable magnesium materials alloyed with the essential elements of life, such as Ca and Sr, are a current research frontier. In this study, biodegradable ultrafine-grained pure Mg...

Implant-associated infections is one of the most challenging post-operative complications in bone-related implantations. To tackle this clinical issue, we developed a low-cost and durable surface coating for medical grade titanium implants that uses positively charged silane molecules. The in vitro antimicrobial tests revealed that the titanium sur...

IntroductionAt the time of writing, we are all coping with the global COVID-19 pandemic. Amongst other things, this has had a significant impact on postponing virtually all routine clinic visits and elective surgeries. Concurrently, the Magnetic Expansion Control (MAGEC) rod has been issued with a number of field safety notices and UK regulator med...

Scoliosis is a congenital disease that causes lateral curvature in the spine. Its assessment relies on the identification and localization of vertebrae in spinal X-ray images, conventionally via tedious and time-consuming manual radiographic procedures that are prone to subjectivity and observational variability. Reliability can be improved through...

Study design: A retrospective review of prospectively collected data. Objective: The objective of this study was to investigate the fusion status of the lumbar spine and lumbosacral junction at 2 years postoperatively after complex adult spinal deformity (ASD) surgery. Summary of background data: Achieving fusion is crucial for maintaining opt...

The use of magnesium ion (Mg2+)-modified biomaterials in bone regeneration is a promising and cost-effective therapeutic. Despite the widespread observation on the osteogenic effects of Mg2+, the diverse roles played by Mg2+ in the complex biological process of bone healing have not been systematically dissected. Here, we reveal a previously unknow...

Scoliosis is a congenital disease in which the spine is deformed from its normal shape. Measurement of scoliosis requires labeling and identification of vertebrae in the spine. Spine radiographs are the most cost-effective and accessible modality for imaging the spine. Reliable and accurate vertebrae segmentation in spine radiographs is crucial in...

Bracing is the most common non-operative treatment option for patients with adolescent idiopathic scoliosis (AIS). However, existing brace designs have deficiencies, including a long production lead time and low patient compliance caused by the negative impacts of bracing on quality of life (QoL). The aim of this study was to address these problems...

Aims The purpose of this study was to evaluate the incidence and analyze the trends of surgeon-reported complications following surgery for adolescent idiopathic scoliosis (AIS) over a 13-year period from the Scoliosis Research Society (SRS) Morbidity and Mortality database. Methods All patients with AIS between ten and 18 years of age, entered in...

Study designProspective radiographic study.Objectives To determine the three-dimensional (3D) changes in deformity correction with magnetically controlled growing rod (MCGR) distractions.Summary of background dataMCGRs can achieve similar coronal plane correction as traditional growing rods. The changes in the sagittal and axial planes are unknown...

Study designBiomechanical analysis of scoliosis instrumentation using superelastic Nickel–titanium shape memory (SNT) rods. Objective To compare SNT with conventional Titanium (Ti) and Cobalt–chrome (Co–Cr) rods. Summary of background dataA clinical trial has documented comparable efficacy between two adolescent idiopathic scoliosis (AIS) cohorts i...

There are many nonsurgical treatment options from adolescent idiopathic scoliosis (AIS) to control the progression of the spinal curvature. However, the existing studies are so diverse and diffuse that it is challenging to find potential trends for further studies without a more comprehensive review in place for reference purposes. Thus, the object...

Accurate vertebral identification and labeling is essential in image-guided spinal disease diagnosis and treatment planning. Unfortunately, spinal assessments traditionally rely on tedious and time-consuming manual measurement subject to observer variability. In particular, the measurement of scoliosis requires the segmentation of individual verteb...

Scoliosis is a congenital disease that causes lateral curvature in the spine. Its assessment relies on the identification and localization of vertebrae in spinal X-ray images, conventionally via tedious and time-consuming manual radiographic procedures that are prone to subjectivity and observational variability. Reliability can be improved through...

Surface topography has been reported to play a key role in modulating cell behaviors, yet the mechanism through which it modulates these behaviors is not fully understood, especially in the case of three-dimensional (3D) topographies. In this study, a series of novel hemispherical 3D imprints ranging from the nanoscale to the microscale were prepar...

Magnesium biometals exhibit great potentials for orthopeadic applications owing to their biodegradability, bioactive effects and satisfactory mechanical properties. However, rapid corrosion of Mg implants in vivo combined with large amount of hydrogen gas evolution is harmful to bone healing process which seriously confines their clinical applicati...

Study design: Post-hoc analysis of a prospective, multi-center cohort study. Objective: To analyze the impact of smoking on rates of postoperative adverse events (AEs) in patients undergoing high-risk adult spine deformity surgery. Summary of background data: Smoking is a known predictor of medical complications after adult deformity surgery,...

Rapid corrosion of biodegradable magnesium alloys under in vivo condition is a major concern for clinical applications. Inspired by the stability and biocompatibility of titanium oxide (TiO2) passive layer, a functionalized TiO2/Mg2TiO4 nano-layer has been constructed on the surface of WE43 magnesium implant by using plasma ion immersion implantati...

Introduction: Depletion of extracellular matrix producing nucleus pulposus (NP) cells in intervertebral disc (IVD) degeneration limits the self-repair ability per se. Currently, tyrosine kinase receptor 2 (Tie2) and disialoganglioside 2 (GD2) expressing progenitor cells were identified in human adult NP tissue based on in vitro clonogenicity and in...

Study design: Retrospective case study on prospectively collected data. Objectives: The purpose of this explorative study was: 1) to determine if patterns of spinal cord injury could be detected through intra-operative neuromonitoring (IONM) changes in pediatric patients undergoing spinal deformity corrections, 2) to identify if perfusion based...

Study design: Narrative review. Objective: The prevalence of adult spinal deformity (ASD) has been cited anywhere between 2-32%, while the prevalence in the elderly population has been estimated at 68%. Neurologic complications following ASD surgery remains a concern. Previous literature reported incidence of neurologic complications varied betw...