- Overview
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The Hippy Lab is dedicated to reducing the burden of hip disorders for children and families locally, across British Columbia, Canada and globally. We study pediatric hip conditions like developmental dysplasia of the hip (DDH) to improve early diagnosis, treatment and management, which in turn improves patient outcomes, enabling children to live healthy, active, pain-free lives.
- Publications
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Anterior Hip Clearance in Residual Legg-Calvé-Perthes Disease
Journal of Pediatric Orthopaedics
Luke G. Johnson and Honglin Zhang and Benjamin Joseph and Emily K. Schaeffer and Kishore Mulpuri and David R. Wilson
DOI: 10.1097/BPO.0000000000002949
07/2025A Systematic Review to Assess Gender Diversity in Authorship Within the Orthopaedic Surgery Literature
Indian Journal of Orthopaedics
Bryn O. Zomar and Tarini Boparai and Erin You and Kendra Jackson and Natalie South and Emily K. Schaeffer
DOI: 10.1007/s43465-025-01462-x
07/2025Gender Equity Issues in Orthopaedics: A Scoping Review
Indian Journal of Orthopaedics
Emily K. Schaeffer and Delaney R. Webber and Sharon Shrestha and Morgan G. Tidler and Tamseela Ahmed and Andrea M. Simmonds
DOI: 10.1007/s43465-025-01415-4
05/2025The Women in ORTHopaedics Program Offers Early Exposure to Orthopaedic Surgery for Young Women. A Pre- and Post-Event Survey Comparison
Journal of the Pediatric Orthopaedic Society of North America
Marianna Hsu and Hayley Spurr and Anthony P. Cooper and Emily K. Schaeffer
DOI: 10.1016/j.jposna.2024.100139
02/2025An Examination of Screening Practices for Developmental Dysplasia of the Hip Across Sri Lankan Medical Specialties
JAAOS: Global Research and Reviews
Duneesha De Silva and Dimuthu Chrishantha Tennekoon and Shaman Rajindrajith and Upul Jerrard Fernando and Anuradha Rajapaksha and Alaric Aroojis and Kishore Mulpuri and Emily Schaeffer and Sunil Ranjith Wijayasinghe
DOI: 10.5435/JAAOSGlobal-D-24-00264
02/2025Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review
BMJ Open
Patrícia Eduarda Conrado Martins Ro Jaleca and Daniel Frank Liggio and Sana Arora and Sheila Lam and Emily Schaeffer and Patricia Moreno Grangeiro
DOI: 10.1136/bmjopen-2024-094660
02/2025Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review protocol
BMJ Open
Patrícia Eduarda Conrado Martins Ro Jaleca and Daniel Liggio and Sheila Lam and Sana Arora and Emily Schaeffer and Patricia Moreno Grangeiro
DOI: 10.1136/bmjopen-2024-085403
10/2024Developmental Dysplasia of the Hip and Laterality: The Importance of Graded Severity of the Contralateral Hip
Indian Journal of Orthopaedics
Emily K. Schaeffer and Charles T. Price and Kishore Mulpuri
DOI: 10.1007/s43465-024-01157-9
09/2024Comparison of brace to observation in stable, radiological developmental dysplasia of the hip: a protocol for a global multicentre non-inferiority randomised trial
BMJ Open
Bryn O Zomar and Jeffrey N Bone and Vuong Nguyen and Kishore Mulpuri and Simon Kelley and Emily K Schaeffer
DOI: 10.1136/bmjopen-2024-084738
07/2024Management of long bone fractures and traumatic hip dislocations in paediatric patients: study protocol for a prospective global multicentre observational cohort registry
BMJ Open
Bryn O Zomar and Maio Chen and Emily K Schaeffer and Kishore Mulpuri and Alexander Joeris
DOI: 10.1136/bmjopen-2023-079836
03/2024Application of statistical shape modeling to the human hip joint: a scoping review
JBI Evidence Synthesis
Luke G. Johnson and Sara Bortolussi-Courval and Anjuli Chehil and Emily K. Schaeffer and Colleen Pawliuk and David R. Wilson and Kishore Mulpuri
DOI: 10.11124/JBIES-22-00175
03/2023Caregiver Experiences Using Orthotic Treatment Options for Developmental Dysplasia of the Hip in Children
Journal of Pediatric Orthopaedics
Grzybowski, G. and Bliven, E. and Wu, L. and Schaeffer, E.K. and Gibbard, M. and Zomar, B.O. and Casagrande Cesconetto, A. and Mundy, C. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000002312
2023A Retrospective Study of Risk Factors and Outcomes in the Surgical Management of Slipped Capital Femoral Epiphysis
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
Jin, W. and Farrell, S. and Habib, E. and Sandhu, A. and Bone, J.N. and Schaeffer, E. and Mulpuri, K.
2022Surveillance for Developmental Dysplasia of the Hip in India: Consensus Guidelines From the Pediatric Orthopaedic Society of India, Indian Academy of Pediatrics, National Neonatology Forum of India, Indian Radiological and Imaging Association, Indian Federation of Ultrasound in Medicine and Biology, Federation of Obstetric and Gynaecological Societies of India, and Indian Orthopaedic Association
Indian Pediatrics
Aroojis, A. and Anne, R.P. and Li, J. and Schaeffer, E. and Kesavan, T.M.A. and Shah, S. and Patwardhan, S. and Karnik, A. and Thanawala, U.
DOI: 10.1007/s13312-022-2577-3
2022Unilateral versus bilateral reconstructive hip surgery in children with cerebral palsy: A survey of pediatric orthopedic surgery practice and decision-making
Journal of Children's Orthopaedics
Miller, S.D. and Juricic, M. and Baraza, N. and Fajardo, N. and So, J. and Schaeffer, E.K. and Shore, B.J. and Narayanan, U. and Mulpuri, K.
DOI: 10.1177/18632521221121846
2022Evaluating paediatric orthopaedic teleradiology services at a tertiary care centre
Journal of Pediatric Orthopaedics Part B
Habib, E. and Krishnaswamy, W. and Wu, J.K. and Schaeffer, E.K. and Mulpuri, K.
DOI: 10.1097/BPB.0000000000000850
2022Developmental Dysplasia of the Hip: An Examination of Care Practices of Pediatricians
Journal of Pediatrics
Taylor, I.K. and Burlile, J.F. and O{'}Brien, K. and Schaeffer, E.K. and Mulpuri, K. and Shea, K.G.
DOI: 10.1016/j.jpeds.2022.02.047
2022Care Practices of Indian Pediatricians for the Screening and Diagnosis of Developmental Dysplasia of the Hip
Indian Journal of Pediatrics
Anne, R.P. and Li, J. and Schaeffer, E. and Aroojis, A. and Mulpuri, K. and Murki, S.
DOI: 10.1007/s12098-022-04200-5
2022Hip Surveillance for Children with Cerebral Palsy: A Survey of Orthopaedic Surgeons in India
Indian Journal of Orthopaedics
Li, J. and Ganjwala, D. and Johari, A. and Miller, S. and Schaeffer, E.K. and Mulpuri, K. and Aroojis, A.
DOI: 10.1007/s43465-021-00432-3
2022Variability in the Follow-up Management of Pediatric Femoral Fractures
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
Sanatani, G.E. and Habib, E. and Bone, J.N. and Sandhu, A. and Schaeffer, E.K. and Mulpuri, K.
2022The Natural History of Non-operatively Managed Legg–Calvé–Perthes’ Disease
Indian Journal of Orthopaedics
Ailabouni, R. and Zomar, B.O. and Slobogean, B.L. and Schaeffer, E.K. and Joseph, B. and Mulpuri, K.
DOI: 10.1007/s43465-021-00543-x
2022Interobserver and Intraobserver Reliability in the Salter Classification of Avascular Necrosis of the Femoral Head in Developmental Dysplasia of the Hip
Journal of Pediatric Orthopaedics
Schaeffer, E.K. and Ponton, E. and Sankar, W.N. and Kim, H.K.W. and Kelley, S.P. and Cundy, P.J. and Price, C.T. and Clarke, N.M.P. and Wedge, J.H. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000001979
2022A Global Survey of Patient and Caregiver Experiences throughout Care for Developmental Dysplasia of the Hip
Journal of Pediatric Orthopaedics
Gibbard, M. and Zivkovic, I. and Jivraj, B. and Schaeffer, E. and Robillard, J.M. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000001813
2021Survey of the impact of COVID-19 on pediatric orthopaedic surgeons globally
Journal of Pediatric Orthopaedics
Gibbard, M. and Ponton, E. and Sidhu, B.V. and Farrell, S. and Bone, J.N. and Wu, L.A. and Schaeffer, E. and Cooper, A. and Aroojis, A. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000001887
2021Inter-rater and Intra-rater Reliability in the Radiographic Diagnosis of Growth Arrest in Paediatric Physeal Fractures
Indian Journal of Orthopaedics
Banting, N. and Schaeffer, E.K. and Bone, J. and Habib, E. and Hooper, N. and Reilly, C.W. and Cooper, A. and Mulpuri, K.
DOI: 10.1007/s43465-020-00327-9
2021Inter-rater and Intrarater Reliabilities of the Identification of a "Gothic Arch" in the Acetabulum of Children with Cerebral Palsy
Journal of Pediatric Orthopaedics
Miller, S. and Habib, E. and Bone, J. and Schaeffer, E. and Yang, B.W. and Shea, J. and Maleki, A. and Shore, B.J. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000001615
2021Developmental Dysplasia of the Hip: An Examination of Care Practices of Orthopaedic Surgeons in India
Indian Journal of Orthopaedics
Hooper, N. and Aroojis, A. and Narasimhan, R. and Schaeffer, E.K. and Habib, E. and Wu, J.K. and Taylor, I.K. and Burlile, J.F. and Agrawal, A. and Shea, K. and Mulpuri, K.
DOI: 10.1007/s43465-020-00233-0
2021Do No Harm: Considerations for Pediatric Orthopaedic Practice during the Coronavirus Pandemic
Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews
Schaeffer, E.K. and Bone, J.N. and Mulpuri, K.
DOI: 10.5435/JAAOSGlobal-D-20-00055
2020Is the modified gartland classification system important in deciding the need for operative management of supracondylar humerus fractures?
Journal of Children's Orthopaedics
Teo, T.L. and Schaeffer, E.K. and Habib, E. and El-Hawary, R. and Larouche, P. and Shore, B. and Aarvold, A. and Carsen, S. and Reilly, C. and Mulpuri, K.
DOI: 10.1302/1863-2548.14.200093
2020Demographic and Practice Variability Amongst Indian Centres in a Multicentre Prospective Observational Study on Developmental Dysplasia of the Hip
Indian Journal of Orthopaedics
Pinto, D. and Aroojis, A. and Shah, H. and Patwardhan, S. and Venkatadass, K. and Sahu, C. and Schaeffer, E. and Mulpuri, K.
DOI: 10.1007/s43465-021-00516-0
2020The Orthopaedic Management of Human Disorganization Syndrome
Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews
Smit, K. and So, J. and Schaeffer, E. and Armstrong, L. and Verchere, C. and Mulpuri, K.
DOI: 10.5435/JAAOSGlobal-D-20-00059
2020Global Collaborations in Developmental Dysplasia of the Hip
Indian Journal of Orthopaedics
Mulpuri, K. and Schaeffer, E.K. and Price, C.T.
DOI: 10.1007/s43465-021-00504-4
2020Recommendations for the Care of Pediatric Orthopaedic Patients during the COVID-19 Pandemic
Journal of the American Academy of Orthopaedic Surgeons
Farrell, S. and Schaeffer, E.K. and Mulpuri, K.
DOI: 10.5435/JAAOS-D-20-00391
2020Developmental Dysplasia of the Hip: An Examination of Care Practices of Pediatric Orthopaedic Surgeons in North America
Journal of pediatric orthopedics
Taylor, I.K. and Burlile, J.F. and Schaeffer, E.K. and Geng, X. and Habib, E. and Mulpuri, K. and Shea, K.G.
DOI: 10.1097/BPO.0000000000001505
2020The use of virtual reality in reducing anxiety during cast removal: A randomized controlled trial
Journal of Children's Orthopaedics
Jivraj, B.A. and Schaeffer, E. and Bone, J.N. and Stunden, C. and Habib, E. and Jacob, J. and Mulpuri, K.
DOI: 10.1302/1863-2548.14.200090
2020Examining the Short-Term Natural History of Developmental Dysplasia of the Hip in Infancy: A Systematic Review
Indian Journal of Orthopaedics
Zomar, B.O. and Mulpuri, K. and Schaeffer, E.K.
DOI: 10.1007/s43465-021-00510-6
2020Reply to Letter to the Editor: Recommendations for the Care of Pediatric Orthopaedic Patients During the COVID-19 Pandemic
The Journal of the American Academy of Orthopaedic Surgeons
Schaeffer, E.K. and Farrell, S. and Mulpuri, K.
DOI: 10.5435/JAAOS-D-20-00743
2020Even Experts Can Be Fooled: Reliability of Clinical Examination for Diagnosing Hip Dislocations in Newborns
Journal of Pediatric Orthopaedics
Harper, P. and Joseph, B.M. and Clarke, N.M.P. and Herrera-Soto, J. and Sankar, W.N. and Schaeffer, E.K. and Mulpuri, K. and Aarvold, A.
DOI: 10.1097/BPO.0000000000001602
2020Development of a DDH Care Pathway for India: A Study Methodology to Guide Similar Efforts in Other Countries and for Other Conditions
Indian Journal of Orthopaedics
Li, J. and Aroojis, A. and Mulpuri, K. and Shea, K.G. and Schaeffer, E.K.
DOI: 10.1007/s43465-021-00534-y
2020Content Analysis of Frequency of Information About Developmental Dysplasia of the Hip on Twitter
Indian Journal of Orthopaedics
Kodali, N. and Sidhu, B.V. and So, J. and Habib, E. and Robillard, J.M. and Mulpuri, K. and Schaeffer, E.K.
DOI: 10.1007/s43465-021-00553-9
2020Ultrasound Characteristics of Clinically Dislocated But Reducible Hips With DDH
Journal of Pediatric Orthopaedics
Striano, B. and Schaeffer, E.K. and Matheney, T.H. and Upasani, V.V. and Price, C.T. and Mulpuri, K. and Sankar, W.N.
DOI: 10.1097/BPO.0000000000001048
2019Anatomy and Physiology of the Pediatric Hip
The Pediatric and Adolescent Hip: Essentials and Evidence
Schaeffer, E.K. and Mulpuri, K.
DOI: 10.1007/978-3-030-12003-0_2
2019Management of irreducible hip dislocations in infants with developmental dysplasia of the hip diagnosed below 6 months of age
Journal of Pediatric Orthopaedics
Aarvold, A. and Schaeffer, E.K. and Kelley, S. and Clarke, N.M.P. and Herrera-Soto, J.A. and Price, C.T. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000001205
2019AAOS Appropriate Use Criteria: The Management of Developmental Dysplasia of the Hip in Infants up to 6 Months of Age: Intended for Use by General Pediatricians and Referring Physicians
Journal of the American Academy of Orthopaedic Surgeons
Schaeffer, E. and Lubicky, J. and Mulpuri, K.
DOI: 10.5435/JAAOS-D-18-00500
2019Assessing the reliability of the modified gartland classification system for extension-type supracondylar humerus fractures
Journal of Children's Orthopaedics
Teo, T.L. and Schaeffer, E.K. and Habib, E. and Cherukupalli, A. and Cooper, A.P. and Aroojis, A. and Sankar, W.N. and Upasani, V.V. and Carsen, S. and Mulpuri, K. and Reilly, C.
DOI: 10.1302/1863-2548.13.190005
2019Closed Reduction for Developmental Dysplasia of the Hip: Early-term Results from a Prospective, Multicenter Cohort
Journal of Pediatric Orthopaedics
Sankar, W.N. and Gornitzky, A.L. and Clarke, N.M.P. and Herrera-Soto, J.A. and Kelley, S.P. and Matheney, T. and Mulpuri, K. and Schaeffer, E.K. and Upasani, V.V. and Williams, N. and Price, C.T.
DOI: 10.1097/BPO.0000000000000895
2019AAOS Appropriate Use Criteria: The Management of Developmental Dysplasia of the Hip in Infants up to Six Months of Age: Intended for Use by Orthopaedic Specialists
Journal of the American Academy of Orthopaedic Surgeons
Schaeffer, E. and Mulpuri, K. and Lubicky, J.
DOI: 10.5435/JAAOS-D-18-00499
2019Acetabuloplasty in closed triradiate cartilage
Pediatric Pelvic and Proximal Femoral Osteotomies: A Case-Based Approach
Schaeffer, E.K. and Mulpuri, K.
DOI: 10.1007/978-3-319-78033-7_14
2018Evidence-based Recommendations for Pediatric Orthopaedic Practice
Journal of Pediatric Orthopaedics
Mulpuri, K. and Schaeffer, E.K. and Sanders, J. and Zaltz, I. and Kocher, M.S.
DOI: 10.1097/BPO.0000000000001230
2018Need for Higher Quality Evidence to Determine the Utility of Postoperative Radiography
Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews
Teo, T.L. and Schaeffer, E.K. and Mulpuri, K.
DOI: 10.5435/JAAOSGlobal-D-18-00026
2018Evaluating the role of prereduction hip traction in the management of infants and children with developmental dysplasia of the hip (DDH): Protocol for a systematic review and planned meta-analysis
BMJ Open
Walton, S. and Schaeffer, E. and Mulpuri, K. and Cundy, P. and Williams, N.
DOI: 10.1136/bmjopen-2017-019599
2018A Systematic Review and Meta-analysis on the Reproducibility of Ultrasound-based Metrics for Assessing Developmental Dysplasia of the Hip
Journal of Pediatric Orthopaedics
Quader, N. and Schaeffer, E.K. and Hodgson, A.J. and Abugharbieh, R. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000001179
2018Vertebral Fractures in Duchenne Muscular Dystrophy Patients Managed with Deflazacort
Journal of Pediatric Orthopaedics
Singh, A. and Schaeffer, E.K. and Reilly, C.W.
DOI: 10.1097/BPO.0000000000000817
2018Nonoperative Treatment of Type IIA Supracondylar Humerus Fractures: Comparing 2 Modalities
Journal of Pediatric Orthopaedics
Roberts, L. and Strelzow, J. and Schaeffer, E.K. and Reilly, C.W. and Mulpuri, K.
DOI: 10.1097/BPO.0000000000000863
2018Do Immediate Postoperative Radiographs Change Patient Management after Fracture Fixation? A Systematic Review
Journal of Orthopaedic Trauma
Teo, T. and Schaeffer, E. and Cooper, A. and Mulpuri, K.
DOI: 10.1097/BOT.0000000000001152
2018Developmental dysplasia of the hip: Addressing evidence gaps with a multicentre prospective international study
Medical Journal of Australia
Schaeffer, E.K. and Mulpuri, K.
DOI: 10.5694/mja18.00154
2018Introduction to Evidence-based Recommendations for Pediatric Orthopaedic Practice
Journal of Pediatric Orthopaedics
Mulpuri, K. and Schaeffer, E.K. and Thompson, G.H. and Hensinger, R.N.
DOI: 10.1097/BPO.0000000000000834
2018Pavlik Harness Disease Revisited: Does Prolonged Treatment of a Dislocated Hip in a Harness Adversely Affect the aangle?
Journal of Pediatric Orthopaedics
Gornitzky, A.L. and Schaeffer, E.K. and Price, C.T. and Sankar, W.N.
DOI: 10.1097/BPO.0000000000000818
2018Automatic Evaluation of Scan Adequacy and Dysplasia Metrics in 2-D Ultrasound Images of the Neonatal Hip
Ultrasound in Medicine and Biology
Quader, N. and Hodgson, A.J. and Mulpuri, K. and Schaeffer, E. and Abugharbieh, R.
DOI: 10.1016/j.ultrasmedbio.2017.01.012
2017Prevention of hip displacement in children with cerebral palsy: a systematic review
Developmental Medicine and Child Neurology
Miller, S.D. and Juricic, M. and Hesketh, K. and Mclean, L. and Magnuson, S. and Gasior, S. and Schaeffer, E. and O{'}donnell, M. and Mulpuri, K.
DOI: 10.1111/dmcn.13480
2017Avascular necrosis in children with cerebral palsy after reconstructive hip surgery
Journal of Children's Orthopaedics
Phillips, L. and Hesketh, K. and Schaeffer, E.K. and Andrade, J. and Farr, J. and Mulpuri, K.
DOI: 10.1302/1863-2548.11.170078
2017What Risk Factors and Characteristics Are Associated With Late-presenting Dislocations of the Hip in Infants?
Clinical Orthopaedics and Related Research
Mulpuri, K. and Schaeffer, E.K. and Andrade, J. and Sankar, W.N. and Williams, N. and Matheney, T.H. and Mubarak, S.J. and Cundy, P.J. and Price, C.T. and IHDI Study Group
DOI: 10.1007/s11999-015-4668-0
2016What Is the Impact of Center Variability in a Multicenter International Prospective Observational Study on Developmental Dysplasia of the Hip?
Clinical Orthopaedics and Related Research
Mulpuri, K. and Schaeffer, E.K. and Kelley, S.P. and Casta{\~n}eda, P. and Clarke, N.M.P. and Herrera-Soto, J.A. and Upasani, V. and Narayanan, U.G. and Price, C.T. and IHDI Study Group
DOI: 10.1007/s11999-016-4746-y
2016Multiple physical stresses induce ¿-globin gene expression and fetal hemoglobin production in erythroid cells
Blood Cells, Molecules, and Diseases
Schaeffer, E.K. and West, R.J. and Conine, S.J. and Lowrey, C.H.
DOI: 10.1016/j.bcmd.2013.10.007
2014Simvastatin and t-butylhydroquinone suppress KLF1 and BCL11A gene expression and additively increase fetal hemoglobin in primary human erythroid cells
Blood
Macari, E.R. and Schaeffer, E.K. and West, R.J. and Lowrey, C.H.
DOI: 10.1182/blood-2012-07-443986
2013A Daphnane Diterpenoid isolated from Wikstroemia polyantha induces an inflammatory response and modulates miRNA activity
PLoS ONE
Khong, A. and Forestieri, R. and Williams, D.E. and Patrick, B.O. and Olmstead, A. and Svinti, V. and Schaeffer, E. and Jean, F. and Roberge, M. and Andersen, R.J. and Jan, E.
DOI: 10.1371/journal.pone.0039621
2012 - Research
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The Global Hip Dysplasia Registry (GHDR)
The hip joint is a ball-and-socket joint; normally, the femoral head (ball) is seated firmly in the acetabulum (socket). Developmental dysplasia of the hip (DDH) is the most common pediatric hip condition, affecting 1-3% of infants. DDH represents a spectrum of hip joint abnormalities, ranging from mild dysplasia characterized by an abnormally shallow acetabulum, to a complete dislocation of the femoral head from the acetabulum. Early diagnosis is critical, as when detected late or left untreated, DDH can lead to pain, osteoarthritis of the hip and the need for a hip replacement in early adulthood. Despite decades of research, studies have historically been limited to single centre and/or retrospective investigations, limiting the quality of evidence available. Combined with persistent confusion in diagnostic terminology, there remains substantial practice variability between surgeons and across centres.
Founded in 2016, the Global Hip Dysplasia Registry (GHDR) evolved from a more limited study to comprehensively capture prospective data across the full spectrum of DDH in a globally relevant manner. Development of a comprehensive registry allows for the expansion of diagnoses captured and number of patients eligible, providing a unique and unprecedented platform for examining numerous aspects of the full DDH spectrum including treatment outcomes and risk factors. The major objectives of the registry are to identify area variations in screening and diagnostic practices, and to compare radiographic and clinical outcomes of different treatment and management approaches within and across diagnostic categories.
Currently, over 9500 patients have been recruited into the study from over 20 contributing centres in 9 different countries across 5 continents. The study has also generated more than 20 publications and 35 conference proceedings to date, and continues to grow. We are now developing targeted sub-studies within the auspices of the broader registries. These hypothesis-testing studies will allow us to rigorously answer longstanding questions in the field via randomized controlled trials. For example, we have designed a non-inferiority randomized controlled trial that will commence shortly examining whether observation is non-inferior to brace treatment for clinically stable hips with radiological dysplasia.Brace versus Observation for Radiological Dysplasia
A non-inferiority randomized control trial - Management of infants with a mild form of developmental dysplasia of the hip (DDH), called radiological dysplasia, is remarkably variable, with clinical equipoise or controversy and evident discrepancies in practice between surgeons and across centres. Early detection is key to optimizing outcomes and minimizing long-term disability and impact on quality of life for the child and family. Brace treatment is common to address this radiological dysplasia; however, evidence for treating stable, radiologically dysplastic hips is lacking. It is unclear whether this approach provides significant benefit above careful observation by ultrasound. Natural history seems more favorable for these hips compared to treatment, since the majority of centred hips tend to normalize during growth.
Utilizing the unprecedented global platform of GHDR, this specific trial functions as a targeted sub-study within the more extensive registry, and is a multi-centre, international prospective randomized non-inferiority trial designed to evaluate the necessity to treat infants with radiological DDH. In this CIHR-funded study, we aim to: 1) Determine whether observation is non-inferior to bracing for infants with radiological DDH; and 2) Provide a strong recommendation for management of this subset of DDH patients. Patients presenting with radiological DDH under three months of age are randomized to either the brace treatment or the observation group. Patients in both groups are monitored by clinical exam and ultrasound throughout the bracing or observation period. The primary outcome measure is the acetabular index (AI) measured on a two-year radiograph. Should the AI in the observation group be no more than three degrees higher than the brace group, we can conclude that observation alone is sufficient for infants with radiological DDH and thus avoid unnecessary treatment.Development of Care Pathways for DDH
In many Global South countries, DDH is often diagnosed after walking age, leading to more invasive surgeries and long-term disability. DDH care pathways aim to enhance early detection and must be tailored to meet a country’s needs and diverse practice settings. We have developed a multi-phase methodology using a modified Delphi approach for context-specific DDH care pathway development, and implemented it as a proof-of-concept in India. We have recently completed development of a similar care pathway in Sri Lanka, and work is currently underway in Brazil. Additionally, we lack a standardized care pathway for DDH screening and diagnosis here in Canada; thus, taking lessons learned from our global care pathway work, we are currently developing national consensus guidelines here as well that can be adapted for provincial implementation.GrantsCo-Investigator. Advanced MR Imaging of Perthes Disease to Improve Treatment. Funding Source: Canadian Institutes of Health Research.
Co-Primary Investigator. PedORTHO: A prospective multicenter observational registry of orthopaedic trauma and health outcomes in skeletally immature children. Funding Source: AO Documentation and Publishing Foundation, Clinical Investigation and Documentation (AOCID).
Co-Primary-Investigator. Peterson Fund for Global Hip Health. Funding Source: BC Children's Hospital Foundation.
Co-Primary-Investigator. PedORTHO: A prospective multicenter observational registry of orthopaedic trauma and health outcomes in skeletally immature children. Funding Source: British Columbia Orthopaedic Association.
Co-Primary-Investigator. Observation vs Bracing in dysplastic stable hips in infants. Funding Source: Pediatric Orthopaedic Society of North America.
Co-Primary-Investigator. Centre for International Child Health: China Care Pathway Development and Knowledge Exchange. Funding Source: Centre for International Child Health.
Co-Primary-Investigator. Global Pediatric Orthopaedic Implant Safety & Efficacy. Funding Source: OrthoPediatrics.
Co-Investigator. Digital Health Accelerator Grant: Tracked 2D Ultrasound in DDH. Funding Source: BC Children’s Hospital Research Institute.
Co-Primary-Investigator. Comparing observations vs bracing radiologically dysplastic, stable hips in infants with DDH. An international, multi-centre non-inferiority randomized control trial. Funding Source: Canadian Institutes of Health Research.
Co-Primary-Investigator. Development of a Care Pathway for Developmental Dysplasia of the Hip in India: A study methodology to guide similar efforts in other countries and for other conditions. Funding Source: Canadian Institutes of Health Research – IMHA Inclusive Research Excellence Prize – Team Science.
Co-Investigator. Patient/Parent engagement in DDH research. Funding Source: Michael Smith Health Research BC Convening and Collaborating Grant.
Co-Investigator. An Assessment of Outcomes in the Operative and Non-operative Management of Pediatric Radial Neck Fractures – a single-centre prospective study. Funding Souce: Evidence to Innovation BCCHR Seed Grant.
Co-Investigator. Integrating Data Quality Assurance and Dynamic Modelling for Predicting Clinical Markers and Follow-up in Pediatric DDH Patients: A Comprehensive Work on Global Hip Dysplasia Registry. Funding Source: BCCHR Digital Health Accelerator Grant.
Honours & Awards2023–present - For Children We Care Endowed Scholar, BC Children's Hospital Foundation
2021 - Branch for Global Surgical Care Instructor Appreciation Award, University of British Columbia
2021 - Science Co-Op Supervisor Recognition Award, University of British Columbia
2020 - Science Co-Op Supervisor Recognition Award, University of British Columbia
Congratulations CIHR Spring 2025 Project Grant recipients
Congratulations to the investigators and their teams who were awarded funding through the Canadian Institutes of Health Research (CIHR) Spring 2025 Project Grant competition.
