Overview

Dr. Mulpuri’s clinical practice and research interests have a major focus on the pediatric hip and cerebral palsy. He regularly treats patients with a wide range of conditions including but not limited to: Developmental Dysplasia of the Hip (DDH), Cerebral Palsy (CP), Legg–Calvé–Perthes disease, osteogenesis imperfecta (OI), slipped capital femoral epiphysis (SCFE) and trauma.

He is the Research Director of the International Hip Dysplasia Institute (IHDI) and currently holds the medical lead position for the Child Health BC Hip Surveillance Program for Children with Cerebral Palsy. He also is Co-Lead for the Evidence to Innovation Theme at BCCHR. He is the Founding President of the Canadian Pediatric Orthopaedic Group (CPOG), which facilitates the academic and scientific exchange of thoughts and ideas between Canadian pediatric orthopaedic surgeons and creates invaluable opportunities for educational activities and collaborative research across Canada.

In addition, he leads the Bone Health & Mobility Research Team at BC Children’s Hospital and currently acts as Principal Investigator or Co-Investigator on various local and international multi-centre research studies. He is regularly involved with the development of new clinical practice guidelines, most recently chairing the work group that developed the guidelines for non-operative treatment and management of DDH.

Research

Legg–Calvé–Perthes Disease
Legg–Calvé–Perthes (Perthes) disease is a self-limiting pediatric hip disorder characterized by disruption of blood flow to the hip joint causing avascular necrosis of the femoral head. It most commonly occurs in children ages 2-12 and is more common in males than in females. Dr. Mulpuri is a member of the Coordinating Committee for the International Perthes Study Group (IPSG), comprised of pediatric orthopaedic surgeons from around the world who each have the goal of advancing knowledge and care of patients with Perthes disease through international collaborative research. Currently, Dr. Mulpuri is leading a number of research studies on Perthes disease being conducted at BC Children’s Hospital, including the international multi-centre IPSG study on the role of non-weightbearing on femoral head shape and outcome after hip surgery for patients with Perthes disease. Other current studies include a Perthes disease-specific validation study for pediatric functional outcome scores.

Cerebral Palsy
Cerebral palsy (CP) is a term that encompasses a group of neurological disorders that affect body movement, posture, muscle coordination and balance. It appears in infancy or early childhood and may lead to chronic disability. Children with severe CP are at high risk for hip dislocations and different treatment strategies exist which have a direct impact on the physical function and quality of life for these children. Dr. Mulpuri was instrumental in creating the first formal hip surveillance program for children with CP in North America – the Child Health BC Hip Surveillance Program for Children with Cerebral Palsy - and is currently active as the medical lead. This province-wide program was developed with the goal of enrolling all patients with cerebral palsy to eventually establish comprehensive monitoring and intervention guidelines for their hips. Dr. Mulpuri is also actively involved in a number of research projects at BC Children’s Hospital which have the aim of assessing and improving the management and functional outcomes of children with CP. He is collaborating with an international network of pediatric orthopaedic surgeons on a multi-centre prospective comparative cohort study investigating the outcomes of hip interventions for children with CP, the first of its scope to systematically study the impact of hip instability and its management on patient quality of life using the validated Child Health Index of Life with Disabilities (CPCHILD©) questionnaire.

Developmental Dysplasia of the Hip
Dr. Mulpuri holds the role of Research Director for the International Hip Dysplasia Institute (IHDI). The IHDI is a not-for-profit organization that is driven by advocacy and philanthropic efforts, with the goal of improving diagnosis, treatment and patient outcomes for children with DDH. DDH is the most common pediatric hip condition that ranges in severity from a mildly dysplastic but reduced hip to a frankly dislocated hip. In order to identify best practices and standardize screening and management decisions, the IHDI began a multi-centre, prospective observational study of infants aged 0 to 18 months with dislocated hips at rest in 2010, and is currently in the process of expanding the study into the first comprehensive prospective DDH registry worldwide. The IHDI study coordinator is a postdoctoral research fellow at UBC and BC Children’s Hospital and the study database is housed at BCCHR. This database will have a direct impact on the treatment methods and standard of care for DDH not only in BC, but also around the world. Every child born is screened for hip instability, with a DDH diagnosis in 15-20/1000 live births, and a dislocated hip diagnosis in 1-2/1000 live births.

Research Group Members

Anjuli Chehil, Medical Student:Medical Student
Jaimy Coates
Jennifer Farr
Eva Habib, Clinical Research Coordinator
Cindy Hsieh, Volunteer Research Student
Winston Jin, Research Assistant
Bejaan Jivraj, Medical Student and Research Volunteer
Luke Johnson, Research Assistant
Carly Jones, Graduate Student
Ammarah Kaderdina, Research Student
Arunkumar Kannan, Research Student
Tesia Kelleway, Research Volunteer
Varun Nair, Summer Research Student/Volunteer
Prashant Pandey, Masters Student
Aava Param, Research Volunteer
Gabrielle Sanatani, Research Assistant
Emily Schaeffer
Caitlyn Siu, Co-op Research Assistant
Joel Sloan
Judy So, Research Assistant
Nathan Wei
Judy Wu, Undergraduate Research Assistant
Luke Wu, Co-op Research Assistant
Roya Yamini