Unni Narayanan, MBBS, M.Sc., FRCS(C)
The Hospital for Sick Children
Paediatric Orthopaedic Surgeon
University of Toronto
Fellowship Program in Paediatric Orthopaedics
Paediatric Orthopaedic Competency Base Curriculum Program
Director of Residents
Paediatric Orthopaedic Rotation
Bloorview Research Institute
Paediatric Orthopaedic Consultant (various institutions)
Dr. Unni G. Narayanan is a paediatric orthopaedic surgeon at The Hospital for Sick Children (SickKids). He is an Associate Professor in the Department of Surgery at the University of Toronto (U of T) and a Senior Scientist at the Bloorview Research Institute. He also acts as a paediatric orthopaedic consultant at the Holland Bloorview Kids Rehabilitation Hospital in Toronto, ErinoakKids Children’s Treatment Centre in Mississauga, Grandview Children’s Rehabilitation Centre in Oshawa and Five Counties Children’s Centre in Peterborough.
A native of Madras (Chennai), India, and a graduate of Madras Medical College, he completed his orthopaedic residency at the University of Minnesota, a cerebral palsy/gait analysis fellowship at Gillette Children’s Hospital, and his paediatric orthopaedic fellowship at SickKids. He followed this with a master’s degree in clinical epidemiology at U of T before being appointed to his current position.
His clinical practice is focused primarily on the care of children with cerebral palsy (CP). He also has an interest in the management of congenital, and acquired lower limb deformities and length discrepancies and paediatric trauma.
Dr. Narayanan’s research involves the exploration of patient priorities and preferences for the development of outcome measures for use in clinical trials to evaluate the effectiveness of interventions and health-care technologies for musculoskeletal disorders in children. His research is funded by the Canadian Institutes of Health Research (CIHR) and other agencies. His work has been recognized with the Mac Keith Press Young Investigator Award from the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) in 2005, the Angela Kuo Memorial Investigator Award from Pediatric Orthopaedic Society of North America (POSNA) in 2006, and the Arthur H. Huene Memorial Award from POSNA in 2013 for his work on CP hip outcomes.
He has served on the Board of Directors of the AACPDM and POSNA, been a member of and chaired various committees in both Societies. In 2006, he was the Scientific Program Chair of the 60th (Diamond Jubilee) Annual meeting of AACPDM. He has also served a five-year term on the Orthopaedic Examination Board for the Royal College of Physicians and Surgeons of Canada.
A significant proportion of his time is devoted to teaching orthopaedic and paediatric residents and paediatric orthopaedic fellows at SickKids, where he serves as the Director of the Fellowship program as well as the director of the paediatric orthopaedic program for the Orthopaedic Residents of the University of Toronto. He has received numerous teaching and research awards for his work. Dr. Narayanan has travelled widely as an invited speaker or visiting professor both within North America and internationally to discuss his research and lecture on cerebral palsy, outcomes research, evidence based orthopaedics and a wide range of paediatric orthopaedic subjects.
Clinical Care Activities
- Cerebral palsy
- Lower limb length discrepancy and complex deformity correction
- Clubfeet and other foot disorders
- Patient Priorities and Outcome Measurement Development
- Clinical Trials
- Outcomes Research
- Cerebral Palsy Research Network (CPRN) Registry Project (Leadership Team).
The Cerebral Palsy Research Network (CPRN) was established to bring together clinicians from across North America who work with children with cerebral palsy. Every center with a CP clinic will consent their patients to include their treatment data in the CPRN registry. This registry will enable clinician researchers to find practice variation and create quality initiatives to improve outcomes for all patients regardless of where they are treated. Dr. Narayanan is one of the founders of the CPRN and leads its orthopaedic group. For more information, visit the Cerebral Palsy Research Network.
- Cerebral Palsy Hip Outcomes Project: CHOP Study (Principal Investigator).
International multi-centre study involving investigators in North America, Europe and Australasia to investigate the health-related quality of life outcomes of hip interventions for children with severe cerebral palsy, using a prospective longitudinal comparative cohort study design. Funded by the Canadian Institutes of Health Research (CIHR). Additional funding from the Arthur H. Huene Memorial Award from the Pediatric Orthopaedic Society of North America; and the Pedal with Pete Research Award from the American Academy of Cerebral Palsy & Developmental Medicine.
- The Gait Outcomes Assessment List (GOAL) Project (Principal Investigator).
Development and validation of a new priority (goal) based outcome measure for gait related interventions in children: The Gait Outcomes Assessment List (GOAL) Questionnaire.
- Outcomes of Spinal Deformity Management in Cerebral Palsy (HARMS Study Foundation) (Co-PI).
International multi-centre study of the impact of spinal deformity in cerebral palsy on health-related quality of life and outcomes of management of spinal deformity in CP.
- Gait Analysis RCT: Functional Outcomes Following Orthopaedic Surgery based on Gait Laboratory Analysis versus Observational Analysis: A Randomized Controlled Trial (Principal Investigator).
Funded by CIHR, this multi-centre study is a randomized trial to evaluate the effectiveness of gait analysis for decision making and its impact on functional outcomes following multi-level orthopaedic surgery for children with ambulatory cerebral palsy. This project was awarded the 2006 Angela Kuo Memorial Young Investigator Award from the Pediatric Orthopaedic Society of North America.
- Parental & Patient Priorities Related to Childhood Disability (Principal Investigator).
Exploring and defining the priorities and preferences (concerns, desires, goals and expectations) of parents and their children with chronic disabilities, in order to develop meaningful outcome measures to evaluate the effectiveness of various interventions that are recommended to address these priorities.
- The CPCHILD Project (Principal Investigator).
The Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD©) Questionnaire is a validated measure of health-related quality of life for children with severe disabilities. The measure has been adopted worldwide, with translated versions validated in multiple languages including: German, Dutch, French, Spanish, Norwegian, Swedish, Polish, Hebrew, Farsi, Korean, Malay, Chinese, Brazilian Portuguese, and others in development. This project was awarded the MacKeith Press Young Investigator Award in 2006, by the American Academy of Cerebral Palsy & Developmental Medicine.
- Pedal-With-Pete Foundation Award, American Academy for Cerebral Palsy and Developmental Medicine, 2014
- Arthur H. Huene Memorial Research Award, Pediatric Orthopaedic Society of North America, 2013
- Dr. John Whittaker Memorial Cerebral Palsy Award, Bloorview Research Institute, 2011
- External Faculty Teaching Award, Developmental Pediatrics Program, University of Toronto, 2009
- Robert Salter / Orthopaedic Chair Resident Teaching Award, University of Toronto, 2008
- Angela Kuo Memorial Award, Pediatric Orthopaedic Society of North America, 2006
- Mac Keith Press Young Investigator Award, American Academy of Cerebral Palsy & Developmental Medicine, 2004
- Marc Asher Award, Pediatric Orthopaedic Society of North America, 2004
- Teaching Excellence Award, Department of Paediatrics, University of Toronto, 2004
- Claire Bombardier Award, University of Toronto, Toronto, Most Promising Student - Clinical Epidemiology, 2001
- Open Fellowship Award (Academic Excellence), University of Toronto, 2000 – 2001
- Clinical Epidemiology Research Award, University of Toronto, 2000
- AAOS/OREF Health Services Research Fellowship Award, American Academy of Orthopaedic Surgery/Orthopaedic Research Education Foundation, 1999 – 2001
- Ramon Gustillo Award for Best Resident Research, University of Minnesota, 1998
- Sung KH, Kwon SS, Narayanan UG, Chung CY, Lee KM, Lee SY, Lee DJ, Park MS. Transcultural adaptation and validation of the Korean version of Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD). Disabil Rehabil. 2014 Jun 25:1-5.
- Boutis K, Howard A, Constantine E, Cuomo A, Somji Z, Narayanan UG. Evidence into Practice: Pediatric Orthopaedic Surgeon Use of Removable Splints for Common Pediatric Fractures. J Pediatr Orthop. 2014 May 30.
- Zalmstra TA, Elema A, Boonstra AM, Maathuis KG, Narayanan UG, V D Putten AA, Reinders-Messelink HA, Vlaskamp C, Lindeboom R. Validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) in a sample of Dutch non-ambulatory children with cerebral palsy. Disabil Rehabil. 2014 May 26:1-6.
- Jung NH, Brix O, Bernius P, Schroeder AS, Kluger GJ, Beyerlein A, Weir S, von Kries R, Narayanan UG, Mall V, Berweck S. German Translation of the Caregiver Priorities and Child Health Index of Life with Disabilities Questionnaire: Test-Retest Reliability and Correlation with Gross Motor Function in Children with Cerebral Palsy. Neuropediatrics. 2014 Apr 3.
- Gardner RO, Bradley CS, Howard A, Narayanan UG, Wedge JH, Kelley SP. The incidence of avascular necrosis and the radiographic outcome following medial open reduction in children with developmental dysplasia of the hip: A systematic review. Bone Joint J. 2014 Feb 1;96-B(2):279-86.
- Pellegrino LA, Ortolan EV, Magalhães CS, Viana AA, Narayanan UG. Brazilian Portuguese translation and cross-cultural adaptation of the “Caregiver Priorities and Child Health Index of Life with Disabilities” (CPCHILD©) questionnaire. BMC Pediatr. 2014 Feb 1;14(1):30.
- Escott BG, Ravi B, Weathermon AC, Acharya J, Gordon CL, Babyn PS, Kelley SP, Narayanan UG. EOS low-dose radiography: a reliable and accurate upright assessment of lower-limb lengths. J Bone Joint Surg Am. 2013 Dec 4;95(23):e1831-7.
- Boutis K, Grootendorst P, Willan A, Plint AC, Babyn P, Brison RJ, Sayal A, Parker M, Mamen N, Schuh S, Grimshaw J, Johnson D, Narayanan U. Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries. CMAJ. 2013 Oct 15;185(15):E731-8.
- Webb BD, Barrera M, Beyene J, Carcao M, Daneman D, Elliott I, Gong GW, Halperin IJ, Lord S, Melville H, Narayanan UG, Ota S, Solomon M, Sung L, Young NL, Zachos M, Feldman BM. Determinants of quality of life in children with chronic somatic disease: pilot data from the GapS Questionnaire. Qual Life Res. 2013 Mar 1;22(2):339-49. [Epub 2012 Mar 30]. In Press.
- Cohen E, Lacombe-Duncan A, Spalding K, MacInnis J, Nicholas D, Narayanan UG, Gordon M, Margolis I, Friedman JN. Integrated complex care coordination for children with medical complexity: a mixed-methods evaluation of tertiary care-community collaboration. BMC Health Serv Res. 2012 Oct 23;12:366.
- Narayanan UG. Management of children with ambulatory cerebral palsy: an evidence-based review. J Pediatr Orthop. 2012 Sep 1;32 Suppl 2:S172-81.
- Alves C, Steele M, Narayanan U, Howard A, Alman B, Wright JG. Open reduction and internal fixation of unstable slipped capital femoral epiphysis by means of surgical dislocation does not decrease the rate of avascular necrosis: a preliminary study. J Child Orthop. 2012 Aug 1;6(4):277-83.
- Fehlings D, Narayanan U, Andersen J, Beauchamp R, Gorter JW, Kawamura A, Kiefer G, Mason M, McCormick A, Mesterman R, Switzer L, Watt J. Botulinum toxin-A use in paediatric hypertonia: Canadian practice patterns. Can J Neurol Sci. 2012 Jul 1;39(4):508-15.
- Narayanan UG, Phillips JH. Flexibility in fixation: an update on femur fractures in children. J Pediatr Orthop. 2012 Jun 1;32 Suppl 1:S32-9.
- Narayanan UG. To do or not to do the other hip? Dev Med Child Neurol. 2012 Mar 1;54(3):201-2.
For more recent publications see PubMed