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Outcomes Research: Hip

OTHER AREAS:  MUSCULOSKELETAL TUMOURS  |  SPINE  |  TRAUMA


Incidence and Classification of AVN Following Treatment of DDH

SickKids Principal Investigator: Dr. John Wedge

Osteonecrosis of the femoral head is a major potential complication following the treatment of developmental dysplasia of the hip (DDH). 
It remains unclear if the radiographic changes associated with osteonecrosis are clinically relevant. 

This study examines the relationship between morphological changes on radiographs, health-related quality of life, physical function and hip function.

Publications:

  1. Roposch A, Wedge JH, Riedl G. Reliability of Bucholz and Ogden classification for osteonecrosis secondary to developmental dysplasia of the hip. Clin Orthop Relat Res. 2012 Dec;470(12):3499-505. doi: 10.1007/s11999-012-2534-x. Epub 2012 Aug 18. PMID:22903283
  2. Roposch A, Odeh O, Doria AS, Wedge JH. The presence of an ossific nucleus does not protect against osteonecrosis after treatment of developmental dysplasia of the hip.Clin Orthop Relat Res. 2011 Oct;469(10):2838-45. doi: 10.1007/s11999-011-1801-6. Epub 2011 Feb 11. PMID:21312075
  3. Roposch A, Liu LQ, Offiah AC, Wedge JH. Functional outcomes in children with osteonecrosis secondary to treatment of developmental dysplasia of the hip. J Bone Joint Surg Am. 2011 Dec 21;93(24):e145. doi: 10.2106/JBJS.J.01623. PMID:22258780

Standardized Diagnostic Criteria for Developmental Dysplasia of the Hip in Early Infancy

SickKids Principal Investigator: Dr. John Wedge

Clinicians use various criteria to diagnose developmental dysplasia of the hip (DDH) in early infancy, but the importance of these various criteria for a definite diagnosis is controversial. This study aims to establish a consensus among pediatric orthopaedic surgeons worldwide regarding the most relevant criteria for diagnosis of DDH in infants younger than 9 weeks.

Publications: 
Roposch A, Liu LQ, Hefti F, Clarke NM, Wedge JH. Standardized diagnostic criteria for developmental dysplasia of the hip in early infancy. Clin Orthop Relat Res. 2011 Dec;469(12):3451-61. doi: 10.1007/s11999-011-2066-9. Epub 2011 Sep 28. PMID:21952742

Cerebral Palsy Hip Outcomes Project: CHOP Study

SickKids Principal Investigator: Dr. Unni Narayanan

Funding: CIHR, POSNA and the AACPDM

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.

International Competency Based Training for the Application of a Pavlik Harness

SickKids Principal Investigators: Dr. Simon Kelley and Dr. Lucas Murnaghan

Funding: Pediatric Orthopaedic Society of North America (POSNA)

The Pavlik Harness (PH) is the most commonly used treatment for Developmental Dysplasia of the Hip worldwide. Formal educational methods and evaluation tools for PH application have not been developed. This study seeks international consensus to develop a learning module; an evaluation tool and to assess competence after module use.

International Consensus of Pavlik Harness Management in Developmental Dysplasia of the Hip: Setting the Standard and Evaluating Outcomes

SickKids Principal Investigator: Catharine Bradley

Funding: Institute of Medical Science, University of Toronto and The Hospital for Sick Children

Developmental dysplasia of the hip is most commonly treated with the Pavlik Harness (PH). Despite this, there is no standardization for the use of the PH. This study seeks to obtain international consensus on PH treatment parameters and to assess the feasibility of conducting an international trial on PH use.

Prospective Observational Cohort Study of Children with Hips Dislocated at Rest

SickKids Principal Investigator: Dr. Simon Kelley

Funding: The International Hip Dysplasia Institute (IHDI)

Controversy in the medical literature currently exists on how to best treat children with dislocated hips. This multi-site prospective study seeks to identify and analyze treatment patterns and outcomes from treatment centres around the world with the intent to address how to best manage these challenging patients.

Outcomes Research in Developmental Dysplasia of the Hip (DDH)

SickKids Principal Investigator: Dr. Simon Kelley

Developmental dysplasia of the hip is a very common condition in childhood. We have developed a prospective database from children attending the baby hip clinic will be used to give us a better understanding, on a long-term basis, of what happens to patients in order to improve patient care and outcomes.

 Parental & Patient Priorities Related to Childhood Disability

SickKids Principal Investigator: Dr. Unni Narayanan

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.

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