• Alvarez, Christine

    Titles
    Investigator, BC Children's Hospital

    Clinical Associate Professor, Division of Pediatric Orthopedics, Department of Orthopedics, University of British Columbia
    Member, Division of Pediatrics, BC Children’s Hospital

    Degrees / Designations
    B.Sc., M.Sc., MD, FRCSC
    Primary Area of Research
    Evidence to Innovation
    Secondary Area(s) of Research
    Phone
    604-875-2178
    Fax
    604-875-2275
    Lab Phone
    604-875-2000 ext. 6008
    Assistant
    Sarah Park
    Assistant Phone
    604-875-2178
    Mailing Address
    BC Children's Hospital
    Room A203
    4480 Oak Street
    Vancouver, BC V6H 3V4
    Affiliate Websites
    Research Areas
    • Orthopaedics
    • Clubfoot
    • Hereditary Multiple Exostoses
    • Gait
    Summary

    My research involves orthopaedics.  I do both basic and clinical research and bring the research into clinical practice. I have pioneered the use of Botox (the same medicine used for wrinkles) in the treatment of clubfoot and continue to advance its use through research. I also focus on using gait analysis, measuring how people walk, and doing research on how people walk normally and with certain conditions such as clubfoot. I also conduct research into hereditary multiple exostoses (HME), a condition where people develop multiple bony bumps on their skeleton.

    Current Projects

    Clubfoot follow up
    We have found that injecting Botulinum Toxin A into the tricep surae muscle complex of the leg can replace the Achilles tenotomy in the Ponsetti method of treatment of Clubfoot (Journal of Pediatric Orthopaedics 2005; 25(2):229-235). We are currently following the long-term outcome of this treatment and integrating the knowledge into the clinical practice of the Clubfoot Clinic at BC Children’s Hospital.

    Genotype phenotype correlations in HME
    HME is cause by mutations in one of two genes EXT1 or EXT2. We have found an association between a more severe presentation of the condition (phenotype) and the underlying mutation (genotype).  This study was done on a small group of families and provided valuable information. The next step is to examine a large number of families to increase the scientific and statistical evidence behind these findings. This research has translated into a change in our care for HME patients to a more regimented whole body review of their condition.

    Idiopathic toe walking and Botox: Randomized control trial of Botulinum Toxin A to treat idiopathic toe walking
    This trial is being conducted in collaboration with Dr. B. Sawatzky. The normal pattern of gait in those over three years old is a heel toe pattern. Those who walk on their toes beyond age three are felt to have an abnormal gait pattern. Toe walking can lead to achilles tendon contracture which may lead to additional problems. The traditional treatment is to cast the foot and stretch the heel cord. This study is to examine whether injection of the gastrocnemius muscle to weaken it and then cast the foot to stretch the heel cord is more effective than casting alone (with placebo injection).

    Selected Publications

    Alvarez C, De Vera M, Chhina H, Black A.: Normative data for the dynamic pedobarographic profiles of children. Gait Posture. 2008 Aug;28(2):309-15. 

    Alvarez, C, Tredwell, S, Keenan, S, Beauchamp, R, De Vera, M, Choit, R, Sawatzky, B. Treatment of Idiopathic Clubfoot Utilizing Botulinum A Toxin: A New Method and Its Short Term Outcomes.  Journal of Pediatric Orthopaedics  2005; 25(2):229-235

    Alvarez C, Robert Litchfield, Dianne Jackowski, Sharon Griffin, and Alexandra Kirkley.  A Prospective, Double-Blind, Randomized Clinical Trial Comparing Subacromial Injection of Betamethasone and Xylocaine to Xylocaine Alone in Chronic Rotator Cuff Tendinosis Am J Sports Med 2005 33: 255-262.

    Alvarez, C, Litchfield, R, Jackowski, D, Griffin, S, Kirkley, A.  A Prospective, Double-Blind, Randomized Clinical Trial Comparing Subacromial Injection of Betamethasone and Xylocaine versus Xylocaine in Rotator Cuff Tendinosis.  American Journal of Sports Medicine. 2005;33(2):255-262.

    Alvarez, C., Genotype-Phenotype Correlations in Hereditary Multiple Exostoses in British Columbia, in Faculty of Medice, Department of Surgery. 2003, University of British Columbia: Vancouver, BC. p. 253

    Metzler, M, Li, G, Gan, L, Georgiou, J, Gutekunst, CA, Wang, Y, Torre, E, Devon, RS, Oh, R, Legendre-Guillemin, V, Rich, M, Alvarez, C, Gertsenstein, M, McPherson, PS, Nagy, A, wang, YT, Roder, JC, Hayden, MR, et al. Disruption of the endocytic protein HIP1 results in neurological deficits and decreased AMPA trafficking. EMBO J. 2003; 22(13):3254-3266.

    Kirley, A, Alvarez, C, Griffin, S.  The development and evaluation of a disease-specific quality-of-life questionnaires for disorders of the rotator cuff: The Western Ontario Rotator Cuff Index.  Clinical Journal of Sport Medicine 2003;13:84-92.

    Grants
    Honours & Awards

    Robert E. Salter Research Award, Canadian Orthopaedic Foundation – 2003

    Research Group Members
    • Mary De Vera
    • Sean Tredwell
    • Angie Perdios