Emily Schaeffer

PhD

Investigator and Research Director, Orthopedic Surgery, BC Children's Hospital

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.

Academic Affiliations

  • Assistant Professor, Division of Pediatric Orthopaedics, Department of Orthopaedics, Faculty of Medicine, University of British Columbia
  • Research Theme: Evidence to Innovation
  • Research Group(s): Clinical Practice, Outcomes and Innovation; Clinical and Community Data, Analytics and Informatics; Global Health and Innovations

Contact Information

Location

4480 Oak Street, Vancouver, British Columbia, Canada, V6H 3N1

Assessing Caregiver Experiences Using Hip Spica Casts in Children Treated for Developmental Dysplasia of the Hip

Journal of Pediatric Orthopaedics

Tarini Boparai and Sana Arora and Luke Wu and Emily Bliven and Georgia Grzybowski and Kishore Mulpuri and Emily K. Schaeffer

DOI: 10.1097/BPO.0000000000003114

02 / 2026

An Examination of Screening Practices for Developmental Dysplasia of the Hip Across Sri Lankan Medical Specialties

Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews

De Silva, D. and Tennekoon, D.C. and Rajindrajith, S. and Fernando, U.J. and Rajapaksha, A. and Aroojis, A. and Mulpuri, K. and Schaeffer, E. and Wijayasinghe, S.R.

DOI: 10.5435/JAAOSGlobal-D-24-00264

A Systematic Review to Assess Gender Diversity in Authorship Within the Orthopaedic Surgery Literature

Indian Journal of Orthopaedics

Zomar, B.O. and Boparai, T. and You, E. and Jackson, K. and South, N. and Schaeffer, E.K.

DOI: 10.1007/s43465-025-01462-x

The 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

Hsu, M. and Spurr, H. and Cooper, A.P. and Schaeffer, E.K.

DOI: 10.1016/j.jposna.2024.100139

Physiotherapy and physical activity in children with Perthes disease an international survey of recommendations from paediatric orthopaedic surgeons

Bone and Joint Open

Hailer, Y.D. and Perry, D.C. and Schaeffer, E. and Li, J. and Mulpuri, K.

DOI: 10.1302/2633-1462.66.BJO-2024-0219.R1

Early age-related changes to articular cartilage T1 in hips with Legg"Calv"Perthes disease deformity

Osteoarthritis and Cartilage Open

Johnson, L.G. and Jones, C.E. and Rosenbaum, D.G. and Joseph, B. and Schaeffer, E.K. and Mulpuri, K. and Wilson, D.R.

DOI: 10.1016/j.ocarto.2025.100589

Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review

BMJ Open

Jaleca, P.E.C.M.R. and Liggio, D.F. and Arora, S. and Lam, S. and Schaeffer, E. and Grangeiro, P.M.

DOI: 10.1136/bmjopen-2024-094660

SegFormer3D: Improving the Robustness of Deep Learning Model-Based Image Segmentation in Ultrasound Volumes of the Pediatric Hip

Ultrasound in Medicine and Biology

Hers, B. and Bonta, M. and Du, S. and Mulpuri, K. and Schaeffer, E.K. and Hodgson, A.J. and Garbi, R.

DOI: 10.1016/j.ultrasmedbio.2024.12.013

Gender Equity Issues in Orthopaedics: A Scoping Review

Indian Journal of Orthopaedics

Schaeffer, E.K. and Webber, D.R. and Shrestha, S. and Tidler, M.G. and Ahmed, T. and Simmonds, A.M.

DOI: 10.1007/s43465-025-01415-4

Anterior Hip Clearance in Residual Legg-Calv-Perthes Disease

Journal of Pediatric Orthopaedics

Johnson, L.G. and Zhang, H. and Joseph, B. and Schaeffer, E.K. and Mulpuri, K. and Wilson, D.R.

DOI: 10.1097/BPO.0000000000002949

Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review protocol

BMJ Open

Jaleca, P.E.C.M.R. and Liggio, D. and Lam, S. and Arora, S. and Schaeffer, E. and Grangeiro, P.M.

DOI: 10.1136/bmjopen-2024-085403

Surgeon Recommendations for Physical Activity in Patients with Pediatric Hip Conditions

Journal of Pediatric Orthopaedics

Li, J. and Schaeffer, E.K. and Miller, S. and Schreiber, V.M. and Hailer, Y.D. and Clohisy, J.C. and Kim, H.K.W. and Mulpuri, K.

DOI: 10.1097/BPO.0000000000002732

Comparison of brace to observation in stable, radiological developmental dysplasia of the hip: a protocol for a global multicentre non-inferiority randomised trial

BMJ Open

Zomar, B.O. and Bone, J.N. and Nguyen, V. and Mulpuri, K. and Kelley, S. and Schaeffer, E.K. and Aarvold, A. and Aroojis, A. and Bade, D. and Benaroch, T. and Casta{\~n}eda, P. and Dodwell, E. and Donnan, L. and Hayat, S. and Herrera-Soto, J. and Hooper, N. and Janicki, J. and Kim, H. and Krishnamoorthy, V. and Messner, J. and Grangeiro, P.M. and Patwardhan, S. and Pun, S. and Reidy, M. and Romeo, J. and Rosenfeld, S. and Sankar, W. and Schreiber, V. and Shah, H. and Smit, K. and Tarchala, M. and Thacker, M. and Upasani, V. and Williams, N.

DOI: 10.1136/bmjopen-2024-084738

Risk Factor Analysis for Growth Arrest in Paediatric Physeal Fractures"A Prospective Study

Journal of Clinical Medicine

Hooper, N. and Johnson, L. and Banting, N. and Pathy, R. and Schaeffer, E.K. and Bone, J.N. and Zomar, B.O. and Sandhu, A. and Siu, C. and Cooper, A.P. and Reilly, C. and Mulpuri, K.

DOI: 10.3390/jcm13102946

Developmental Dysplasia of the Hip and Laterality: The Importance of Graded Severity of the Contralateral Hip

Indian Journal of Orthopaedics

Schaeffer, E.K. and Price, C.T. and Mulpuri, K.

DOI: 10.1007/s43465-024-01157-9

Management of long bone fractures and traumatic hip dislocations in paediatric patients: study protocol for a prospective global multicentre observational cohort registry

BMJ Open

Zomar, B.O. and Chen, M. and Schaeffer, E.K. and Mulpuri, K. and Joeris, A. and Buunaaim, A.D.B. and Imran Buckari, S. and Ajith Kumar, M. and Johnson, L. and Little, D. and Schmittenbecher, P. and Bosak Versic, A. and Konstantopoulou, A. and Aguado Maestro, I. and Stitzman Wengrowicz, M. and Carsen, S. and Gupta, S.K. and Narayanan, U. and El Hawary, R. and Malaret Baldo, M.J. and Sepulveda, M.

DOI: 10.1136/bmjopen-2023-079836

Long-Arm Splinting Versus Above-Elbow Casting for Type 1 Supracondylar Fractures of the Humerus in Children: a Randomized Controlled Trial

SN Comprehensive Clinical Medicine

Siu, C. and Farrell, S. and Schaeffer, E.K. and Doan, Q. and Dobbe, A. and Bone, J. and Reilly, C.W. and Mulpuri, K.

DOI: 10.1007/s42399-023-01417-z

Application of statistical shape modeling to the human hip joint: a scoping review

Jbi Evidence Synthesis

Johnson, L.G. and Bortolussi-Courval, S. and Chehil, A. and Schaeffer, E.K. and Pawliuk, C. and Wilson, D.R. and Mulpuri, K.

DOI: 10.11124/JBIES-22-00175

Caregiver 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

A Prospective, Multicenter Study of Developmental Dysplasia of the Hip: What Can Patients Expect after Open Reduction?

Journal of Pediatric Orthopaedics

Kiani, S.N. and Gornitzky, A.L. and Matheney, T.H. and Schaeffer, E.K. and Mulpuri, K. and Shah, H.H. and Yihua, G. and Upasani, V. and Aroojis, A. and Krishnamoorthy, V. and Sankar, W.N.

DOI: 10.1097/BPO.0000000000002383

A 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.

Surveillance 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

The Orthopaedic Management of Hip Dysplasia with Underlying Megalencephaly-Capillary Malformation Syndrome: a Case Report

SN Comprehensive Clinical Medicine

So, J. and Schaeffer, E.K. and Mulpuri, K.

DOI: 10.1007/s42399-022-01123-2

Unilateral 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

Evaluating 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

Developmental 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

Care 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

Hip 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

Variability 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.

The Natural History of Non-operatively Managed Legg"Calv"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

Interobserver 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

A 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

Survey 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

Inter-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

Inter-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

Developmental Dysplasia of the Hip

Evidence Based Orthopedics Second Edition

Schaeffer, E.K. and Sankar, W.N.

DOI: 10.1002/9781119413936.ch181

Developmental 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

Do 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

Is 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

Demographic 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

The 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

Global 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

Recommendations 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

Developmental 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

The 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

Examining 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

Reply to Letter to the Editor: Recommendations for the Care of Pediatric Orthopaedic Patients during the COVID-19 Pandemic

Journal of the American Academy of Orthopaedic Surgeons

Schaeffer, E.K. and Farrell, S. and Mulpuri, K.

DOI: 10.5435/JAAOS-D-20-00743

Even 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

Development 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

Content 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

Ultrasound 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

Anatomy 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

Management 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

AAOS 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

Assessing 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

Closed 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

AAOS 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

Acetabuloplasty 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

Evidence-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

Need 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

Evaluating 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

A 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

Vertebral 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

Nonoperative 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

Do 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

Developmental 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

Introduction 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

Pavlik 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

Automatic 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

Prevention 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

Avascular 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

What 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

What 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

Multiple 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

Simvastatin 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

A 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

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.

Grants

Co-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 & Awards

2023–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

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