By Emily Schaeffer, Tarini Boparai, and the Hippy Lab
World Children’s Day presents a compelling opportunity to reflect on the core motivation that guides the Hippy Lab at the UBC Department of Orthopaedics. Our mission is to improve hip health, mobility, and quality of life for all children in British Columbia, as well as nationally and globally, through research, clinical care, education, and advocacy, with a vision of ensuring hip health for all.
Clinical care, research, and education are essential components that work together to achieve the best possible outcomes for patients and their families. Over the past ten years, the Hippy Lab has effectively integrated these three pillars to advance care and improve health outcomes for children and families around the world.
Local-to-Global-to-Local
Our work is grounded in the principles of local-to-global-to-local. We strive to improve the lives of children and families in British Columbia and across Canada, while also fostering long-term, collaborative partnerships globally to impact families worldwide. Throughout this process, we have discovered that we can learn a great deal from our global partners, which we can then apply in our local context.
The Hippy Lab focuses on various aspects of pediatric orthopedics, with a primary emphasis on conditions affecting the hip health of infants and children. Guided by the READI principles—Respect, Equity, Accessibility, Diversity, and Inclusion—we have established strong global partnerships that enhance the relevance of our work for a diverse patient population. Through these collaborations, we have created opportunities to integrate our research with improvements in clinical care, translating research findings into actionable impacts on health systems both locally and globally.
Hippy Global Registry Program
The Hippy Global Registry Program was established to further our lab’s mission. Our registries collect clinical data as well as patient-reported information, aiming to advance research, clinical care, education, and advocacy. By conducting our registries on a large scale, we seek to impact global health and drive innovation.
World-leading research registries within the Hippy Global Registry Program include the Global Hip Dysplasia Registry (GHDR), the SCFE Longitudinal International Prospective (SLIP) Registry and the Global Paediatric Orthopaedic Implant Safety & Efficacy (POISE) Registry. These registries are dedicated to collecting patient data to identify the best treatments and management strategies to improve long-term mobility and quality of life for children worldwide with conditions such as developmental dysplasia of the hip (DDH) and slipped capital femoral epiphysis (SCFE).
The reach of these registries is genuinely global; we have recruited over 7,500 patients from 63 centers across 16 countries on all six inhabited continents. Additionally, we are continually striving to enhance our global representation. The success of this program is attributed to our collaborative partnerships and the vital contributions of our participating patients and their families.
Driving Catalyst for Globally Inclusive Research
The Global Hip Dysplasia Registry (GHDR) serves as the founding registry and has provided a model for our additional registries. Developmental dysplasia of the hip (DDH) is the most common pediatric hip condition, affecting 1-3 percent of infants. Despite its prevalence, there are many controversies surrounding the screening, diagnosis, and treatment of DDH. The GHDR was established to gather evidence to address these issues within a globally relevant patient population.
Currently, the registry includes nearly 7,000 patients from 32 centers across 7 different countries worldwide. Locally, BC Children’s Hospital has enrolled over 1,500 patients who are participating in the registry. Thanks to the recent addition of centers in Kenya and Uganda, the GHDR is now globally representative, with participation from all inhabited continents. The extensive scale of the GHDR has allowed us to begin answering longstanding questions about the diagnosis, treatment, and outcomes of DDH in a manner that is relevant on a global scale, not just for the Global North.
Randomized Controlled Trials
We created the GHDR with a dual vison: establishing a comprehensive registry for children diagnosed across the entire spectrum of DDH and facilitating the development of targeted, hypothesis-driven studies. This includes conducting randomized controlled trials (RCTs) that address specific questions, all under the guidance of the broader registry in collaboration with our partners.
In alignment with this vision, we received a CIHR Research Project Grant in 2023 to investigate the effectiveness of bracing versus observation in cases of radiological dysplasia. This study aims to provide robust evidence to enhance the management of infants with DDH on a global scale.
Furthermore, we envision that this model of hypothesis-generating registries will stimulate hypothesis-testing RCTs and comparative effectiveness studies, forming the foundation of our research program. This approach will help us maximize the impact of our research in improving and advancing clinical care.
Local-to-Global Partnerships and Collaborations
Partnerships and global collaborations through the Hippy Global Registry Program have created opportunities to integrate our research with improvements in clinical care by developing care pathways. A care pathway uses the best available medical and research evidence to standardize or create a guide for the diagnosis, management, or treatment of a specific condition. Importantly, care pathways are region-specific, recognizing that solutions that work in one part of the world may not be effective in another.
Our team has collaborated with healthcare societies in India to develop two care pathways: one for Developmental Dysplasia of the Hip (DDH) and one for monitoring hip displacement in children with Cerebral Palsy (CP). This successful partnership has led to an expansion of our care pathways program. We recently completed a similar process in Sri Lanka, working with orthopedic surgeons, pediatricians, and radiologists to create a DDH care pathway tailored to their healthcare setting.
Global-to-Local: Bringing the Lessons Home
Having participated in the development of global care pathways, we are now applying the lessons learned from these international efforts to our local context in British Columbia and Canada. Our team has brought together a diverse group of professionals—including orthopedic surgeons, radiologists, nurse practitioners, pediatricians, family physicians, midwives, and patients/families—to create national guidelines for the screening of DDH in Canada. We are also working on leading the implementation of these guidelines at the provincial level in BC.
The potential global impact of these care pathways is immense, a fact recently recognized by UNICEF. In collaboration with the Divi’s Foundation for Gifted Children, UNICEF has pledged $1.2 million toward the implementation of the DDH care pathway developed for India. This partnership holds great promise for future support as we continue to develop care pathways in Canada and other regions around the world.
Engage Children and Families
The Hippy Lab is dedicated to helping children live mobile, pain-free, and active lives—free from the burden of hip conditions. It is important for us to engage with children and their families and involve them in the research process, ensuring that they have a voice in setting priorities.
So far, we have completed 14 focus groups with patients affected by DDH and their family members. These discussions have helped us gain a deeper understanding of their experiences throughout treatment, enabling us to develop more effective educational materials and provide support and connections among families.
We are currently in the process of creating a Patient & Family Advisory Group. This group will identify research priorities, co-develop and design research studies, and advise us on ongoing programs. Together, we can continue to make a meaningful impact on the lives of children and their families, improving hip health, mobility, and quality of life around the world.
Learn more
- Hippy Lab Researchers Awarded Over $1M Funding for Hip Dysplasia Non-Inferiority Randomized Control Trial
- Hippy Global Registry Program
- Hippy Lab Care Pathway
