Kishore Mulpuri
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Background 鈥 Developmental dysplasia of the hip (DDH) represents a range of hip joint instability, present at birth or developed during infancy, ranging from mild instability to a complete dislocation. In India and other Global South countries, DDH is often diagnosed after walking age, requiring more complex and invasive surgeries with greater risk of complications and long-term disability. A DDH care pathway is a decision-making tool that coordinates and standardizes screening, with the aim of reducing late detections. We describe a multi-phase methodology for context-specific DDH care pathway development, demonstrating its use in India.Methods 鈥 In Phase I, seven relevant Indian organizations partnered together and assembled a multidisciplinary working group, which then met fortnightly to establish an evidence base and prepare for the subsequent consensus-building phase. Group members also developed specialty-specific surveys for local providers in India, which were distributed to organizational memberships. During Phase II, panelists participated in a modified Delphi method to reach consensus on a list of best practice statements regarding DDH screening in the Indian context. Phase III applied the statements to build the care pathway. Results 鈥 The entire process was completed within a one-year time span, with all procedures conducted remotely using virtual communication and requiring minimal funds or resources. Specialty surveys demonstrated low awareness about DDH, limited practice of DDH screening, and variability in the quality of ultrasound. The Delphi method concluded after a preliminary survey and two Delphi rounds, reaching consensus on 47 statements, which were condensed into 35. The developed care pathway for India features periodic clinical hip examinations integrated with the country鈥檚 immunization schedule and selective imaging screening, providing flexibility in the timing and modality of imaging. Discussion/Conclusion 鈥 In Global South countries, there is a need for DDH care pathways that are specific to local contexts. Care pathway development is strengthened through the involvement of a multidisciplinary team of local providers and stakeholders. The methodology requires strategies to identify country-specific barriers to care and facilitate group engagement. The cost- and time-effective approach used in India is feasible and can be applied to other conditions and/or countries wishing to establish care pathways.
Publications
- (2022)
Developmental Medicine & Child Neurology, - (2022)
International Journal of Computer Assisted Radiology and Surgery, - (2022)
Journal of Pediatrics, - (2022)
Journal of Pediatric Orthopaedics Part B, 31 (2), 160-168 - (2022)
Indian Journal of Orthopaedics, 56 (1), 58-65 - (2022)
Journal of Pediatric Orthopaedics, 42 (1), E59-E64 - (2022)
Indian Journal of Orthopaedics, 56 (5), 867--873 - (2022)
SN Comprehensive Clinical Medicine, - Variability in the Follow-up Management of Pediatric Femoral Fractures (2022)
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 6 (4) - (2021)
Journal of Pediatric Orthopaedics, 41 (6), e392-e397 - (2021)
Ultrasound in Medicine and Biology, 47 (9), 2713-2722 - (2021)
3D Printing in Medicine, - (2021)
Indian Journal of Orthopaedics, 55 (6), 1559--1567 - (2021)
Indian Journal of Orthopaedics, 55 (1), 158-168 - (2021)
Journal of pediatric orthopedics. Part B, - (2021)
Spine, 46 (14), 975-982 - (2021)
Indian Journal of Orthopaedics, 55 (6), 1357--1359 - (2021)
Indian Journal of Orthopaedics, 55 (S2), 445--451 - (2021)
International Journal of Computer Assisted Radiology and Surgery, - (2021)
Physical & Occupational Therapy In Pediatrics, 41 (3), 300--313 - (2021)
Journal of Pediatric Orthopaedics, 41 (8), E692-E697 - (2021)
Journal of Pediatric Orthopaedics, 41 (7), E563-E569 - (2020)
Ultrasound in medicine & biology, - (2020)
3D Printing in Medicine, - (2020)
Indian Journal of Orthopaedics, 55 (6), 1591-1595 - (2020)
Indian Journal of Orthopaedics, 55 (6), 1549-1558 - (2020)
Journal of Pediatric Orthopaedics, 40 (4), e248--e255 - (2020)
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 4 (5) - (2020)
Bone & joint open, - (2020)
Journal of pediatric orthopedics, - (2020)
Spine, 45 (12), 851-859 - (2020)
Indian Journal of Orthopaedics, 55 (6), 1372-1387 - (2020)
Journal of pediatric orthopedics, - (2020)
Journal of children's orthopaedics, - (2020)
Journal of the American Academy of Orthopaedic Surgeons, 28 (11), e477--e486 - (2020)
The Journal of the American Academy of Orthopaedic Surgeons, - (2020)
Journal of Pediatric Orthopaedics, 40 (5), e329--e334 - (2020)
Indian Journal of Orthopaedics, - Suspension of Hip Surveillance for Children with Cerebral Palsy During the COVID-19 Outbreak: The Benefit of Hip Surveillance Does Not Outweigh the Risk of Infection (2020)
Indian journal of orthopaedics, - (2020)
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, - (2020)
Journal of children's orthopaedics, - (2020)
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 12443, 97-105 - (2019)
Journal of the American Academy of Orthopaedic Surgeons, 27 (8), e369--e372 - (2019)
Journal of Children's Orthopaedics, 13 (6), 569--574 - (2019)
The Pediatric Infectious Disease Journal, 38 (10), 990--993 - (2019)
Computational Methods and Clinical Applications in Musculoskeletal Imaging, , 136--145 - (2019)
Journal of Pediatric Orthopaedics, 39 (3), 111--118 - (2019)
Lecture Notes in Computer Science, , 12--20 - (2019)
Journal of pediatric orthopedics. Part B, - (2019)
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, - (2019)
Journal of Pediatric Orthopaedics, 39 (1), e39--e43 - (2019)
Journal of pediatric orthopedics, - (2019)
Journal of Pediatric Orthopaedics, 39 (9), 453--457 - (2018)
Journal of Pediatric Orthopaedics, 38 (6), e305-e311 - (2018)
Pediatric Pelvic and Proximal Femoral Osteotomies: A Case-Based Approach, , 127-134 - (2018)
Journal of Bone and Mineral Research, 33 (2), 229-240 - (2018)
Medical Journal of Australia, 208 (8), 359-364 - (2018)
Journal of Orthopaedic Trauma, 32 (5), 211-215 - (2018)
BMJ Open, 8 (1) - (2018)
Journal of Pediatric Orthopaedics, 38 (4), e225-e229 - (2018)
Journal of Pediatric Orthopaedics, 38 (1), e25-e26 - (2018)
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, - (2018)
Journal of Pediatric Orthopaedics, 38 (10), 521-526 - (2018)
Medical Image Computing and Computer Assisted Intervention 鈥 MICCAI 2018, , 365--373 - (2018)
Skeletal Radiology, 47 (1), 79-84 - (2018)
Journal of Pediatric Orthopaedics, 38 (8), 393-397 - (2017)
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 10433, 100-107 - Acute kidney injury following spinal instrumentation surgery in children. (2017)
- (2017)
Ultrasound in Medicine and Biology, 43 (6), 1252-1262 - (2017)
Lecture Notes in Computer Science, , 124--132 - (2017)
Journal of Children's Orthopaedics, 11 (5), 326-333 - (2017)
Journal of Pediatric Orthopaedics, 37 (7), e409-e414 - (2017)
- (2017)
Developmental Medicine and Child Neurology, 59 (11), 1130-1138 - (2017)
Journal of Pediatric Orthopaedics, 37 (4), 272-278 - (2016)
- (2016)
- Automatic Evaluation of Scan Adequacy and Dysplasia Metrics in 2D Ultrasound Images of the Neonatal Hip (2016)
Canadian Orthopaedic Association Annual Meeting, - Caregiver attitudes toward the use of smartphone applications in pediatric orthopaedics: A cross-sectional survey study (2016)
Canadian Orthopaedic Association Annual Meeting, - Child Health BC Hip Surveillance Program for Children with Cerebral Palsy E-learning Module (2016)
- Closed Reduction for Developmental Dysplasia of the Hip: Early-term Results From a Prospective, Multicenter Cohort. (2016)
- Comparison of an automatic ultrasound technique to current practice in calculating dysplasia metrics in DDH (2016)
Pediatric Orthopaedic Society of North America Annual Meeting, - Developmental Dysplasia of the Hip and Laterality: The Importance of Graded Severity of the Contralateral Hip (2016)
Canadian Orthopaedic Association Annual Meeting, - (2016)
- (2016)
Surgery of the Spine and Spinal Cord: A Neurosurgical Approach, , 65-75 - Fundamental concepts in evidence鈥揵ased medicine (2016)
Surgery of the Spine and Spinal Cord 鈥 A Neurosurgical Approach, - (2016)
- Investigating Caregiver Perspectives on Health Status and Comfort in Children with Cerebral Palsy Undergoing Surgery for Hip Displacement (2016)
Canadian Orthopaedic Association Annual Meeting, - Management of displaced supracondylar fractures of the humerus using lateral versus cross k wires: A prospective randomized trial (2016)
Canadian Orthopaedic Association Annual Meeting, - Misinterpretation of 鈥淣egative鈥 Results of Superiority Trials in Orthopaedic Literature: The Need for Non-inferiority Trials (2016)
Canadian Orthopaedic Association Annual Meeting, - Participating in clinical research: A parent perspective (2016)
Canadian Orthopaedic Association Annual Meeting, - Splinting versus above elbow casting for Type I supracondylar fractures of the humerus in children: A randomized controlled trial (2016)
Canadian Orthopaedic Association Annual Meeting, - (2016)
- (2016)
American Orthopaedic Association/Canadian Orthopaedic Association Annual Meeting, - (2016)
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 9900 , 602-609 - (2016)
- (2016)
- (2015)
- (2015)
2015 IEEE 12th International Symposium on Biomedical Imaging (ISBI), - (2015)
Pediatric Orthopaedic Society of North America Annual Meeting, - Avascular necrosis in children with cerebral palsy after reconstructive hip surgery (2015)
Canadian Orthopaedic Association Annual Meeting, - (2015)
- Detection and non鈥搊perative management of paediatric developmental dysplasia of the hip in infants (2015)
Canadian Orthopaedic Association Annual Meeting, - (2015)
- Gastrocnemius recession compared to tendo鈥揳chilles lengthening for surgical correction of equinus deformity in children with cerebral palsy: Are we under or over correcting based on gait analysis? (2015)
Canadian Orthopaedic Association Annual Meeting, - Give me a break! Does post鈥搒urgical immobilization increase the risk of low trauma fractures in children with cerebral palsy post hip surgery? (2015)
Canadian Orthopaedic Association Annual Meeting, - Health鈥搑elated quality of life outcomes in paediatric literature (2015)
Canadian Orthopaedic Association Annual Meeting, - (2015)
- Internet鈥揳dministered health related quality of life questionnaires compared to pen and paper in an adolescent scoliosis population: A randomized crossover study (2015)
Canadian Orthopaedic Association Annual Meeting, - (2015)
- Misinterpretation of 鈥渘egative鈥 results of superiority trials in orthopaedic literature: The need for non鈥搃nferiority trials (2015)
Pediatric Orthopaedic Society of North America Annual Meeting, - Non鈥搊perative treatment of Type IIA supracondylar humerus fractures: Comparing two modalities (2015)
Canadian Orthopaedic Association Annual Meeting, - Pavlik treatment for dislocated but irreducible hips in infants aged <6 months: Unilateral hips have high success rate, bilateral hips are doomed to failure (2015)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2015)
- Risk factors for late presenting developmental dysplasia of the hip from a multi鈥揷entre, prospective study group (2015)
Pediatric Orthopaedic Society of North America Annual Meeting, - Risk factors for late presenting developmental dysplasia of the hip from a multicentre, prospective study group (2015)
Canadian Orthopaedic Association Annual Meeting, - (2015)
- The effectiveness of Pavlik harness treatment for fixed congenital dislocations of the hip (2015)
Canadian Orthopaedic Association Annual Meeting, - (2015)
- (2015)
- Crouch gait surgery in CP patients (2014)
Canadian Botulinum Toxin Conference, - (2014)
- (2014)
- I fell off and landed badly鈥: Children鈥檚 experiences of forearm fracture and injury prevention (2014)
American Orthopaedic Association/Canadian Orthopaedic Association Annual Meeting, - Legg鈥揅alv茅鈥揚erthes disease (2014)
American Academy of Orthopaedic Surgeons Annual Conference, - Lower Bone Strength, Density And Trabecular Microstructure At The Distal Radius Is Associated With Increased Risk Of Forearm Fracture In Young Girls (2014)
Pediatric Orthopaedic Society of North America Annual Meeting, - Paediatric patient family engagement with clinical research at a tertiary care paediatric hospital. (2014)
Paediatrics and Child Health (Canada), 19 (10), 537-542 - Prophylactic hip surgery in CP patients (2014)
American Academy of Orthopaedic Surgeons Annual Conference, - (2014)
American Orthopaedic Association/Canadian Orthopaedic Association Annual Meeting, - (2013)
Pediatric Orthopaedic Society of North America Annual Meeting, - Guided growth for angular deformities about the knee in skeletally immature patients: A systematic review of literature to identify successful correction and associated complications (2013)
Pediatric Orthopaedic Society of North America Annual Meeting, - Guided growth for angular deformities about the knee in skeletally immature patients: A systematic review of the literature to identify successful correction and associated complications (2013)
Canadian Orthopaedic Association Annual Meeting, - (2013)
- Presentation and management of children <18 months old with DDH: observations from an international multi鈥揷enter study group (2013)
Pediatric Orthopaedic Society of North America Annual Meeting, - Presentation and management of children <18-months-old with DDH: Observations from an international multi-centre study group (2013)
Canadian Orthopaedic Association Annual Meeting, - Putting knowledge into practice: Hip surveillance in British Columbia (2013)
Canadian Association of Paediatric Health Centres Annual Conference, - A comparison of bone geometry and microstructure between the dominant and non-dominant radius of children (2012)
Canadian Orthopaedic Association Annual Meeting, - A comparison of bone geometry and microstructure between the dominant and non鈥揹ominant radius of children (2012)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2012)
- Acute Kidney Injury in the Pediatric Intensive Care Unit following spinal surgery: A retrospective study (2012)
Canadian Orthopaedic Association Annual Meeting, - (2012)
- (2012)
- Do surgical wait times affect surgical treatment and peri-operative management of patients with cerebral palsy and subluxated or dislocated hips: The surgeons (2012)
Canadian Orthopaedic Association Annual Meeting, - Do surgical wait times affect surgical treatment and peri鈥搊perative management of patients with cerebral palsy and subluxated or dislocated hips: The surgeons鈥 perspective (2012)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2012)
- The creation of the British Columbia consensus on hip surveillance for children with cerebral palsy: A collaborative province鈥搘ide approach (2012)
American Academy of Cerebral Palsy and Developmental Medicine Annual Conference , - (2012)
- (2012)
- Blount鈥檚 disease (2011)
Mercer鈥檚 Textbook of Orthopaedics, - (2011)
Pediatric Orthopaedic Society of North America Annual Meeting, - Developmental coxa vara (2011)
Mercer鈥檚 Textbook of Orthopaedics, - Do surgical wait times affect surgical treatment and peri鈥搊perative management of patients with cerebral palsy and subluxated or dislocated hips: The surgeon鈥檚 perspective (2011)
65th Annual Meeting of the American Academy of CP and Developmental Medicine, - Impact of surgical waitlist times on scoliosis surgery: Surgeon鈥檚 perspective (2011)
American Academy of Orthopaedic Surgeons Annual Meeting, - Obstacles to full鈥搕ext publication in a peer reviewed journal following presentation of abstracts at the Pediatric Orthopedic Society of North America Annual Meetings 2003鈥2005 (2011)
Pediatric Orthopaedic Society of North America Annual Meeting, - Obstetric brachial plexus palsy (2011)
Mercer鈥檚 Textbook of Orthopaedics, - Operative intervention improves outcomes of Perthes Disease鈥 A meta-analysis (2011)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2011)
- (2011)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2011)
- (2011)
- (2010)
- (2010)
- C1 lateral mass screw fixation in children: Indications, outcomes, and technique in 11 consecutive patients (2010)
International Research Society of Spinal Deformities, - Do non鈥搒teroidal anti鈥搃nflammatory drugs inhibit bone healing? A meta鈥揳nalysis of cohort and case control studies (2010)
Canadian Spine Society Annual Meeting, - (2010)
- (2010)
Spine, 35 (6) - (2010)
- (2010)
- (2010)
- Levels of evidence of studies presented at POSNA annual meetings (2010)
Canadian Orthopaedic Association Annual Meeting, - (2010)
- Publication of abstracts submitted to the annual meeting of the Pediatric Orthopaedic Society of North America: Is there a difference between accepted vs. rejected abstracts (2010)
Canadian Orthopaedic Association Annual Meeting, - (2010)
Pediatric Orthopaedic Society of North America Annual Meeting, - The impact of surgical waitlist times on scoliosis surgery: The surgeon's perspective (2010)
Canadian Spine Society Annual Meeting, - The levels of evidence in paediatric orthopaedic journals: Where are we now? (2010)
12th Combined Meeting of the Orthopaedic Associations, - (2009)
Knee Surgery and Orthopaedic Sports Medicine Biennial Congress, - (2009)
- Methodological Considerations Related to High Resolution pQCT Imaging of the Distal Radius in Children and Adolescents (2009)
American Society of Bone Mineral Research Conference, - Minimizing tourniquet pressure in paediatric anterior cruciate ligament reconstructive surgery: A blinded, prospective randomized controlled trial (2009)
Canadian Orthopaedic Association Annual Meeting, - (2009)
- (2009)
- Principles of evidence-based medicine (2009)
Scoliosis Research Society E鈥揟ext, - Quantifying Risk: The quality of logistic regression models in orthopaedic research with recommendations for standards of reporting (2009)
American Academy of Orthopaedic Surgeons Annual Meeting, - Reproducibility of Herring鈥檚 classification using two different techniques and its alteration during the evolution of the disease (2009)
Canadian Orthopaedic Association Annual Meeting, - Cost effectiveness of prophylactic pinning following slipped capital femoral epiphysis (2008)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2008)
- (2008)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2008)
- (2008)
- (2007)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2007)
Canadian Orthopaedic Association Annual Meeting, - (2007)
- (2007)
- Inter鈥搊bserver agreement in the radiographic diagnosis of avascular necrosis of the femoral head following slipped capital femoral epiphysis (2007)
Canadian Orthopaedic Association Annual Meeting, - (2007)
Canadian Orthopaedic Association Annual Meeting, - (2007)
SAE International Journal of Passenger Cars - Electronic and Electrical Systems, - (2007)
Canadian Orthopaedic Association Annual Meeting, - (2007)
- (2006)
- Abdominal injuries associated with Chance fractures in pediatric patients (2006)
Pediatric Orthopaedic Society of North America Annual Meeting, - Anterior interosseous nerve injury following injection of Botox into the forearm (2006)
Canadian Botulinum Toxin Conference (CBTC), - (2006)
- (2006)
- (2006)
- Lumbar spine biomechanics of pediatric chance fractures: recommendations for injury prevention (2006)
2nd Annual Northwest Biomechanics Symposium, - (2006)
- Outcome analysis of Chance fractures in the skeletally immature spine (2006)
Canadian Orthopaedic Association Annual Meeting, - Pediatric chance fractures and associated injuries in British Columbia: Recommendations for Injury Prevention (2006)
BC Injury Research Conference, - Procedural sedation for the reduction of pediatric forearm fractures (2006)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2005)
- Iatrogenic ulnar nerve injury in the management of supracondylar fractures: Number needed to harm (NNH) (2005)
Canadian Orthopaedic Association Annual Meeting, - (2005)
Journal of Pediatric Orthopaedics, 25 (3), 411 - Natural evolution of Perthes disease in British Columbia (2005)
Indian Orthopaedic Association Annual Meeting, - Osteogenesis imperfecta presenting as simultaneous bilateral tibial tubercle avulsion fractures in a child. (2005)
Journal of pediatric orthopedics, 25 (3) - Pediatric Chance fractures and associated neurological injury in British Columbia: recommendations for injury prevention (2005)
International Collaboration on Repair Discoveries (ICORD) Annual Research Meeting, - Procedural sedation for the reduction of paediatric forearm fractures (2005)
Canadian Orthopaedic Association Annual Meeting, - (2005)
- The natural evolution of Perthes disease in British Columbia (2005)
Pediatric Orthopaedic Society of North America Annual Meeting, - Trans鈥損hyseal anterior cruciate ligament reconstruction in skeletally immature patients (2005)
Canadian Orthopaedic Association Annual Meeting, - C1 鈥 C2 Lateral Mass Screw Fixation (2004)
Paediatric Orthopaedic Society Annual Meeting, - C1鈥揅2 facet screws in paediatric patients (2004)
The 11th Meeting of the Combined Orthopaedic Associations, - (2004)
Canadian Orthopaedic Association Annual Meeting, - Outcome analysis of paediatric Chance fractures (2004)
The 11th Meeting of the Combined Orthopaedic Associations, - Sternal split approach to cervico鈥搕horacic junction (2004)
Canadian Spine Society Meeting, - Sternal split approach to cervicothoracic junction (2004)
The 11th Meeting of the Combined Orthopaedic Associations, - Sternal split approach to cervicothoraic junction (2004)
Canadian Orthopaedic Association Annual Meeting, - (2003)
Journal of Pediatric Orthopaedics, 23 (5), 590-600 - (2003)
Journal of Pediatric Orthopaedics, 23 (5), 601-606 - The effect of varus femoral osteotomy on the natural evolution of Perthes disease. Is the timing of osteotomy critical? (2003)
Pediatric Orthopaedic Society of North America Annual Meeting, - The natural evolution of Perthes Disease 鈥 A study of 610 children under 12 years of age at the onset of the disease (2003)
Pediatric Orthopaedic Society of North America Annual Meeting, - (2002)
Journal of Pediatric Orthopaedics, 22 (3), 404-409 - Clavicular pseudarthrosis (2001)
Australian Paediatric Orthopaedic Society Meeting, - Management of cervical spine instability in MPS (2001)
Australian and New Zealand Orthopaedic Association Meeting, - Management of congenital pseudarthrosis of tibia (2001)
South Australian Orthopaedic Meeting, - Natural history of Perthes disease in South India: Analysis of 610 children under the age of 12 (2001)
APOA Meeting, - (2001)
- Delayed fracture 鈥 separation of the capital femoral epiphysis following an ipsilateral transcervical fracture of the femoral neck (2000)
Australian Paediatric Orthopaedic Society Meeting, - (2000)
- (2000)
Journal of Pediatric Orthopaedics, 20 (2), 267-273 - Adolescent Perthes disease (1999)
Annual Conference of Paediatric Orthopaedic Society of India, - Growth abnormalities in congenital pseudarthrosis of the tibia (1999)
44th Annual Conference of Indian Orthopaedic Association, - Results of intramedullary rodding of lower limb bones in osteogenesis imperfecta (1999)
SIROT 99 Conference, - Serum antiprotease levels in primary osteoarthrosis of the knee (1999)
SIROT 99 Conference, - Functional assessment of upper limb in osteogenesis imperfecta (1998)
Annual Conference of Paediatric Orthopaedic Society of India, - Serum antiproteases in primary osteoarthrosis of the knee (1997)
42nd Annual Conference of Indian Orthopaedic Association,
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