Improving rehabilitation and clinical outcomes for musculoskeletal conditions
We are a team of researcher-clinicians concerned about life-long hip health.
Our team collects data for research purposes about infants, children and adolescents who have various conditions of the hip, tracking their treatment and wellbeing through to skeletal maturity at about the age of eighteen.
Our research registries aim to provide insight into the immediate and long-term efficacy of current and future treatments, and to act as a source of new research opportunities which could improve life-long outcomes for people who experience early-life hip disorders. We recognise the value of longitudinal data, and so in the future we aim to work closely with the NZOA Joint Registry. The Joint Registry records arthroplasty surgeries (joint replacements), which tend to occur in middle and late life.
Learn more about the NZOA Joint Registry
Hip Kids data and research
Our registries enable us to collate a comprehensive log of information for each patient, which can be used for retrospective and prospective research into the conditions and their treatment.
Information collected, depending on the registry, comprises demographic information, patient and family histories, the presence of risk factors, clinical and surgical information, ultrasound or radiographic images, diagnostic and Severin classifications, the Modified Harris Hip Score, as well as a range of patient-reported outcome measures (PROM).
PROM used includes PROMIS for Pain Interference, Pain Intensity, Physical Activity, and Global Health Scale; the WOMAC Osteoarthritis Index; the HOOS JR; and the UCLA Score for Activity.
Patients in our registries are recruited from the Canterbury District Health Board service area, which includes the east coast of the South Island from Kaikoura District in the north, to Ashburton District in the south, as well the Chatham Islands. And because of a formal partnership agreement between the Canterbury and West Coast DHBs, we also recruit patients from the West Coast of the South Island. We have only just begun – check back often for news of upcoming publications about the research made possible by our registries.
Our use of REDCap
REDCap is a secure electronic data capture system that is specifically designed to support both online and offline data capture for research studies and surgical operations. In using REDCap we affiliate ourselves with paediatric hip researchers worldwide.
Paediatric hip registry research using REDCap started in 2018 in Canada, and by 2021 when we started our registries, there were 28 other research centres using the same technology. We began with two studies – our IHDR and SLIP registries – with the intention of a Perthes disease registry soon to follow.
Global Hip Dysplasia Registry (GHDR)
Developmental Dysplasia of the Hip (DDH) is a condition where the ball and socket joint of the hip does not properly develop in babies and young children. It is sometimes called hip dysplasia or dislocation of the hip. This is the most common of paediatric hip conditions, with 1-3% of all new-borns diagnosed at birth.
Our GHDR registry establishes a comprehensive database of clinical, treatment, and functional or outcome information about patients who are diagnosed as babies or young children with DDH. The registry includes data collected from patients who experience the full DDH spectrum of abnormalities, increasing study numbers, and offering the potential to improve current screening practices and follow-up on risk factors for over 1,000 patients within the first two years of operation.
In the longer term, we aim to develop a novel understanding of the factors involved in the condition and identify best treatment practices. Having a longitudinal approach offers the opportunity to understand the long-term impact of DDH and treatments on the patient's quality of life and function. Patients range from new-borns to ten years of age at their inclusion in the registry, allowing for the capture of data from earlier missed or late-presenting cases. Follow up of all patients occurs until skeletal maturity, creating a series of dynamic events captured for single patients between the ages of zero to 18 years. Dr Nikki Hooper is Principal Investigator for the GHDR. Sally Rogan also contributes to the working of the registry.
Comparison of brace to observation in stable, radiological developmental dysplasia of the hip: A randomised controlled non-inferiority trial
This is a randomised controlled trial aiming to determine is observation is non-inferior to bracing for infants with radiological dysplasia. Early detection of DDH is critical to optimize outcomes and minimise long-term disability and impact on quality of life for the child and family.
The burden of disease is significant, with a DDH diagnosis in 15-20/1000 live births. Even when treated, DDH is a leading cause of early hip replacement or development of osteoarthritis in young adults, with DDH reportedly accounting for 10-92% of all hip replacements. Consideration must also be given, however, to potential over treatment of infants, particularly in more mild cases of hip instability or radiological dysplasia. The hip joint is immature during infancy, and many cases of mild-to-moderate DDH can spontaneously resolve as the hip joint matures through development. Brace treatment for approximately six weeks is common to address this radiological dysplasia; however, it is unclear whether this approach provides significant benefit above careful observation by ultrasound.
Global Pediatric Orthopaedic Implant Safety & Efficacy (POISE) Clinical Follow-up Program
Implant devices are important tools used in a variety of patient treatment situations in orthopaedic surgery. Their use is essential across a number of orthopaedic indications, including hip conditions, trauma and limb deformity. This study aims to determine the efficacy and longevity of OrthoPediatric implant devices used during surgery as well as patient reported outcomes.
Our people
Dr Nikki Hooper
Dr Nikki Hooper works as a Senior Clinical Lecturer for the University of Otago's Department of Orthopaedic Surgery and Musculoskeletal Medicine located at the Christchurch Hospital campus. She is also an Adult and Paediatric Orthopaedic Surgeon for the Canterbury District Health Board. Dr Hooper is the Principal Investigator for the GHDR registry and provides expertise into the running of the Brace vs Observation Random Controlled Trial and the POISE Study.
Sally Rogan
Sally is the co-ordinator for the paediatric hip registries and is employed as an Assistant Research Fellow by the University of Otago. She is a physiotherapist and has worked with the paediatric population for the past 8 years. Prior to that her work was predominantly with adults with musculoskeletal conditions.
Find us
Our Hip Kids team can be found in the Department of Orthopaedic Surgery and Musculoskeletal Medicine on the lower ground floor of the Christchurch Hospital. The rest of the time we are on the move working in our various other clinical, teaching and business roles.
Find the Christchurch Hospital at 2 Riccarton Avenue, Christchurch.
Contact us
Dr Nikki Hooper
Email nikki.hooper@otago.ac.nz