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Hip Surveillance for Children with Cerebral Palsy: A Survey of Orthopaedic Surgeons in India

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Abstract

Background

The purpose of this study was to assess Indian orthopaedic surgeons’ current practices and beliefs regarding hip surveillance for children with cerebral palsy (CP), to determine potential support for developing hip surveillance guidelines, and to identify knowledge gaps and key obstacles to guideline implementation in India.

Methods

An anonymous, cross-sectional online survey was sent to approximately 350 Paediatric Orthopaedic Society of India (POSI) members who were queried on their practices and beliefs about hip surveillance for children with CP, as well as perceived challenges and requirements for the successful implementation of hip surveillance guidelines in the Indian context.

Results

Out of 107 responses obtained from POSI members, almost all (96.2%) agreed that hip displacement requires standardized monitoring, using surveillance and surgery to prevent hip dislocation. Approximately half (51.5%) of respondents reported using existing hip surveillance guidelines, with most (41.2%) using the Australian guidelines. Almost all (97%) surgeons indicated that hip surveillance guidelines in India are needed, with 100% expressing interest in following guidelines specific to India. Respondents most frequently indicated late referrals to orthopaedics (81.2%), loss of patients to follow-up (78.2%), and lack of resources (43.6%) as challenges to successful hip surveillance in India. Perceived requirements for implementation included developing Indian-specific guidelines (83.2%) as well as educating surgeons (56.4%), physiotherapists/pediatricians (90.1%), and families (82.2%).

Conclusion

Orthopaedic surgeons practicing in India understand the importance of preventing hip dislocations in children with CP through hip surveillance and timely surgical intervention. The results demonstrated strong support for the development of hip surveillance guidelines designed specifically for the Indian healthcare system.

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Acknowledgements

The authors would like to acknowledge the Executive Council and the Research and Grants Committee of the Paediatric Orthopaedic Society of India (POSI) for permission to conduct this survey. We would also like to acknowledge Benjamin Shore for his contributions toward this work.

Funding

This work was partially funded by I’m a HIPpy Foundation, the Peterson Fund for Global Hip Helath, and Divis Foundation for Gifted Children.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, BC Children’s Hospital and University of British Columbia, Vancouver, BC, Canada

    Jacqueline Li

  2. Department of Pediatric Orthopaedics, Ganjwala Orthopaedic Hospital, Ahmedabad, Gujarat, India

    Dhiren Ganjwala

  3. Department of Pedaitric Orthopaedics, Balabhai Nanavati Super Speciality Hospital, Mumbai, India

    Ashok Johari

  4. Division of Physiotherapy, BC Children’s Hospital and University of British Columbia, Vancouver, BC, Canada

    Stacey Miller

  5. Department of Orthopaedic Surgery, BC Children’s Hospital and University of British Columbia, Vancouver, BC, Canada

    Emily K. Schaeffer & Kishore Mulpuri

  6. Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, 400012, India

    Alaric Aroojis

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  1. Jacqueline Li
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  7. Alaric Aroojis
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Contributions

The survey was conceptualized and designed by JL, SM, EKS and KM. DG, AJ and AA adapted the survey for an Indian population, developed the study protocol and distributed the survey. JL, SM and EKS aided in data collection, data analysis, and data interpretation. The first draft of the manuscript was written by JL and edited by DG, AJ, SM, EKS and AA. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alaric Aroojis.

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Conflict of Interest

Kishore Mulpuri has received research support from Allergan, Pega Medical and Depuy Synthes (Johnson and Johnson). None are directly relevant to the research in this paper. For the remaining authors none were declared.

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Li, J., Ganjwala, D., Johari, A. et al. Hip Surveillance for Children with Cerebral Palsy: A Survey of Orthopaedic Surgeons in India. JOIO 56, 58–65 (2022). https://doi.org/10.1007/s43465-021-00432-3

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  • DOI: https://doi.org/10.1007/s43465-021-00432-3

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