Mr Andreas Roposch, orthopaedic surgeon, has won the 2010 best
clinical research award from the European Paediatric Orthopaedic Society
for his work on newborn hip dysplasia. The Society is one of the two
largest professional societies for children’s orthopaedics in the
world. The research, across 32 countries, started from the knowledge
that there is wide variation in the reported prevalence of hip dysplasia
and that treatment for hip dysplasia varies by surgeon, centre and
country.
Mr Roposch comments, “It is unclear why there is such a
wide variation in prevalence rates but it could either be that there are
intrinsic differences in the population studied, or that clinicians use
variable criteria when making the diagnosis of hip dysplasia. The
process of diagnosis is fundamental to clinical medicine. If we don’t
get the diagnosis right, variations in care are inevitable. The lack of
uniform, widely agreed on diagnostic criteria in this age group has the
potential for late diagnoses.”
The confused state of diagnosis
can be shown in their study of clinicians which found over 200
diagnostic criteria for hip dysplasia used in infants under two months
old. In their research, the team established international consensus
about the most important diagnostic criteria for hip dysplasia and
reduced these from 200 to 37 criteria, which will be subject to further
investigation. The ultimate goal is to develop, from basic principals, a
set of standardized diagnostic criteria that is a model of expert
clinicians’ practice. Once validated such criteria will enable other
health care providers to establish the diagnosis of hip dysplasia in a
manner approaching that of clinical experts.
Mr Roposch added
“This research was initially funded by a Pump Prime Award from the GOS
Charity in 2006 but due to its success we were able to secure external
funding [Bupa Foundation]. It shows how successful GOS Charity Funding
can turn out to be and how important internal funding schemes are to get
new research ideas started.”
Hip dysplasia benefits from early
diagnosis and treatment. Oonagh Keith, mother of Siomha, treated at
Great Ormond Street said “If caught early, [hip dysplasia] is one of
those disabilities that doesn’t have to be a disability.”
GOS is a
main referral centre for hip dysplasia, particularly for late diagnosed
patients. Links exist with the UCLH maternity service and academically
with ICH. Children seen at or admitted to GOS for late diagnosed hip
dysplasia have a significant higher risk for unfavourable outcomes
including impaired physical functioning. Improved diagnosis therefore
has the potential to reduce such outcomes.
http://www.dailymail.co.uk/health/article-1231214/Mother-launches-campaign-hip-test-babies-banish-agonising-disability.html
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