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In the regular care area 23.5% of the children were treated with solely soft tissue release which might have been insufficient to prevent dislocation in some cases [ 39- 41].
Furthermore, in the surveillance area, more children (84%) had a recent (in the last two years) pelvic x-ray than children in the regular care area (73%); a reasonable effect of the programme (data not shown).
However, hip dislocations in the regular care area were originally diagnosed as completely dislocated by local clinicians, and no additional hips were deemed dislocated by the reviewer of the present study.
However, the prevalence of hip dislocation among children with GMFCS III - V in the regular care area corresponds to an estimated prevalence of 5.1% in the total CP-population in this area.
Although we only had data from two counties in the regular care area, this might be a reasonable finding which could be considered a potential "downside" of the surveillance programme.
On the other hand, our limited information suggested that the higher number of x-rays per child in the surveillance area partly was outweighed by an apparent need for a pelvic CT scan in a few patients in the regular care area.
Similar(54)
This potential misclassification would, however, lead to an underestimation of hip dislocations and operations in the regular care areas.
In the surveillance area a higher proportion underwent femur osteotomy compared with the regular care areas, and also compared with the Australian surveillance programme.
Nonetheless, the number of children operated on and the total number of operations was not higher in the surveillance compared with the regular care areas.
The difference in prevalence of hip dislocation between the two study populations could theoretically be due to an extraordinary high prevalence in the regular care areas, or an extremely low prevalence in the surveillance area, or both.
The aim of this study was to compare the prevalence of hip dislocation among children with CP in an area providing regular care with an area providing hip surveillance services.
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