title: Prevention of dislocation of the hip in children with cerebral palsy: 20-year results of a population-based prevention programme.
abstract: In 1994 a cerebral palsy (CP) register and healthcare programme was established in southern Sweden with the primary aim of preventing dislocation of the hip in these children. The results from the first ten years were published in 2005 and showed a decrease in the incidence of dislocation of the hip, from 8% in a historical control group of 103 children born between 1990 and 1991 to 0.5% in a group of 258 children born between 1992 and 1997. These two cohorts have now been re-evaluated and an additional group of 431 children born between 1998 and 2007 has been added. By 1 January 2014, nine children in the control group, two in the first study group and none in the second study group had developed a dislocated hip (p < 0.001). The two children in the first study group who developed a dislocated hip were too unwell to undergo preventive surgery. Every child with a dislocated hip reported severe pain, at least periodically, and four underwent salvage surgery. Of the 689 children in the study groups, 91 (13%) underwent preventive surgery. A population-based hip surveillance programme enables the early identification and preventive treatment, which can result in a significantly lower incidence of dislocation of the hip in children with CP.
authors.affiliation: Lund University, Department of Clinical Sciences, Lund, 22185, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Hägglund
authors.affiliation: Lund University, Department of Clinical Sciences, Lund, 22185, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Alriksson-Schmidt
authors.affiliation: Lund University, Department of Clinical Sciences, Lund, 22185, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Lauge-Pedersen
authors.affiliation: Uppsala University, Centre for Clinical Research Västerås, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Rodby-Bousquet
authors.affiliation: Uppsala University, Centre for Clinical Research Västerås, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Wagner
authors.affiliation: Lund University, Department of Clinical Sciences, Lund, 22185, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Westbom
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D005260:Female; D005544:Forecasting; D006617:Hip Dislocation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011159:Population Surveillance; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Cerebral palsy; Hip; Prevention; Surveillance