The Study Of The Clinical Characteristics In Acetabular Dysplasia Patients With Atypical Symptoms

Background Acetabular dysplasia(AD) is a common disease in clinic. If lack of timely diagnosed and treated in its early stage, a majority of patients will cause hip osteoarthritis eventually. Under this circumstance, their life and work are so seriously affected that total hip arthroplasty(THA) will be inevitable at last. At present, domestic and international researches on AD are concentrated on its treatment methods and imaging analysis, but researches on its atypical symptoms have not been reported.Objective To analyze the clinical characteristics of AD patients with atypical symptoms, and to improve the understanding of atypical symptoms of AD.Methods 120 AD patients, diagnosed through pelvic anteroposterior film in our hospital from January 2013 to May 2014, were divided into typical group(TSG) and atypical symptom group(ATSG). Data on general conditions(gender and age), X-ray findings(Crowe classification), clinical symptoms(typical symptoms and other symptoms) and complications(such as flatfoot, hallux valgus, genu varum, etc.) were investigated and statistically analyzed.Results1) Of the 120 AD patients enrolled, there were 33 males and 87 females, with an age range of 16 to 66 years old(mean 46.9±14.1 years old). Of TSG, including 42 patients, there were 12 males and 30 females, with an age range of 18 to 66 years old(mean 48.6±15.5 years old); of ATSG, including 78 patients, there were 21 males and 57 females, with an age range of 16 to 58 years old(mean 39.0±14.8 years old). Theaverage of TSG is larger than ATSG and there were statistically significant differences in terms of age distribution between the two groups(P<0.05). There were more females in both groups and there were no statistically significant differences in terms of gender between the two groups(P>0.05). Patients who were older than 50 years accounted for 7.7% of the patients in TSG and 28.6% in ATSG, and these patients had a lower incidence rate of atypical symptom(P<0.05).2) Of TSG, patients who were classified into CroweⅠ accounted for 35.7%, CroweⅡ 42.9%, CroweⅢ 19.0% and CroweⅣ 2.4%; of ATSG, CroweⅠ accounted for 37.2%, CroweⅡ43.6%, CroweⅢ 19.2% and CroweⅣ 0%. There were no statistically significant differences in terms of Crowe classification on X-ray findings between the two groups(P>0.05).3) All patients in TSG had varying degrees of soreness, pain and activity limitation of hip; of ATSG, patients who were lumbodynia-based accounted for 20.5%, ipsilateral knee pain-based 15.4%, and asymptomatic-based 64.1%.4) Of TSG, patients who were intercurrent with flatfoot accounted for 9.5%, hallux valgus 2.4% and genu varum 4.8%; of ATSG, flatfoot accounted for 9.0%, hallux valgus 2.6% and genu varum 5.1%. There were no statistically significant differences in terms of complications such as flatfoot, hallux valgus, genu varum between the two groups(P>0.05).Conclusion AD patients with atypical symptom are common in clinic, and it is difficult to distinguish them with patients’ symptom alone. The understanding of the clinical characteristics of AD patients with atypical symptoms should be improved and more attention should be paid to physical examination and pelvic anteroposterior X-ray film examination of suspected patients in order to improve the detecting rate of AD.