Leg length inequality after primary total hip arthroplasty

Loughenbury, Faye; McWilliams, Anthony; Smith, Matthew G.; Pandit, Hemant; Stone, Martin

doi:10.1016/j.mporth.2017.11.006

Cited by 3 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the hands of an experienced arthroplasty surgeon both of these techniques can give accurate results. 9 Sir John Charnley, the pioneer of modern hip replacement, originally recommended a direct method of intraoperative comparison of leg lengths by palpating the medial malleoli through surgical drapes. 10 However, Charnley carried out his hip replacements with the patient supine on the operating table.…”

Section: Survey 2 Methods Used To Assess Intraoperative Llimentioning

confidence: 99%

See 1 more Smart Citation

Hip surgeons and leg length inequality after primary hip replacement

et al. 2018

View full text Add to dashboard Cite

This study reports the results of 2 separate surveys of British Hip Society (BHS) members relating to leg length inequality (LLI) after primary total hip replacement (THR). Survey 1: Investigates the members' opinions on the effect of LLI on the outcome of THR and explores the acceptable limits of LLI. Survey 2: Reports on the intraoperative techniques currently used by BHS members to minimise LLI after THR. Results - Survey 1: 97% of all surgeons completing the survey believed that LLI can affect the outcome of THR. Results - Survey 2: All surgeons reported using at least 1 intraoperative technique for assessing leg length with a median of 5 techniques. Over 50% of surgeons use 2 or more tests. Conclusion - Survey 1: 89% of surgeons agreed that 15 mm of LLI after primary uncomplicated THR was always acceptable. 90% of surgeons felt that LLI more than 22.74 mm was never acceptable. Conclusion - Survey 2: Despite the multiple published papers on various methods of assessing leg length intraoperatively, the problem of LLI post THR persists. This study highlights the need for further research to develop a simple intraoperative technique with high accuracy and reproducibility.

show abstract

Section: Survey 2 Methods Used To Assess Intraoperative Llimentioning

confidence: 99%

“…In the hands of an experienced arthroplasty surgeon both of these techniques can give accurate results. 9…”

Section: Survey 2 Methods Used To Assess Intraoperative Llimentioning

confidence: 99%

Hip surgeons and leg length inequality after primary hip replacement

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Leg length discrepancy (LLD) is associated with a number of pathologies including gait and posture abnormalities [ 6 – 8 ] arthritis of lower limbs and lumbar spine [ 7 ] as well as sciatic nerve damage [ 9 ]. Although a number of studies have reported on LL restoration following primary THAs [ 10 – 14 ], LL following complex acetabular reconstruction has not been largely addressed.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of acetabular defects greater than Paprosky type 3B: the importance of functional imaging

Laura

Henckel

Gal

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background 3D Surgical planning has become a key tool in complex hip revision surgery. The restoration of centre of rotation (CoR) of the hips and leg length (LL) are key factors in achieving good clinical outcome. Pelvic imaging is the gold standard for planning and assessment of LL. We aimed to better understand if 3D planning is effective at equalising LL when large acetabular defects are present. Materials and methods This was a prospective case study of 25 patients. We report the analysis of pre-operative LL status and planned LL restoration measured on CT, in relation to the achieved LL measured post-operatively in functional, weight bearing position. Our primary objective was the assessment of restoration of CoR as well as the anatomical and functional LL using biplanar full-length standing low-dose radiographs; our secondary objective was to evaluate the clinical outcome. Results Pre-operative intra-pelvic discrepancy between right and left leg was a mean of 28 mm (SD 17.99, min = 3, max = 60 mm). Post-operatively, the difference between right and left vertical femoral offset (VFO), or CoR discrepancy, was of 7.4 mm on average, significantly different from the functional LL discrepancy (median = 15 mm), p = 0.0024. Anatomical LLD was a median of 15 mm. In one case there was transient foot drop, one dislocation occurred 6 months post-operatively and was treated by closed reduction, none of the patients had had revision surgery at the time of writing. Mean oxford hip score at latest follow up was 32.1/48. Discussion This is the first study to investigate limb length discrepancy in functional position after reconstruction of large acetabular defects. We observed that VFO is not an optimal surrogate for LL when there is significant bone loss leading to length inequality, fixed flexion of the knee and abduction deformity. Conclusions Although challenging, LLD and gait abnormalities can be greatly improved with the aid of an accurate surgical planning. Surgeons and engineers should consider the integration of EOS imaging in surgical planning of reconstruction of large acetabular defects.

show abstract

Total hip replacement explained

Perkins¹

2021

Nursing Made Incredibly Easy!

View full text Add to dashboard Cite

show abstract

Leg length inequality after primary total hip arthroplasty

Cited by 3 publications

References 10 publications

Hip surgeons and leg length inequality after primary hip replacement

Hip surgeons and leg length inequality after primary hip replacement

Reconstruction of acetabular defects greater than Paprosky type 3B: the importance of functional imaging

Total hip replacement explained

Contact Info

Product

Resources

About