The effect of leg length discrepancy upon load distribution in the static phase (standing)

Swaminathan, Vikram; Cartwright-Terry, Matthew; Moorehead, J.D.; Bowey, Andrew; Scott, Simon

doi:10.1016/j.gaitpost.2014.06.020

Cited by 34 publications

(28 citation statements)

References 17 publications

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“…However, the low correlation value between clinical outcomes and postoperative LLD could have originated from other factors than LLD that were not included in this study. Moreover, uneven load distribution during gait with LLD can affect the load distribution of polyethylene in TKA, 25,26 and a long-term follow-up would be needed. Third, preoperative LLD itself, which is not included in regression analysis of this study, also could be a factor that affects the clinical outcomes, although postoperative LLD was found as a significant factor with low correlations in this study.…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty after Previous Ipsilateral Hip Arthroplasty Showed Lower Clinical Outcomes and Higher Leg Length Discrepancy Perception

et al. 2020

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The purpose of this study is to compare perception of leg length discrepancy (LLD) and clinical results of total knee arthroplasties (TKA) in patients with or without previous ipsilateral hip arthroplasty. Between 2008 and 2015, navigation-assisted TKA was performed in 43 patients with previous hip arthroplasty after hip fracture. After 1:3 propensity score matching was performed, 108 patients of primary navigation-assisted TKA (group 1) and 36 patients with hip arthroplasty (group 2) were included. Knee Society (KS) scores, Western Ontario and McMaster Universities Index (WOMAC) scores, and patients' satisfaction including perception of LLD were evaluated. Radiographic evaluation included mechanical axis, component position, and LLD. Logistic regression analysis was performed to find the factors that affect the clinical outcomes. No significant differences in radiologic and clinical evaluations, except for KS function score, patient's satisfaction and LLD (p< 0.001), were detected between the groups. LLD and its perception were significantly higher in group 2 (1.8 ± 3.4 mm in group 1 and 9.7 ± 4.1 mm in group 2, p = 0.000). Risk factors for the low KS function score were found as LLD (odds ratio [OR]: 1.403, p = 0.008) and previous hip arthroplasty itself (OR: 15.755, p = 0.002), but much higher OR was found in previous hip arthroplasty. Although the outcomes of TKA in patients with ipsilateral hip arthroplasty are comparable to those of primary TKA, LLD was high and patient's satisfaction and functional outcomes were low in patients with previous ipsilateral hip arthroplasty. Care should be taken when considering TKA in patients with previous hip arthroplasty. This is a Level III, case control study.

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Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty after Previous Ipsilateral Hip Arthroplasty Showed Lower Clinical Outcomes and Higher Leg Length Discrepancy Perception

et al. 2020

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“…[17] Some degree (less than 2 cm) of leg length discrepancy can be allowed in humans because of a compensatory mechanism that dynamically lengthens the shorter limb and shortens the longer limb,[18] probably to minimize the displacement of the body center of mass and consequently reduce body energy expenditure. [19] However, a leg length discrepancy–whether lengthening or shortening–should be avoided as much as possible, because previous studies demonstrated that leg lengthening, even by less than 1 cm, increases the chance of developing knee osteoarthritis in the longer limb,[20] and that correcting leg length discrepancy of only 5.6 mm relieved chronic low back pain, possibly by reducing lumbar spine lateral flexion and rotation.…”

Section: Discussionmentioning

confidence: 99%

Leg length change after opening wedge and closing wedge high tibial osteotomy: A meta-analysis

Kim

Lee

2017

PLoS ONE

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BackgroundTheoretical considerations suggest that leg length increases after opening wedge high tibial osteotomy (HTO) and decreases after closing wedge HTO; however, in vivo studies have yielded conflicting results. This meta-analysis therefore assessed changes in leg length after opening wedge and closing wedge HTO.MethodsAll studies comparing pre- and postoperative leg length in patients who underwent opening and/or closing wedge HTO were included. Two reviewers independently recorded data from each study in terms of sample size as well as preoperative and postoperative leg length of open wedge and/or closed wedge HTO groups.ResultsFour studies were included in the meta-analysis. Although pooled results showed leg length changes from before to after surgery were –6.93 mm (95% confidence interval [CI]: –17.53 to 3.67 mm; P = 0.20) in opening wedge HTO and 1.97 mm (95% CI: –7.13 to 11.07 mm; P = 0.67) in closing wedge HTO, respectively, these values were statistically not significant. However, the difference in the pooled mean leg length change from before to after surgery between opening wedge and closing wedge HTO was 8 mm, a difference that was significant (95% CI: 6.53 to 9.46 mm; P<0.001).ConclusionThe change in leg length was not statistically significant for either opening or closing wedge HTO. However, leg length change from before to after surgery was 8 mm greater for opening wedge HTO than for closing wedge HTO.

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“…Persons with LLD will have different load distribution on the two legs due to a shift in the body's CoM [12,14]. The goal of compensating the length of the shorter leg is to ensure equal load distribution on both legs which can be achieved by human body balancing, that is, by moving the CoM to its expected position.…”

Section: Human Body Balancingmentioning

confidence: 99%

“…Studies have shown that structural LLD features a higher vertical ground reaction force on the shorter leg than on the longer [12,13]. The Authors of [14] showed that, by using a pedobarograph, the difference in load distribution on the left leg can be measured by simulating a longer or shorter right leg. If the right leg were simulated to be 3.5 cm longer, the load on the left leg would amount to 64% of the patient's mass.…”

Section: Introductionmentioning

confidence: 99%

System for Evaluation and Compensation of Leg Length Discrepancy for Human Body Balancing

Vrhovski¹,

Obrovac²,

Nižetić³

et al. 2019

Applied Sciences

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Leg Length Discrepancy (LLD) causes a shift of the Center of Mass (CoM) of the human body, as well as an asymmetry in load distribution on the lower extremities. Existing LLD evaluation methods do not take into account this shift in the human body’s CoM. In this paper, a methodology and mechatronic system for the Evaluation and Compensation of LLD for Human Body Balancing are described. The human body’s CoM is measured with two force plates located on two parallel manipulators. Since persons with LLD experience a shift in their CoM, by raising the force plate that is under the shorter leg, the human body can be balanced. For this purpose, the Human Body Balancing Algorithm (HBBA) was proposed and developed. By running the HBBA, the height difference between the force plates under the left and right leg can be measured, which then represents the LLD evaluation. Based on this evaluation, it is possible to design and make a shoe insole which compensates the influence of LLD with the goal of equalizing the load on the legs. A virtual mathematical model of the system was created and the simulation results of the HBBA are presented. The mechatronic system, developed and used to conduct experiments and measurements, is described in detail.

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The effect of leg length discrepancy upon load distribution in the static phase (standing)

Cited by 34 publications

References 17 publications

Total Knee Arthroplasty after Previous Ipsilateral Hip Arthroplasty Showed Lower Clinical Outcomes and Higher Leg Length Discrepancy Perception

Total Knee Arthroplasty after Previous Ipsilateral Hip Arthroplasty Showed Lower Clinical Outcomes and Higher Leg Length Discrepancy Perception

Leg length change after opening wedge and closing wedge high tibial osteotomy: A meta-analysis

System for Evaluation and Compensation of Leg Length Discrepancy for Human Body Balancing

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