Limb-length discrepancy after total hip arthroplasty: novel treatment and proposed algorithm for care

Limb-length discrepancy after total hip arthroplasty (THA) leads to patient dissatisfaction and can be a cause of orthopedic surgery malpractice cases. Nonsurgical and surgical techniques exist to correct limb-length discrepancies. Two limb-lengthening methods were used to correct greater than 2-cm limb-length discrepancies after THA: lengthening over a femoral nail with an external fixator and lengthening with an intramedullary kinetic skeletal distractor. These techniques achieved equal length in less than 4 weeks, with both resulting in a healed distraction gap within 4 months. No patient had loss of proximal or distal joint motion, and mean Harris Hip Score was 90 points at final follow-up. No surgical complications were reported with the intramedullary skeletal kinetic distractor. Limb lengthening using an intramedullary skeletal kinetic distractor is a viable treatment option resulting in reliable lengthening, healing of the distraction gap, and progression to full weight bearing.