Total Hip Arthroplasty in Patients With Multifactorial Perceived Limb Length Discrepancy
Amgad M Haleem1, Kevin F Wiley2, Raul Kuchinad3
1Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Department of Orthopaedic Surgery, Cairo University, Cairo, Egypt.
Background:
Patients with advanced hip arthritis can present with multifactorial limb length discrepancies (LLDs) owing to bony shortening from growth arrest, proximal hip migration, soft-tissue contractures, and pelvic obliquity. The patient perceives an LLD that is a combination of true LLD and apparent LLD.
Methods:
We retrospectively reviewed 7 cases with multifactorial mean perceived LLD of 7.7 cm (range, 3.6-11 cm) that underwent primary total hip arthroplasty and auxiliary soft-tissue procedures. Perceived LLD, true LLD, and apparent LLD were defined and were compared before and after surgery in this cohort of patients with a mean follow-up of 57.4 months.
Results:
The mean perceived LLD at final follow-up was 1.0 ± 0.9 cm compared with that of 7.7 ± 2.6 cm preoperatively (P < .05). Postoperative true LLD was 0.7 ± 0.8 cm compared with that of 3.2 ± 0.8 cm preoperatively (P < .05). At final follow-up, all 7 patients were ambulating without any assistive devices and were satisfied with their surgical outcome.
Conclusion:
With careful preoperative clinical and radiographic assessments as well as planning for multifactorial perceived LLD, this can be adequately corrected with primary total hip arthroplasty and auxiliary soft-tissue procedures resulting in good radiologic and functional outcomes.
