Hip surgeons and leg length inequality after primary hip replacement

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Leg length inequality (LLI) is a potential complication following primary total hip replacement (THR).
• The British Hip Society (BHS) surveyed its members to understand current practices and opinions regarding LLI post-THR.

Purpose of the Study:

• To investigate surgeons' opinions on the impact of LLI on THR outcomes.
• To determine surgeons' perceptions of acceptable LLI limits.
• To report on intraoperative techniques used to minimize LLI during THR.

Main Methods:

• Two separate surveys were distributed to members of the British Hip Society.
• Survey 1 focused on opinions regarding LLI's effect on THR outcomes and acceptable LLI thresholds.
• Survey 2 gathered data on intraoperative techniques employed to reduce LLI.

Main Results:

• 97% of responding surgeons believe LLI affects THR outcomes.
• All surveyed surgeons utilize intraoperative methods for leg length assessment, with a median of 5 techniques used per surgeon.
• 89% consider 15 mm of LLI acceptable, while 90% deem LLI exceeding 22.74 mm unacceptable.

Conclusions:

• Despite numerous published assessment methods, LLI remains an issue after THR.
• There is a clear need for the development of accurate, reproducible, and simple intraoperative techniques to manage LLI.