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Optimizing leg length correction in total hip arthroplasty.

Kenji Fujita1,2, Tamon Kabata3, Yoshitomo Kajino1

  • 1Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.

International Orthopaedics
|October 10, 2019
PubMed
Summary
This summary is machine-generated.

A leg length discrepancy (LLD) of 7mm or less may reduce patient discomfort after total hip arthroplasty (THA). Pre-existing LLD and pelvic tilt can influence perceived leg length, impacting satisfaction post-THA.

Keywords:
Perceived leg length discrepancyRadiographic leg length discrepancyTotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Patient Outcomes Research

Background:

  • Residual leg length discrepancy (LLD) is a frequent cause of patient dissatisfaction after total hip arthroplasty (THA).
  • Accurate leg length restoration is crucial for optimizing patient satisfaction and functional recovery following THA.

Purpose of the Study:

  • To propose a method for determining an optimal leg length correction goal in THA.
  • To identify radiographic thresholds for minimizing patient-reported discomfort after THA.

Main Methods:

  • Retrospective analysis of 132 patients undergoing THA.
  • Evaluation of radiographic LLD (R-LLD) and perceived LLD (P-LLD).
  • Correlation of R-LLD with patient-reported discomfort and leg length satisfaction.

Main Results:

  • Overall residual discomfort rate was 9.1% (12/132 patients), with most discomfort attributed to a longer leg.
  • A residual LLD within 7mm showed a discomfort rate of 6.8%, comparable to a 2mm threshold (7.8%).
  • Patients with R-LLD of 8mm or more experienced a significantly higher discomfort rate (57.1%).

Conclusions:

  • A 7mm threshold for R-LLD appears reasonable for reducing residual discomfort after THA.
  • Pre-operative radiographic LLD and perceived LLD differences, along with pelvic tilt and scoliosis, influence post-operative leg length perception.
  • Individualized leg length goals considering pre-operative patient factors may be necessary to minimize dissatisfaction.