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Mean limb length discrepancy after total hip arthroplasty
Adnan Rasheed1, Muhammad Kaleem Shaukat1, Farhad Alam1
1Orthopaedics Department, University Medical and Dental College, Madinah Teaching Hospital, Faisalabad, Pakistan.
Insights
Limb length discrepancy (LLD) after total hip arthroplasty (THA) is common, but usually minimal. Most patients have LLD within 10mm, though some may require shoe adjustments for significant differences.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Patient Outcomes Research
Background:
- Limb length discrepancy (LLD) is a frequent complication of total hip arthroplasty (THA), leading to patient dissatisfaction.
- Limited literature exists on LLD following THA in Pakistan.
- Addressing LLD is crucial for improving patient outcomes and satisfaction after THA.
Purpose of the Study:
- To determine the mean preoperative and postoperative LLD in patients undergoing primary THA.
- To analyze the difference between preoperative and postoperative LLD.
- To provide data that can inform preoperative planning and surgical execution to minimize LLD.
Main Methods:
- A descriptive case series study involving 44 patients undergoing primary THA.
- Data collected from September 2018 to September 2019 at Madinah Teaching Hospital, Faisalabad.
- Patients aged 18-70 years were included, using non-probability consecutive sampling.
Main Results:
- The mean preoperative LLD was -19.02 mm (SD 21.31).
- The mean postoperative LLD was 7.25 mm (SD 9.46).
- 91% of patients had postoperative LLD, with 88.6% within ±10 mm, while 11.4% had LLD >10 mm causing functional impairment.
Conclusions:
- Postoperative LLD after primary THA is typically minimal and within acceptable limits in experienced surgeons' hands.
- A small percentage of patients may experience significant LLD, potentially requiring compensatory measures like shoe wear.
- The findings underscore the importance of meticulous surgical technique and preoperative planning to manage LLD.
Background:
Limb length discrepancy (LLD) is one of the most common complications of primary total hip arthroplasty (THA) causing patients dissatisfaction. In this study we determined the mean of preoperative limb length discrepancy (LLD), postoperative LLD after THA and their difference. Previously very little literature is available on this topic in Pakistan, so the results of my study will be a useful addition in the existing as well as local literature. Also, on the basis of these results, need of some preoperative planning and executing the plan in the operating room to eliminate LLD can be recommended.
Methods:
It is a descriptive case series study (Clinical Practice Article) conducted on 44 patients undergoing primary Total Hip arthroplasty (THA) at orthopaedics department Madinah Teaching Hospital Faisalabad from Sep 2018 to Sept 2019. Patients having age between 18-70 years including both genders were studied with non-probability, consecutive sampling.
Results:
In our study mean of pre-operative LLD is -19.02 with standard deviation of 21.31 and mean of post-operative LLD is 7.25 mm with standard deviation of 9.46. This study tells that 91% of patients undergoing primary THA without using any method to eliminate LLD have postoperative LLD but 88.6% of patients (39 patients out of 44) have postoperative LLD in the range of 0 to ±10 mm which is not much significant. But 11.4% of patients (5 patients out of 44) have postoperative LLD >10 mm which causes functional impairment.
Conclusion:
We can say that in most of the patients postoperative LLD after primary THA is very minimal and within acceptable range in experienced hands but a few patients can have a significant LLD in order to gain better joint stability which can be compensated by shoe wears.
