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Leg length inequality after total hip arthroplasty.

K B Turula, O Friberg, T S Lindholm

Clinical Orthopaedics and Related Research

|January 1, 1986

Summary

Leg length inequality (LLI) after hip replacement surgery (THA) is significantly underestimated by clinical measurements compared to radiographic analysis. This discrepancy highlights the need for further investigation into LLI as a cause of hip pain and implant loosening.

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Area of Science:

Orthopedic Surgery
Radiology
Biomechanical Engineering

Background:

Leg length inequality (LLI) is a common complication following total hip arthroplasty (THA).
Accurate assessment of LLI is crucial for patient outcomes and revision surgery planning.
Discrepancies between clinical and radiographic measurements of LLI can impact treatment decisions.

Purpose of the Study:

To compare radiographically measured leg length inequality (LLI) with clinically measured LLI in patients who have undergone cemented total hip arthroplasty (THA).
To investigate the potential association between LLI and complications such as aseptic loosening and unexplained pain after THA.

Main Methods:

Weight-bearing anteroposterior (AP) hip radiographs were obtained from 55 patients with cemented THA.

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Radiographic leg length inequality was measured.

Clinical measurements of leg length were also recorded for comparison.

Main Results:

Mean radiologic LLI was 8.7 mm for unilateral THA and 11.6 mm for bilateral THA.
Clinical measurements significantly underestimated LLI, with mean values of 2.8 mm (unilateral) and 4.2 mm (bilateral).
A significant difference was observed between radiographic and clinical LLI measurements in both unilateral and bilateral THA groups.

Conclusions:

Radiographic assessment reveals substantially greater leg length inequality after cemented THA than clinical measurements suggest.
The significant underestimation of LLI by clinical methods warrants further investigation.
Leg length inequality should be considered a potential contributing factor to aseptic loosening and unexplained pain in THA patients.