[Leg length discrepancy following total hip arthroplasty : How often and when is it problematic?]

Leg length discrepancy (LLD) is a frequent source of dissatisfaction and litigation following total hip arthroplasty (THA). To minimize the risk of postoperative LLD, meticulous planning before surgery and intraoperative clinical and radiographic assessment are critical.

The discrimination between structural and functional causes is a key aspect in the management of LLD and guides therapeutic decision-making. Functional LLDs are common in the early postoperative phase and typically respond well to conservative treatment. In patients with neurologic deficits or recurrent dislocations revision surgery is warranted. There is no universally accepted threshold for revision in patients with persistent LLD unresponsive to non-operative measures, and surgical re-intervention should be based on individual decision-making in these cases. This review summarizes current evidence on the etiology, diagnosis, prevention, and management of leg length discrepancy following THA.