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Leg-length discrepancy in revision total hip arthroplasty : computer-assisted navigation improves the discrepancy
Troy D Bornes1,2, Sebastian B Braun1, Christopher G Anderson1
1Stavros Niarchos Complex Joint Reconstruction Center, Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York, USA.
Bone & Joint Open
|August 21, 2025
Summary
Computer-assisted navigation significantly reduces leg-length discrepancy (LLD) after revision total hip arthroplasty (rTHA). This technology optimizes LLD correction, especially for acetabular component revisions, offering improved outcomes compared to non-navigated procedures.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Leg-length discrepancy (LLD) is a common complication following total hip arthroplasty (THA), leading to patient dissatisfaction.
- Revision THA (rTHA) presents unique challenges in achieving accurate leg length restoration.
Purpose of the Study:
- To characterize LLD in revision THA.
- To compare the effectiveness of navigated versus non-navigated rTHA in correcting LLD.
Main Methods:
- A retrospective cohort study of 202 patients undergoing rTHA between 2017 and 2021.
- Comparison of navigated and non-navigated rTHA groups based on LLD, re-revision rates, and patient-reported outcome measures (PROMs).
Main Results:
- Mean postoperative LLD was 4.3 mm. Navigated rTHA showed significantly lower postoperative LLD (3.7 mm) compared to preoperative LLD (7.5 mm).
- Postoperative LLD was significantly lower in navigated rTHA (3.7 mm) versus non-navigated rTHA (4.9 mm) across various preoperative LLD subgroups.
- No significant difference in PROMs or re-revision rates was observed between the navigated and non-navigated groups.
Conclusions:
- Computer-assisted navigation improves leg-length correction in rTHA, particularly for acetabular component revisions.
- Navigation should be considered for rTHA to optimize leg-length equalization.
- While navigation improved LLD, PROMs did not differ significantly between groups in this study.
