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Controlling Leg Length Change During Total Hip Arthroplasty Using Three-Dimensional Modeling and a Single

Alexander F Heimann1, Stephen B Murphy2

  • 1Department of Orthopaedic Surgery and Traumatology, HFR Cantonal Hospital, University of Fribourg, Fribourg, Switzerland.

The Journal of Arthroplasty
|May 2, 2026
PubMed
Summary
This summary is machine-generated.

This study shows that combining 3D planning with one intraoperative measurement accurately restores leg length in total hip arthroplasty (THA). This method significantly improves leg length control, reducing patient dissatisfaction.

Keywords:
3D planningintraoperative measurementleg-length inequalitypatient-specific planningtotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Leg length inequality is a common patient complaint after total hip arthroplasty (THA).
  • Accurate leg length restoration is crucial for patient satisfaction following THA.
  • Existing methods for leg length assessment during THA can be imprecise.

Purpose of the Study:

  • To evaluate a novel workflow for precise leg length restoration in primary THA.
  • To assess the accuracy of combining computed tomography (CT)-based 3D planning with a single intraoperative measurement.
  • To determine the feasibility of this streamlined approach for improving leg length control.

Main Methods:

  • Analyzed 40 patients undergoing primary THA with mixed reality assistance.
  • Utilized CT-based 3D planning to measure the distance between the prosthesis shoulder and greater trochanter preoperatively.
  • Replicated this measurement intraoperatively to predict leg length change and compared with EOS scan results.

Main Results:

  • Preoperative leg length discrepancy averaged -2.4 mm.
  • The workflow achieved a mean absolute error of only 0.1 mm in leg length restoration.
  • 95% of patients had leg length restored within 3 mm, and 100% within 5 mm.

Conclusions:

  • Patient-specific 3D planning and a single intraoperative measurement provide highly accurate leg length restoration in THA.
  • This streamlined workflow offers superior leg length control compared to other intraoperative techniques.
  • The method has the potential to significantly enhance patient outcomes and satisfaction after primary THA.