Abstract
Objective: The present study was designed and implemented to assess the incidence and occurrence of LLD in post-hip arthroplasty and also to evaluate the causes of limb length discrepancy both intra- and post-operative period to manage total hip arthroplasty effectively. Methods: It is a prospective study involving 52 patients underwent for THA and conducted in the Department of Orthopedics, Tertiary Care Hospital, Visakhapatnam, India from the period of January 2013 to December 2019. The study used Southern approach or “Moore” approach. All the patients are assessed for limb length discrepancy immediately after the surgery and followed at 6 weeks, 3 months, and after 6 years. Results: Three patients had significant limb length discrepancy among the 52 patients (5.77%) while the remaining had no significant discrepancies in all X-rays which assess the radiological discrepancies in length. The study yields a satisfactory result as very few patients reported LLD during follow-up period and outcomes such as pain alleviation, walking capacity, limping, and patient satisfaction were insignificantly influenced by leg lengthening (p≤0.05). Conclusion: A combination of pre-operative templating, intra-operative marking and usage of intra-operative image intensifier and an understanding of anatomy, biomechanics of hip, and implant design would reduce the error of limb length discrepancy.
Highlights
Limb length discrepancy (LLD) is an orthopedic problem in which the two legs are of unequal length
It was observed that the study yields satisfactory outcomes as very few patients reported LLD during followup period and outcomes such as pain alleviation, walking capacity, limping, and patient satisfaction were insignificantly influenced by leg lengthening (p≤.0.05)
Limb length discrepancy (LLD) is an orthopedic problem in which the two legs are of unequal length after total hip arthroplasty (THA) and it is not a rare problem; and in most cases, the condition will progress with time period and good physical therapy
Summary
Limb length discrepancy (LLD) is an orthopedic problem in which the two legs are of unequal length. Patient’s discernment of limb length inequality within a short post-operative period is quite common. In most of the cases, this symptom resolves with time and physical therapy. The prevalence of LLD is generally seen in 90% cases. LLD is common in the general population, with prevalence ranging from 2.4 to 6.8 mm (mean magnitude of disparity is 5.2 mm). In 53–75% of the population, the right leg is anatomically shorter than the left. The amount of LLD is unaffected by gender. There are discrepancies in both definitions and reported normative values due to a lack of agreement in the literature concerning a significant level of LLD and a universally acknowledged LLD assessment procedure
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