Changes in patient-perceived leg length discrepancy following total hip arthroplasty.

Abstract

Leg length discrepancy (LLD) after total hip arthroplasty (THA) prevents functional recovery and reduces patient satisfaction. We investigated impact of changes in patient-perceived LLD on patient satisfaction and walking ability. one hundred and forty-nine patients with unilateral hip osteoarthritis undergoing THA from 2014 to 2017, (125 women, 24 men; average age, 68.5years) with an objective LLD < 1cm were included. Outcome measures included the patient-perceived LLD, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, 10-m walking speed, and affected leg loading rate, assessed preoperatively and at 3weeks, 3months, and 1year postoperatively. The absolute patient-perceived LLD (mean ± SD) (the number of patients with perceived LLD > 5mm) were 6.4 ± 9.6mm [88 patients (59%)] preoperatively; and 2.2 ± 4.0mm [48 (32%); p < 0.001], 0.7 ± 2.3mm [17 (11%); p < 0.001], and 0.4 ± 1.6mm [10 (7%); p = 0.095] at 3weeks, 3months, and 1year postoperatively, respectively. All outcome measures improved over time. One year postoperatively, a weak positive correlation between the patient-perceived LLD and WOMAC or 10-m walking speed (r = 0.24, 0.23, respectively) was found. The risk of patient-perceived LLD persisting > 1year postoperatively was 5.5-fold higher in patients who exhibited it at 3months and those with a WOMAC score > 10 at 3months postoperatively, using multivariate logistic regression. Achieving a post-THA objective LLD < 1cm significantly reduced the patient-perceived LLD up to 3months postoperatively. The residual patient-perceived LLD at 1year postoperatively was predicted from the WOMAC score or the presence of patient-perceived LLD at 3months after THA. Therapeutic level IV.