Abstract
BackgroundLeg length inequalities (LLIs) are a common finding in patients with a total hip arthroplasty (THA). Therefore, we compared the effects of simulated LLIs in patients with total hip arthroplasty (THA) with a matched control group.Research questionDo LLIs lead to different effects on the musculoskeletal apparatus of patients with a THA then in a control group?MethodsIn 99 patients with a THA the effects of simulated LLIs were compared to a matched control group of 101 subjects without a hip arthroplasty. First, we compared methods for LLI quantification (tape measurements, pelvic x- ray and rasterstereography). Second, the effects of simulated LLIs on the spine and pelvis were evaluated in both groups using surface topography. LLIs of 5, 10, 15, 20 and 30 mm were simulated on both sides with a simulation platform. The changes of pelvic position (pelvic obliquity & pelvic torsion) and the effects on spinal posture (surface rotation & lateral deviation) were measured and analysed using a surface topography system.ResultsMean LLI measured with a tape was 0.9 mm (SD +/- 14.8). Mean pelvic obliquity measured on x-rays was 1.2 mm (SD +/- 11.6) and with surface topography 0.9 mm (SD +/- 7.9). Simulated LLIs resulted in significant changes of pelvic position and spinal posture in the patient and control group. Interestingly, our study showed that simulated LLIs lead to greater changes in pelvic position (p<0.05) in patients with a THA.SignificanceThis is the first study to demonstrate that LLIs might have a greater impact on the pelvic position of THA patients than in native hips, which could indicate that LLIs do need to be compensated differently in patients with THA than in patients without a THA.
Highlights
Leg length inequalities (LLIs) are present in up to 60–70% of the healthy population, and they are a frequent finding in every orthopaedic clinic [1]
Simulated LLIs resulted in significant changes of pelvic position and spinal posture in the patient and control group
The results of this current study confirm these findings that even in patients with a total hip arthroplasty (THA), LLIs have a significant influence on pelvic obliquity, pelvic torsion, lateral deviation and surface rotation of the spine
Summary
Leg length inequalities (LLIs) are present in up to 60–70% of the healthy population, and they are a frequent finding in every orthopaedic clinic [1]. Surface topography is a method that allows to evaluate the effects of LLIs on the pelvic position and spinal posture, since it is a non-invasive imaging technique that uses light lines to scan and analyse the back surface of patients. This technique has shown its high validity and reliability in measuring LLIs and their effects on the spine and pelvis in numerous previous studies of patients without a THA [19,20,21]. We compared the effects of simulated LLIs in patients with total hip arthroplasty (THA) with a matched control group.
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