Abstract
The use of cementless total hip arthroplasty (THA) is on the increase. In order to achieve rotational and axial stability larger implants may be required than originally templated for. This could potentially result in a lar-ger leg length inequality. Our objective was to determine whether there is greater inequality in leg length post-operatively in cementless THA as compared to cemented implants. 136 consecutive patients undergoing elective THA between June 2007 and May 2008 were included. Post-operative digital radiographs were ex-amined to determine leg length. Twenty seven patients (20%) underwent a cemented procedure and 109 (80%) a cementless procedure. In the cemented group the mean leg length discrepancy was 7.3 mm (range 19 mm short to 21 mm long). In the cementless group the mean measured leg length discrepancy was 6.3 mm (range 18 mm short to 23 mm long). There was no significant difference between the two groups (P = 0.443). This study shows that with accurate pre-operative templating, both cemented and cementless proce-dures produce comparable and acceptable leg length discrepancies.
Highlights
Total hip arthroplasty is a very successful operation in the management of end stage hip osteoarthritis with over 64,000 primary procedures being performed in the UK last year [9]
Studies have shown that a discrepancy greater than 10 mm can result in a limp, back pain, sciatica, stiffness, hip dislocation, the need for a shoe raise and early failure [7,13,15,17]
The aim of this study was to determine if leg length discrepancy exists to a greater degree in cementless total hip arthroplasty (THA) compared with cemented hip replacements
Summary
Total hip arthroplasty is a very successful operation in the management of end stage hip osteoarthritis with over 64,000 primary procedures being performed in the UK last year [9]. Leg length discrepancy (LLD) is a well documented complication of total hip replacement. Reports in the literature show a change in leg length following THA from 21 mm short to 35 mm long [5,7,15]. Studies have shown that a discrepancy greater than 10 mm can result in a limp, back pain, sciatica, stiffness, hip dislocation, the need for a shoe raise and early failure [7,13,15,17]. These problems are problematic in the younger population where the impact on quality of life may be more marked
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