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General Orthopaedics

A Simple Method to Minimize Limb Length Discrepancy After Total Hip Arthroplasty

International Society for Technology in Arthroplasty (ISTA) 2012 Annual Congress



Abstract

Introduction

To minimize leg length discrepancies (LLD), preoperative measures are taken using the PACS; the head center to the proximal end of the lesser trochanter distance (HLD) of the opposite side of the operating limb are calculated, while during operation, the modular neck selection is adapted to equal the opposing limb's length.

The purpose of this study was to see whether the HLD method would show far less occurrences of LLD, in comparison to the conventional method(preoperative templating and shuck test).

Method

349 (412 hips) patients who had undergone THRA were divided into two groups based upon which methods they had used to equalize limb length during operation: (1) HLD method, and (2) conventional methods. Six months after surgery, using the PACS system, LLD's of the two groups were compared.

Results

The mean postoperative LLD was 2.6±4.2 (0–15) mm in the HLD group and 5.2±7.0 (0–23) mm in the conventional group. In the HLD group, 81% (174/215) of the hips had LLD < 6 mm after surgery versus 72% (141/197) of the hips in the conventional group (P < 0.038). The mean Harris hip score (HHS) after THA improved from 47.2 to 93.3 in the HLD group and 46.8 to 91.8 in the conventional group.

Discussion

Statistically, there was a significant difference of LLD between the two groups (p=0.038). HLD method, which is non-invasive and simple, would minimize LLD after total hip arthroplasty.