Evaluating functional outcome of patients with limb length discrepancy after total hip replacement: a clinical prospective study

Authors

  • Kamaldeep Deol Multispeciality Hospital, Gurdaspur, Punjab, India
  • Dhalwinder Singh Department of Orthopaedics, Government Medical College, Amritsar, Punjab, India
  • Aditya Vijay Multispeciality Hospital, Jalandhar, Punjab, India

DOI:

https://doi.org/10.18203/2349-2902.isj20250139

Keywords:

Functional outcome, Limb length discrepancy, Total hip replacement

Abstract

Background: Total hip arthroplasty is a reliable procedure for relief of pain in patients with avascular necrosis of head of femur and osteoarthritis of hip joint. In order to optimize function, hip mechanics should be restored to as near normal as possible. This includes restoration of limb length as well as femoral offset after total hip arthoplasty. There are two types of limb length discrepancies-apparent and true. Apparent Limb length discrepancy is due to pelvic obliquity. True limb length discrepancy is actual discrepancy caused due to under or oversized implants or due to contracture of tissues not allowing bones to achieve their anatomical position.

Methods: Surgeries were performed at Dayanand medical hospital. Preoperative templating was performed in all cases. Patients were examined before surgery and six months after surgery. In order to compare the outcomes of patients with different degrees of leg length discrepancy, patients were divided into four groups. The limb length discrepancy was measured both clinically and radiologically.

Results: Leg length discrepancies were there in postoperative patients. 3 have shortening of more than 5 mm, 8 have lengthening between 5-10 mm, 7 patients have lengthening more than 10 mm, 28  have  discrepancy within 5mm. Functional outcome of patients was measured by using Harris hip score at a follow up of six months. In our series mean preoperative Harris hip score was 45.59 and mean Harris hip score at follow up was 89.70 (97–84), of which 52.2% graded as excellent and 47.8% as good.

Conclusions: In our study we found no correlation between leg length discrepancy and functional outcome following total hip arthroplasty was found.

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References

Iversen MD, Chudasama N, Losina E, Katz JN. Influence of self-reported leg length discrepancy on function and satisfaction 6 years after total hip replacement. J Geriatr Phys Ther. 201;34(3):148–52. DOI: https://doi.org/10.1519/JPT.0b013e31820e16dc

Desai AS. Leg length discrepancy after total hip arthroplasty: a review of literature Musculoskelet Med. 2013;6:336–41. DOI: https://doi.org/10.1007/s12178-013-9180-0

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treated by mould arthroplasty: An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-55. DOI: https://doi.org/10.2106/00004623-196951040-00012

Whitehouse MR, Stefanovich-Lawbuary NS, Brunton LR, Blom AW. The Impact of Leg Length Discrepancy on Patient Satisfaction and Functional Outcome Following Total Hip Arthroplasty. The journal of arthroplaty 2013;28(8):1408-14. DOI: https://doi.org/10.1016/j.arth.2012.12.009

Plaass C, Clauss M, Ochsner PE, Ilchmann T. Influence of leg length discrepancy on clinical results after total hip arthroplasty. Hip Int. 2011;21(4):441-9. DOI: https://doi.org/10.5301/HIP.2011.8575

Mahmood SS, Mukka SS, Crnalic S, Sayed-Noor AS. The influence of leg length discrepancy after total hip arthroplasty on function and quality of life . The journal of arthroplasty. 2015;30(9):1638-42. DOI: https://doi.org/10.1016/j.arth.2015.04.012

Turula KB, Friberg O, Lindholm TS, Tallroth K, Vankka E. Leg Length Inequality After Total Hip Arthroplasty. Clin Orthop Relat Res. 1986;(202):163-8. DOI: https://doi.org/10.1097/00003086-198601000-00020

Weng WJ, Wang F, Zhang HL, Qiu XS, Qiu Y. Leg length discrepancy after total hip arthroplasty: impacts on postoperative function and patients' satisfaction. Zhongguo Gu Shang. 2009;22(12):906-8.

Konyves A, Bannister GC. The importance of leg length discrepancy after total hip arthroplasty. J Bone Joint Surg Br. 2005;87:155-7. DOI: https://doi.org/10.1302/0301-620X.87B2.14878

Renkawitz T, Weber T, Dullien S, Woerner M, Dendorfer S, Grifka J, et al. Tobias leg lengthand offset differences above 5 mm after total hip arthroplasty are associated with altered gait kinematics Gait Posture. 2016;49:196-201. DOI: https://doi.org/10.1016/j.gaitpost.2016.07.011

Beard DJ, Palan J, Andrewb JG, Nolan J, Murray DW, EPOS Study Group.Incidence and effect of leg length discrepancy following total hip arthroplasty. Physiotherapy. 2008;94:91–6. DOI: https://doi.org/10.1016/j.physio.2008.01.005

Chiu HC, Mau LW, Hsu YC, Chang JK. Postoperative 6 month and 1 year evaluation of health related quality of life in total hip replacement patients. J Formos Med Assoc. 2001;100(7):461-5.

White TO, Dougall TW. Arthroplasty of the hip. Leg Length is not important. J Bone Joint Surg Br. 2002;84(3):335-8. DOI: https://doi.org/10.1302/0301-620X.84B3.12460

Fujimaki H, Inaba Y, Kobayashi N, Tezuka T, Hirata Y, Saito T. Leg length discrepancy and lower limb alignment after total hip arthroplasty in unilateral hip osteoarthritis patients J Orthop Sci. 2013;18:969–76. DOI: https://doi.org/10.1007/s00776-013-0457-3

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Published

2025-01-28

How to Cite

Kamaldeep, Singh, D., & Aditya. (2025). Evaluating functional outcome of patients with limb length discrepancy after total hip replacement: a clinical prospective study. International Surgery Journal, 12(2), 163–168. https://doi.org/10.18203/2349-2902.isj20250139

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Original Research Articles