Perception of imposed leg length inequality in normal subjects

Seamus O’Brien, George Kernohan, Claire Fitzpatrick, Janet Hill, David Beverland

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Lower limb length differences of up to 10mm exist in 60% - 95% of the population.There are usually no symptoms or functional effects. Following Total Hip Arthroplasty (THA), satisfactory clinical results can be spoiled by dissatisfaction due to a change in leg length. Although the change in leg length may be modest in comparison to the normal variation, the patient may perceive this as a leg length discrepancy. To study the average threshold for perception, artificial leg length discrepancies of 5 mm to 25 mm were created in 30 young healthy adults using calibrated wooden blocks. Responses were recorded and analysed using a chi-squared test for independence and an independent measures t-test. Awareness of leg length discrepancy was related to the magnitude of the discrepancy (X2 (15)= 156.6, p
LanguageEnglish
Pages505-511
JournalHip International
Volume20
Publication statusPublished - 14 Dec 2010

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Leg Length Inequality
Leg
Artificial Limbs
Arthroplasty
Hip
Young Adult
Lower Extremity
Population

Keywords

  • Leg length discrepancy
  • Total hip arthroplasty

Cite this

O’Brien, S., Kernohan, G., Fitzpatrick, C., Hill, J., & Beverland, D. (2010). Perception of imposed leg length inequality in normal subjects. Hip International, 20, 505-511.
O’Brien, Seamus ; Kernohan, George ; Fitzpatrick, Claire ; Hill, Janet ; Beverland, David. / Perception of imposed leg length inequality in normal subjects. In: Hip International. 2010 ; Vol. 20. pp. 505-511.
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abstract = "Lower limb length differences of up to 10mm exist in 60{\%} - 95{\%} of the population.There are usually no symptoms or functional effects. Following Total Hip Arthroplasty (THA), satisfactory clinical results can be spoiled by dissatisfaction due to a change in leg length. Although the change in leg length may be modest in comparison to the normal variation, the patient may perceive this as a leg length discrepancy. To study the average threshold for perception, artificial leg length discrepancies of 5 mm to 25 mm were created in 30 young healthy adults using calibrated wooden blocks. Responses were recorded and analysed using a chi-squared test for independence and an independent measures t-test. Awareness of leg length discrepancy was related to the magnitude of the discrepancy (X2 (15)= 156.6, p",
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note = "Address for correspondence: Dr. Seamus O’Brien Outcomes Assessment Unit Musgrave Park Hospital Stockman’s Lane Belfast BT9 7JB, N. Ireland Reference text: 1. Harris WH, Sledge CB. Total hip and total knee replacement (Part 1). N Engl J Med 1990; 323: 725-31. 2. Harris WH, Sledge CB. Total hip and total knee replacement (Part 2). N Engl J Med 1990; 323: 801-7. 3. Cuckler JM. Limb length and stability in total hip replacement. Orthopedics 2005; 28: 951-3. 4. Clark CR, Huddleston HD, Schoch EP 3rd, Thomas BJ. Leglength discrepancy after total hip arthroplasty. J Am Acad Orthop Surg 2006; 14: 38-45. 5. Maloney WJ, Keeney JA. Leg length discrepancy after total hip arthroplasty. J Arthroplasty 2004; 19: 108-10. 6. Ranawat CS, Rao RR, Rodriguez JA, Bhende HS. Correction of limb-length inequality during total hip arthroplasty. J Arthroplasty 2001; 16: 715-20. 7. Woolson ST, Hartford JM, Sawyer A. Results of a method of leg length equalization for patients undergoing primary total hip replacement. J Arthroplasty 1999; 14: 159-64. 8. Sarin VK, Pratt WR, Bradley GW. Accurate femur repositioning is critical during intraoperative total hip arthroplasty length and offset assessment. J Arthroplasty 2005; 20: 887-91. 9. O’Brien S, Beverland DE, Wallace ME, et al. Evidence-based surgery: a brief report on the development of a cemented custom hip-replacement stem. J Orthopaedic Nursing, 1998; 2: 5-10. 10. O’Brien S. The hip factory- the success rate of total hip replacement at one of the UK’s largest orthopaedic units. Nurs Times 1994; 90: 34-5. 11. Dunn HK, Hess WE. Total hip reconstruction in chronically dislocated hips. J Bone Joint Surg Am 1976; 58: 838-45. 12. Price B. A model of body-image care. J Adv Nurs 1990; 15: 585-93. 13. Stinson JT, Scheller AD. Clinical evaluation of the symptomatic total hip replacement. Cited in, Turner R H and Scheller A D (ed.): Revision Total Hip Arthroplasty. Grune & Stratton, Inc, New York, 1982. 14. Williamson JA, Reckling FW. Limb length discrepancy and related problems following total hip joint replacement. Clin Orthop Relat Res 1978; 134: 135-8. 15. Green WT, Wyatt GM, Anderson M. Orthoroentgenography as a method of measuring the bones of the lower extremities. Clin Orthop Relat Res 1968; 61: 10-5. 16. Love BR, Wright K. Leg length discrepancy after total hip replacement. J Bone Joint Surg Br 1983; 65: 103-7. 17. Woo RY, Morrey BF. Dislocation after total hip arthroplasty. J Bone Joint Surg Am 1982; 64: 1295-306. 18. Edeen J, Sharkey PF, Alexander AH. Clinical significance of leg length inequality after total hip arthroplasty. Am J Orthop 1995; 24: 347-51. 19. 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. 20. Brand RA, Yack HJ. Effects of leg length discrepancies on the forces at the hip joint. Clin Orthop Relat Res 1996; 333: 172-80. 21. Abraham WD, Dimon JH. Leg length discrepancy in total hip arthroplasty. Orthop Clin North Am 1992; 23: 201-9. 22. Woolson ST. Leg length equalization during total hip replacement. Orthopedics 1990; 13: 17-21. 23. Haddad FS, Meermans G. Radiographic assessment of leg length discrepancy in total hip arthroplasty. 75th Annual Meeting American Academy of Orthopaedic Surgeons, March 5-9, 2008. San Francisco: P009. 24. Bal BS. Managing litigation risk in minimally invasive total joint surgery. American Academy of Orthopaedic Surgeons Bulletin April 2006; 54(2). 25. Attarian DE, Vail TP. Medicolegal Aspects of Hip and Knee Arthroplasty. Clin Orthop Relat Res 2005; 433: 72-6. 26. Kirby RL, Price NA, Machos DA. The influence of foot position on standing balance. J Biomech 1987; 20: 423-7. 27. Murray MP, Peterson RM. Weight distribution and weight shifting activity during normal standing posture. Phys Ther 1973; 53: 741-8. 28. Lawrence D. Lateralization of weight in the presence of structural short leg: a preliminary report. J Manipulative Physiol Ther 1984; 7: 105-8. 29. Vink P, Kamphuisen HA. Leg length inequality, pelvic tilt and lumbar back muscle activity during standing. Clin Biomech 1989; 4: 115-7. 30. Maher RK, Kirby RL, MacLeod DA. Simulated leg length discrepancy: its effects on mean centre-of-pressure and postural sway. Arch Phys Med Rehab 1985; 66: 822-4. 31. Cummings G, Scholz JP, Barnes K. The effect of imposed leg length difference on pelvic bone symmetry. Spine 1993; 18: 368-73. 32. Hurley MV. The effects of joint damage on muscle function and proprioception. Man Ther 1997; 2: 11-7.",
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O’Brien, S, Kernohan, G, Fitzpatrick, C, Hill, J & Beverland, D 2010, 'Perception of imposed leg length inequality in normal subjects', Hip International, vol. 20, pp. 505-511.

Perception of imposed leg length inequality in normal subjects. / O’Brien, Seamus; Kernohan, George; Fitzpatrick, Claire; Hill, Janet; Beverland, David.

In: Hip International, Vol. 20, 14.12.2010, p. 505-511.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Perception of imposed leg length inequality in normal subjects

AU - O’Brien, Seamus

AU - Kernohan, George

AU - Fitzpatrick, Claire

AU - Hill, Janet

AU - Beverland, David

N1 - Address for correspondence: Dr. Seamus O’Brien Outcomes Assessment Unit Musgrave Park Hospital Stockman’s Lane Belfast BT9 7JB, N. Ireland Reference text: 1. Harris WH, Sledge CB. Total hip and total knee replacement (Part 1). N Engl J Med 1990; 323: 725-31. 2. Harris WH, Sledge CB. Total hip and total knee replacement (Part 2). N Engl J Med 1990; 323: 801-7. 3. Cuckler JM. Limb length and stability in total hip replacement. Orthopedics 2005; 28: 951-3. 4. Clark CR, Huddleston HD, Schoch EP 3rd, Thomas BJ. Leglength discrepancy after total hip arthroplasty. J Am Acad Orthop Surg 2006; 14: 38-45. 5. Maloney WJ, Keeney JA. Leg length discrepancy after total hip arthroplasty. J Arthroplasty 2004; 19: 108-10. 6. Ranawat CS, Rao RR, Rodriguez JA, Bhende HS. Correction of limb-length inequality during total hip arthroplasty. J Arthroplasty 2001; 16: 715-20. 7. Woolson ST, Hartford JM, Sawyer A. Results of a method of leg length equalization for patients undergoing primary total hip replacement. J Arthroplasty 1999; 14: 159-64. 8. Sarin VK, Pratt WR, Bradley GW. Accurate femur repositioning is critical during intraoperative total hip arthroplasty length and offset assessment. J Arthroplasty 2005; 20: 887-91. 9. O’Brien S, Beverland DE, Wallace ME, et al. Evidence-based surgery: a brief report on the development of a cemented custom hip-replacement stem. J Orthopaedic Nursing, 1998; 2: 5-10. 10. O’Brien S. The hip factory- the success rate of total hip replacement at one of the UK’s largest orthopaedic units. Nurs Times 1994; 90: 34-5. 11. Dunn HK, Hess WE. Total hip reconstruction in chronically dislocated hips. J Bone Joint Surg Am 1976; 58: 838-45. 12. Price B. A model of body-image care. J Adv Nurs 1990; 15: 585-93. 13. Stinson JT, Scheller AD. Clinical evaluation of the symptomatic total hip replacement. Cited in, Turner R H and Scheller A D (ed.): Revision Total Hip Arthroplasty. Grune & Stratton, Inc, New York, 1982. 14. Williamson JA, Reckling FW. Limb length discrepancy and related problems following total hip joint replacement. Clin Orthop Relat Res 1978; 134: 135-8. 15. Green WT, Wyatt GM, Anderson M. Orthoroentgenography as a method of measuring the bones of the lower extremities. Clin Orthop Relat Res 1968; 61: 10-5. 16. Love BR, Wright K. Leg length discrepancy after total hip replacement. J Bone Joint Surg Br 1983; 65: 103-7. 17. Woo RY, Morrey BF. Dislocation after total hip arthroplasty. J Bone Joint Surg Am 1982; 64: 1295-306. 18. Edeen J, Sharkey PF, Alexander AH. Clinical significance of leg length inequality after total hip arthroplasty. Am J Orthop 1995; 24: 347-51. 19. 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. 20. Brand RA, Yack HJ. Effects of leg length discrepancies on the forces at the hip joint. Clin Orthop Relat Res 1996; 333: 172-80. 21. Abraham WD, Dimon JH. Leg length discrepancy in total hip arthroplasty. Orthop Clin North Am 1992; 23: 201-9. 22. Woolson ST. Leg length equalization during total hip replacement. Orthopedics 1990; 13: 17-21. 23. Haddad FS, Meermans G. Radiographic assessment of leg length discrepancy in total hip arthroplasty. 75th Annual Meeting American Academy of Orthopaedic Surgeons, March 5-9, 2008. San Francisco: P009. 24. Bal BS. Managing litigation risk in minimally invasive total joint surgery. American Academy of Orthopaedic Surgeons Bulletin April 2006; 54(2). 25. Attarian DE, Vail TP. Medicolegal Aspects of Hip and Knee Arthroplasty. Clin Orthop Relat Res 2005; 433: 72-6. 26. Kirby RL, Price NA, Machos DA. The influence of foot position on standing balance. J Biomech 1987; 20: 423-7. 27. Murray MP, Peterson RM. Weight distribution and weight shifting activity during normal standing posture. Phys Ther 1973; 53: 741-8. 28. Lawrence D. Lateralization of weight in the presence of structural short leg: a preliminary report. J Manipulative Physiol Ther 1984; 7: 105-8. 29. Vink P, Kamphuisen HA. Leg length inequality, pelvic tilt and lumbar back muscle activity during standing. Clin Biomech 1989; 4: 115-7. 30. Maher RK, Kirby RL, MacLeod DA. Simulated leg length discrepancy: its effects on mean centre-of-pressure and postural sway. Arch Phys Med Rehab 1985; 66: 822-4. 31. Cummings G, Scholz JP, Barnes K. The effect of imposed leg length difference on pelvic bone symmetry. Spine 1993; 18: 368-73. 32. Hurley MV. The effects of joint damage on muscle function and proprioception. Man Ther 1997; 2: 11-7.

PY - 2010/12/14

Y1 - 2010/12/14

N2 - Lower limb length differences of up to 10mm exist in 60% - 95% of the population.There are usually no symptoms or functional effects. Following Total Hip Arthroplasty (THA), satisfactory clinical results can be spoiled by dissatisfaction due to a change in leg length. Although the change in leg length may be modest in comparison to the normal variation, the patient may perceive this as a leg length discrepancy. To study the average threshold for perception, artificial leg length discrepancies of 5 mm to 25 mm were created in 30 young healthy adults using calibrated wooden blocks. Responses were recorded and analysed using a chi-squared test for independence and an independent measures t-test. Awareness of leg length discrepancy was related to the magnitude of the discrepancy (X2 (15)= 156.6, p

AB - Lower limb length differences of up to 10mm exist in 60% - 95% of the population.There are usually no symptoms or functional effects. Following Total Hip Arthroplasty (THA), satisfactory clinical results can be spoiled by dissatisfaction due to a change in leg length. Although the change in leg length may be modest in comparison to the normal variation, the patient may perceive this as a leg length discrepancy. To study the average threshold for perception, artificial leg length discrepancies of 5 mm to 25 mm were created in 30 young healthy adults using calibrated wooden blocks. Responses were recorded and analysed using a chi-squared test for independence and an independent measures t-test. Awareness of leg length discrepancy was related to the magnitude of the discrepancy (X2 (15)= 156.6, p

KW - Leg length discrepancy

KW - Total hip arthroplasty

M3 - Article

VL - 20

SP - 505

EP - 511

JO - Hip International

T2 - Hip International

JF - Hip International

SN - 1120-7000

ER -

O’Brien S, Kernohan G, Fitzpatrick C, Hill J, Beverland D. Perception of imposed leg length inequality in normal subjects. Hip International. 2010 Dec 14;20:505-511.