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
|Publication status||Published (in print/issue) - 14 Dec 2010|
Bibliographical noteAddress for correspondence:
Dr. Seamus O’Brien
Outcomes Assessment Unit
Musgrave Park Hospital
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:
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:
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;
32. Hurley MV. The effects of joint damage on muscle function
and proprioception. Man Ther 1997; 2: 11-7.
- Leg length discrepancy
- Total hip arthroplasty