Abstract
Objectives
The clinical importance of a leg length discrepancy (LLD) following total hip arthroplasty (THA) remains controversial. This study was undertaken to determine the effects of LLD on clinical outcomes at up to 3 years follow-up.
Design and setting
Prospective, multicentre study.
Participants
Nine hundred and eighty-seven cases of primary THA, categorised into two main groups: the NoLLD group (LLD of less than 10mm) and the LLD group (LLD of 10mm or more).
Main outcome measures
The primary outcome measure was the change in Oxford Hip Score (ΔOHS) at up to 3 years follow-up. Secondary outcome measures were length of operating time and hospital stay, and revision and dislocation rates. Potential predisposing factors for LLD, including body mass index, age and type of anaesthesia employed, were examined.
Results
At 3 years, the LLD group had a significantly worse ΔOHS [22.0; 95% confidence interval (CI) 20.5 to 23.5] compared with the NoLLD group (23.8; 95% CI 23.1 to 24.5) (P=0.034). There were no significant differences in revision (P=0.389) or dislocation (P=0.220) rates between the two groups. Use of an epidural was associated with a decreased incidence of developing an LLD of 10mm (P=0.004).
Conclusion
A postoperative LLD of 10mm or more leads to poorer functional outcomes. Further studies are needed to assess the impact of an LLD on clinical outcomes in the longer term.
Citation
Incidence and effect of leg length discrepancy following total hip arthroplasty
D.J. Beard, J. Palan, J.G. Andrew, J. Nolan, D.W. Murray, EPOS Study Group
Physiotherapy - June 2008 (Vol. 94, Issue 2, Pages 91-96, DOI: 10.1016/j.physio.2008.01.005)