Management of limb-length discrepancy after THA

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There are several strategies to address the common complication of limb-length discrepancy (LLD) after total hip arthroplasty (THA). From allowing ample time for soft tissues to elongate, to shoe lifts and surgical revision, there are tools available to help surgeons alleviate a patient's symptoms. Perhaps most importantly is clear communication with patients about potential complications and ensuring understanding that there are some cases of LLD that are not correctable. 

 

As discussed in Part I of this article series, leg-length discrepancy (LLD) is a common complication in total hip arthroplasty (THA), with incident reports ranging greatly (between 1 and 50 percent) [1, 2]. Despite patient education about the possibility of LLD after THA, it has been shown that the THA patient is more likely to remember the potential benefits of the procedure over the potential complications [3]. This incongruity may help explain why it is the number one reason for litigation against the US orthopedic community [4, 5]. It is generally accepted that a LLD of less than 10 mm is well tolerated by patients and therefore is a reasonable target for facilitating good functional outcomes [6].

 

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  • Structural versus functional
  • Presentation
  • Nonoperative treatment suggestions
  • Operative treatment indications and suggestions
  • Conclusion
  • References

Part 1 | Prevention of limb-length discrepancy during THA

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Part 3 | Patients with hip dysplasia
 

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Contributing experts

This series of articles was created with the support of the following specialists (in alphabetical order):

Biju Benjamin

University College London Hospital
London, United Kingdom

Babar Kayani

University College London Hospital
London, United Kingdom

Jurek Pietrzak

University College London Hospital
London, United Kingdom

This issue was created by Word+Vision Media Productions, Switzerland

 

References

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