Management of limb-length discrepancy after THA

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].

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].