Abstract
Leg-length inequality is not uncommon following primary total hip arthroplasty and can be distressing to the patient. An excellent clinical result with respect to pain relief, function, component fixation, range of motion and radiographic appearance can be transformed into a surgical failure because of patient dissatisfaction due to leg-length inequality.
Postoperative leg-length discrepancy was determined radiographically for 200 patients who had had a primary custom total hip arthroplasty. In all cases the opposite hip was considered to have a normal joint center.
The femoral component was designed and manufactured individually for each patient using screened marker x-rays. A graduated calliper was used at the time of surgery to control depth of femoral component insertion. The transverse acetabular ligament was used to control placement of the acetabular component and therefore restore acetabular joint center.
Using this method 94% of subjects had a postoperative leg-length discrepancy that was 6mm or less when compared to the normal side (average, +0.38mm). The maximum value measured for leg-length discrepancy was +/−8mm.
We describe a simple technique for controlling leg length during primary total hip arthroplasty and propose an alternative radiographic method for measuring leg-length discrepancy.
The abstracts were prepared by Raymond Moran. Correspondence should be addressed to him at the Irish Orthopaedic Assocation, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
