Abstract
Introduction
Restoration of anatomy is essential in total hip arthroplasty (THA) to optimize function and stability. Leg-length discrepancy of ≥10mm is poorly tolerated and can be the subject of litigation. We use a multimodal protocol to optimize soft tissue balancing which involves pre- operative templating, leg-length measurement supine and after positioning, use of an intra-operative leg-length and offset measurement device and implants with standard and high-offset options.
Methods
Radiological leg-length and femoral offset were measured in a consecutive series of 100 patients who had THA for unilateral arthritis by an independent observer pre- and post-operatively using validated methods and the contra lateral hip as a control.
Results
Leg-length was restored to within 5mm of the contra lateral side in 80% of patients (mean 1.5mm (95% CI −5.7 to +8.7)). Offset was restored to within 5mm in 90% of patients (mean 0.6mm (95% CI −5.6 to +6.8)).
Conclusion
We have narrowed the range of discrepancy compared to other studies. Intra-operative measurement of offset is difficult unless a specific device is utilized. We have restored the femoral offset accurately within a narrow range of the mean. We recommend a similar protocol to ensure restoration of leg-length and offset and maximize function and patient satisfaction.
