We evaluated an operative technique, described
by the Exeter Hip Unit, to assist accurate introduction of the femoral
component. We assessed whether it led to a reduction in the rate
of leg-length discrepancy after total hip arthroplasty (THA). A total of 100 patients undergoing THA were studied retrospectively;
50 were undertaken using the test method and 50 using conventional
methods as a control group. The groups were matched with respect
to patient demographics and the grade of surgeon. Three observers
measured the depth of placement of the femoral component on post-operative
radiographs and measured the length of the legs. There was a strong correlation between the depth of insertion
of the femoral component and the templated depth in the test group
(R = 0.92), suggesting accuracy of the technique. The mean leg-length
discrepancy was 5.1 mm (0.6 to 21.4) pre-operatively and 1.3 mm
(0.2 to 9.3) post-operatively. There was no difference between Consultants
and Registrars as primary surgeons. Agreement between the templated
and post-operative depth of insertion was associated with reduced
post-operative leg-length discrepancy. The intra-class coefficient
was R ≥ 0.88 for all measurements, indicating high observer agreement.
The post-operative leg-length discrepancy was significantly lower
in the test group (1.3 mm) compared with the control group (6.3
mm, p <
0.001). The Exeter technique is reproducible and leads to a lower incidence
of leg-length discrepancy after THA. Cite this article:
