Limb Length Discrepancy in Total Hip Arthroplasty: Is the Lesser Trochanter a Reliable Measure of Leg Length?
| Autor: | Alexander B. Christ, Matthew C. Gallo, Douglass W. Tucker, Jay R. Lieberman, Nathanael Heckmann, Brian C Chung, Amit S Piple |
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| Rok vydání: | 2021 |
| Předmět: |
Radiography
Arthroplasty Replacement Hip Scanography 03 medical and health sciences Femoral head 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine Femur Limb length discrepancy Aged 030222 orthopedics Leg business.industry Leg length Middle Aged Leg Length Inequality medicine.anatomical_structure Lesser Trochanter Female Level iii Nuclear medicine business Total hip arthroplasty |
| Zdroj: | The Journal of arthroplasty. 36(10) |
| ISSN: | 1532-8406 |
| Popis: | Background Limb length discrepancy (LLD) after total hip arthroplasty may affect clinical outcomes and patient satisfaction. Preoperative LLD estimates on anteroposterior pelvic radiographs fail to account for anatomical limb variation distal to the femoral reference points. The objective of this study is to determine how variations in lower limb skeletal lengths contribute to true LLD. Methods Full-length standing anteroposterior radiographs were used to measure bilateral leg length, femoral length, and tibial length. Leg length was evaluated using 2 different proximal reference points: the center of the femoral head (COH) and the lesser trochanter (LT). Mean side-to-side discrepancy (MD) and percentage asymmetry (%AS) for each measurement were evaluated in the overall cohort and when stratified by patient demographic variables. Results One hundred patients were included with an average age of 62.9 ± 11.2 years. Average femoral length was 434.0 ± 39.8 mm (MD 4.3 ± 3.5 mm) and tibial length was 379.9 ± 34.6 mm (MD 5.9 ± 12.7 mm). Average COH-talus was 817.5 ± 73.2 mm (MD 6.4 ± 5.1 mm). Average LT-talus was 760.5 ± 77.6 mm (MD 5.8 ± 5.1 mm). Absolute asymmetry >10 mm was detected in 16% of patients for COH-talus and 15% for LT-talus, while %AS >1.5% was detected in 13% of patients for COH-talus and 18% for LT-talus. Female gender was associated with increased femoral length %AS (P = .037). Conclusion Approximately 1 in 6 patients have an LLD of >10 mm when measured from either the LT or COH. Surgeons using either of these common femoral reference points to estimate LLD on pelvic radiographs should consider these findings when planning for hip reconstruction. Level of Evidence Level III. |
| Databáze: | OpenAIRE |
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