Lld

Aim

Leg Length discrepancy (LLD) is a well known complication following hip arthroplasty. There are many papers looking at LLD after total hip replacement however there are none looking at LLD after hip hemiarthroplasty for fracture neck of femur. Our aim was to accurately assess leg length discrepancy following cemented hip hemiarthroplasty.

Method

Sixty consecutive patients who underwent cemented hip hemiarthroplasty for fracture neck of femur between 2008 and 2009 were selected for the study. Patient details including implant sizes, were collected from theatre records.

We used the trauma cad software to accurately calculate LLD after appropriate calibration. We measured pre & post-operative femoral position to calculate the degree of LLD. The LLD’s were calculated by two observers to look for any inter-observer differences.

We excluded cases where the xray was too externally rotated, missed out the greater trochanter or no post-op xrays were available.

Research3

Results

ixteen cases were excluded for not meeting the inclusion criteria. In the remaining forty four patients, the mean leg length discrepancy was a 5.6 mm increase in length with a range of 5.3 mm shortening to 20.7 mm lengthening. The 95% confidence intervals was 1.8 mm above and below the mean.

Pearson’s correlation coefficient between pre and post operative leg length showed no significant length discrepancy with a coefficient of 0.42.

There was no significant inter – observer error.

LLD for both observers

Graph

Discussion

Many studies looking at LLD after total hip arthroplasty had a mean lengthening of 9mm. Our study has shown that hip hemiarthroplasties have marginally better results.

However some LLD still exists and we feel that this could have been due to the absence of pre-op templating, inaccurate femoral cut and the inability of the implant to accommodate variations in patient femoral neck angle.

We believe that correcting these issues could reduce LLD, accurately restore normal anatomy and reduce the potential complications of low back pain, nerve palsy and abnormal gait associated with LLD.

Download original document lld.pdf

 

Manchester Hip Clinic News

HIP SURGERY

Fracture

As patients who have had a hip replacement age, there is a decrease in the strength of their bones and an increase in the risk of fracture a...

HIP SURGERY

Dislocation

As hip replacements age, the components will wear and the hip will lose its' initial soft-tissue tension. This combined with a general incre...

HIP SURGERY

Hip Arthroscopy

This is an innovative procedure that allows access to the hip joint using minimally invasive surgical techniques. It has been carried out ep...

HIP SURGERY

Hip Replacements

When a patient has severe arthritis and painkillers no longer effectively control the symptoms, hip joint replacement is advised. This has t...

HIP SURGERY

Implant loosening

Implant loosening is the most common cause/indication for revision hip surgery. Hip replacements have been carried out in the UK regularly s...

HIP SURGERY

Hip revision surgery

Revision hip surgery is carried out for a variety of reasons. These can include the original hip wearing out, the presence of deep infection...

Contact Details

Reasearch3

Spire Manchester Hospital,
Russell Road, Whalley Range,
Manchester. M16 8AJ
Tel: 0773 979 1305
info@manchesterhipclinic.com