Introduction:We conducted a prospective study to find out change in limb length (lengthening/shortening) after total knee arthroplsty in unilateral and bilateral total knee arthroplasty (TKA) because few literature is available regarding limb length discrepancy in TKA in comparison to total hip arthroplasty. Limb length discrepancy (LLD) may lead to low back pain and gait abnormalities. Material and methods: We divided 58 patients into two groups: Group A (28 patients) includes patients who underwent unilateral TKA and Group B (30 patients) includes patients who underwent bilateral TKA. We assessed the patients clinico-radiologically in terms of limb length (supine position), deformity, Sagital-flexion deformity/extensor lag, coronal -varus/valgus, range of motion, knee stability, patellar tracking and Hip-knee-ankle angle preoperatively and postoperatively. Results: In group A, mean limb length difference (operated limb gained length as compared to unoperated limb) was 1.11 cm. Out of 22 patients (78%) in whom limb length discrepancy was present, only 7 patients (31%) having limb length discrepancy perceived it. In group B, mean limb length difference was 1.03 cm. Fourteen patients (47%) in group B had LLD but none of them perceived it. Clinically 22 patients (78%) in group A and 14 patients (47%) in group B had LLD. Radiologically 25 patients (89%) in group A and 22 patients (73%) in group B had LLD. Out of the 7 patients who perceived LLD, all had LLD radiologically too. Conclusion:We reckoned that limb length discrepancy is more common in unilateral TKA. Limb length discrepancy of 2 cm or more is perceived by the patients operated for unilateral TKA. But in bilateral TKA, none of the patient perceived LLD because in this group LLD was less than 2 cm. Limb length discrepancy may leads to dissatisfaction of the patients and poor functional outcome.
Background: Internal xation is the treatment of choice for intertrochanteric fractures. Failed xation is very cumbersome for the patients due to pain and functional disability. Hip arthroplasty as a salvage procedure in these patients is a technical challenge due to bone loss and poor bone quality. e purpose of this study was to evaluate the outcome of total hip arthroplasty in failed xation of intertrochanteric fractures. Materials and methods: In a prospective study, eighteen patients (13 male and 5 females) with a diagnosis of failed xation of intertrochantric fracture con rmed either by fracture collapse or established nonunion were included. Mean age of patients was 69 years (range: 53 to 79 years). Total hip arthroplasty was done in all patients. Assessment was done clinically by Harris hip score (HHS) and radiologically by x-rays. Trochanteric nonunion was found in seven patients which was treated either by tension band wire or Ethibond. Results: All patients had full weight bearing walk. e mean followup was of three years. e mean duration of surgery was 125 minutes and average blood loss was 600 ml. No patients were lost to followup. ere was no dislocation. e mean Harris hip score increased from 35.71 to 88.37 at 1 year. Conclusion: Hip arthroplasty a enuated pain and improved function in majority of patients. It requires meticulous preoperative planning. Despite technical difficulties it is an effective salvage procedure a er failed xation of intertrochanteric fracture.
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