Correction of limb-length inequality during total hip arthroplasty

Ranawat, Chitranjan S.; Rao, Rajesh; Rodríguez, José A.; Bhende, Harish

doi:10.1054/arth.2001.24442

Cited by 191 publications

(160 citation statements)

References 5 publications

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“…Discussion Typical pathologic features of degenerative joint disease of the hip are progressive loss of cartilage and superior migration of the femoral head, which result in LLD. One of the intraoperative challenges in a THA is correcting a LLD without compromising hip stability [2,37]. Preexisting LLDs should be accounted for during preoperative planning and should be corrected at the time of THA [4].…”

Section: Resultsmentioning

confidence: 99%

“…Preexisting LLDs should be accounted for during preoperative planning and should be corrected at the time of THA [4]. A common complication of THA is postoperative limb lengthening [11,37,38], which may be required to provide adequate stability [2]. Edeen et al [11] reported a mean difference of 14.9 mm between the surgically treated and contralateral limbs, and 32% of their patients were aware of and dissatisfied with this problem.…”

Section: Resultsmentioning

confidence: 99%

“…The surgeon must use this information to determine the femoral osteotomy level. Various methods of measuring limb length change during surgery include comparing the dimensions of the resected bone with the dimensions replaced by the prosthesis [12,57,58], comparing the distance between the center of the trial head and the lesser trochanter [30,43], the use of mechanical jigs and measuring calipers [6,22,37,44], or the use of reference pins driven into the pelvis [3,21,31]. Some surgeons advocate the use of computer-assisted methods [33,41,55].…”

Section: Resultsmentioning

confidence: 99%

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Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

Meermans

Malik

Witt

et al. 2011

Clinical Orthopaedics &Amp; Related Research

149

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Background Pelvic radiographs are helpful in assessing limb-length discrepancy (LLD) before and after THA but are subject to variation. Different methods are used to determine LLDs. As a pelvic reference, both ischial tuberosities and the teardrops are used, and as a femoral reference, the lesser trochanter and center of the femoral head are used. Questions/purposes We validated the different methods for preoperative radiographic measurement of LLDs and evaluated their reliability. Patients and Methods LLDs were measured on full-leg radiographs for 52 patients (29 men, 23 women) with osteoarthritis (OA) of the hip and compared with different methods for measuring LLDs on AP radiographs of the pelvis. Results The true LLD varied from À8.0 to 9.1 mm. When the biischial line was used as a pelvic reference, the LLD measured on AP pelvis radiographs was different from the true LLD. No difference was found when the interteardrop line was used as a pelvic reference. There was substantial interobserver agreement when the lesser trochanter was used as a femoral reference (kappa = 0.66-0.70) and excellent interobserver and intraobserver agreement for all other measurements (kappa = 0.84-0.93). Conclusions Our data show use of the biischial line as a pelvic reference should be discouraged and the interteardrop line is a better alternative. The center of the femoral head is a more reliable femoral landmark compared with the lesser trochanter. Level of Evidence Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

Meermans

Malik

Witt

et al. 2011

Clinical Orthopaedics &Amp; Related Research

149

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“…Preoperatively, we estimated Trendelenburg's sign and functional leg length inequality by measuring the xiphisternum to medial malleolus distances and tried to determine the limb lengthening acceptable to the patient, keeping in mind all stiff pelvis or lumbar spine deformities and muscle contracture [29,30]. Elevated shoes at different heights were used for all patients with unilateral congenital dislocation to determine preoperatively the approximate acceptable limits of leg lengthening.…”

Section: Methodsmentioning

confidence: 99%

High Hip Center Technique Using a Biconical Threaded Zweymüller® Cup in Osteoarthritis Secondary to Congenital Hip Disease

Christodoulou¹,

Dialetis²,

Christodoulou

2010

Clinical Orthopaedics &Amp; Related Research

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Background The high hip center technique used for a deficient acetabulum is reconstruction of the hip at a high center of rotation. In the literature, there is no consensus regarding the value of this technique. Questions/purposes We investigated whether the newgeneration biconical threaded Zweymüller 1 cup fixed in a high nonanatomic position in patients with arthritis secondary to congenital hip disease experienced different rates of polyethylene wear and long-term survivorship when compared with anatomically positioned cups. Patients and Methods We studied the polyethylene wear rate and Kaplan-Meier survivorship of 104 titanium threaded Zweymüller 1 cups in 88 patients (81 females), placed in 70 hips at near-normal hip center and in 34 hips at a high hip center position at a distance of 31.1 to 60 mm (mean, 39.7 mm) from the interteardrop line. Minimum followup was 2 years (mean ± SD, 8.6 ± 3.5 years; range, 2-15 years). ResultsThe mean linear polyethylene wear rates in the near-normal and high hip center groups were not different (0.110 ± 0.050 mm and 0.113 ± 0.057 mm, respectively

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“…6 There is no evidence for increased incidence of hip or knee arthrosis for LLDs of 2cm or less. 7 In the words of Gross, 1 "It is concluded that there seems little indication for equalisation of discrepancies less than 2 cm. For larger amounts of discrepancy, "clinical judgment" still must be weighed on an individual basis, as individual variation among patients with leg length discrepancy confounds any precise classification of functional disability."…”

Section: Resultsmentioning

confidence: 99%

Treatment of limb length dyscripancy following surgeries around hip in Tertiary Care Institute in India

Mahajan¹

2017

JMSCR

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Correction of limb-length inequality during total hip arthroplasty

Cited by 191 publications

References 5 publications

Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

High Hip Center Technique Using a Biconical Threaded Zweymüller® Cup in Osteoarthritis Secondary to Congenital Hip Disease

Treatment of limb length dyscripancy following surgeries around hip in Tertiary Care Institute in India

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