Effect of Preoperative Leg Length Discrepancy on Functional Outcome and Patient Satisfaction After Total Hip Arthroplasty in Cases of Osteonecrosis of the Femoral Head

Dong, Ning; Yang, Chen; Li, Shuqiang; Gao, Yu-Hang; Liu, Jianguo; Qi, Xiaojun

doi:10.1016/j.arth.2016.05.039

Cited by 16 publications

(5 citation statements)

References 33 publications

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“…Although there were differences in postoperative LLD and FO difference between the two groups, there was no difference in Harris score at 3 months postoperatively, which may be related to the use of walking aids by patients in the early postoperative period. Whitehouse et al (32) noted no significant correlation between postoperative structural LLD and functional outcome, while abductor weakness due to FO generally occurs at 6-12 months and does not change early (33). Therefore, there was no significant difference in Harris score at 3 months postoperatively in our study.…”

Section: Discussioncontrasting

confidence: 47%

“…To minimize bias, all radiographs were taken in the same radiology department with the same standardized technique, ensuring 10-15°of internal rotation of both femurs. Thirdly, the function and pain in the early postoperative period showed no correlation with postoperative LLD and FO (32,33,35), and a longer follow-up is required in order to assess the impact of FO and LLD on function. Finally, our technique still requires a learning curve to be able to do the various intraoperative markings properly.…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative method of femoral head central measurement to prevent leg length discrepancy following hemiarthroplasty

Ma²,

Wu³

et al. 2023

Front. Surg.

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PurposeThis study aimed to introduce and investigate the safety and efficiency of the intraoperative central measurement method of the femoral head (IM-CMFH) to prevent leg length discrepancies (LLD) after hemiarthroplasty.MethodsOverall, 79 patients aged 75 to 85 years with femoral neck fractures who underwent hemiarthroplasty were divided into two groups: the Control group (n = 46) and the IM-CMFH group (n = 33). The two groups were compared for postoperative LLD and the proportions of patients with greater than 10 mm, 6–10 mm, and within 5 mm, postoperative femoral offset (FO) difference and the proportions of patients within 5 mm, incremental greater than 5 mm and reduction greater than 5 mm. Next, the vertical distance from the center of the femoral head to the tip of the greater trochanter on the anatomical axis of the femur (VD-CFH-TGTAAF), leg length, and FO on the operative and non-operative sides within the IM-CMFH group. Finally, operative time, hemoglobin loss, Harris scores 3 months after surgery, and postoperative complications were analyzed.ResultsCompared with the control group, the postoperative LLD and FO differences were significantly lower in the IM-CMFH group (P = 0.031; P = 0.012), and the proportion of patients with postoperative LLD greater than 10 mm decreased significantly (P = 0.041), while the proportion of patients with FO difference of within 5 mm increased (P = 0.009). In addition, there was no significant difference in the operative time, hemoglobin loss, and Harris score at 3 months postoperatively and postoperative complications between the two groups (P > 0.05). There was no significant difference in FO, leg-length, and VD-CFH-TGTAAF between the operative and non-operative sides within the IM-CMFH group (P > 0.05).ConclusionSatisfactory results can be achieved by using the IM-CMFH to prevent LLD following hemiarthroplasty, and there is no increase in operative time, hemoglobin loss, or postoperative complications. This technique is efficient for hemiarthroplasties and is both simple and convenient.

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Intraoperative method of femoral head central measurement to prevent leg length discrepancy following hemiarthroplasty

Ma²,

Wu³

et al. 2023

Front. Surg.

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“…However, single AP plane pelvic radiograph is the common method in the clinic to assess leg lengths. Multiple studies have used single AP plane radiographic images to assess how preoperative LLD may impact patient perceived-LLD, functional outcomes, and patient satisfaction postoperatively [ 3 , 34 ]. Additionally, clinical outcome measures were not available, thus prohibiting comparisons between those with and without LLD and subsequent analysis of clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis

Carlos,

Drain,

Byrapogu

et al. 2023

Arthroplasty Today

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“…The improper rotation of the femoral head center is one of the typical complications observed with hip arthroplasty [ 13 , 14 ], which often results in changes to hip biomechanics, gait abnormalities, lower back pain, sciatica, joint instability, and an increased risk of dislocation [ 2 , 15 ], thus adversely affecting the subjective perception of the patient and the recovery and restoration of clinical function after hip arthroplasty. As a result, orthopedic surgeons are constantly investigating methods to restore the proper position of the FHC.…”

Section: Discussionmentioning

confidence: 99%

A simple method for restoring the femoral head center in hip arthroplasty: a 3-dimensional analysis in the Chinese population

Tian

Mao

Gao

et al. 2022

BMC Musculoskelet Disord

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Background Various authors have successfully demonstrated that the distance from the greater trochanter to the femoral head center (GTFHC) and the distance from the lesser trochanter to the femoral head center (LTFHC) can be used as parameters to determine the recovery of the femoral head center (FHC) during hip arthroplasty. It is necessary to undertake an anatomical study concerning the correlations between the greater trochanter (GT), the lesser trochanter (LT), and the FHC using data obtained from the 3D-CT reconstruction method. Methods The study comprised 293 patients (151 males and 142 females), with an average age of 65.06 years. The femoral head diameter(FHD), the linear distance from FHC to GT (GTFHC), and the linear distance from FHC to LT(LTFHC) were all measured and recorded data. The correlation between FHD with LTFHC and GTFHC was assessed using Pearson correlation coefficients, and the ratio of LTFHC and GTFHC to FHD was calculated from this ratio. All measured parameters were compared between the left and right sides and the sexes of the participants. Results The average ratios of GTFHC/FHD and LTFHC/FHD were 0.99 and 0.95, respectively .96% of the LTFHC had absolute lateral differences of < 4 mm . 92% of the GTFHC had absolute lateral differences of < 4 mm. Conclusion LTFHC and GTFHC are reliable reference parameters for preoperative planning and reconstruction of FHC of hip arthroplasty. The ratio displayed in this research may yield insight into a practical and straightforward method for orthopedic surgeons to perform hip arthroplasty in patients with femoral neck fractures. Ratios from studies based on the same race may be desirable for future work.

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Effect of Preoperative Leg Length Discrepancy on Functional Outcome and Patient Satisfaction After Total Hip Arthroplasty in Cases of Osteonecrosis of the Femoral Head

Cited by 16 publications

References 33 publications

Intraoperative method of femoral head central measurement to prevent leg length discrepancy following hemiarthroplasty

Intraoperative method of femoral head central measurement to prevent leg length discrepancy following hemiarthroplasty

An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis

A simple method for restoring the femoral head center in hip arthroplasty: a 3-dimensional analysis in the Chinese population

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