Results of a method of leg-length equalization for patients undergoing primary total hip replacement

Woolson, Steven T.; Hartford, James M.; Sawyer, Aenor

doi:10.1016/s0883-5403(99)90119-5

Cited by 227 publications

(162 citation statements)

References 7 publications

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“…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%

“…Some authors recommend the surgically treated limb length should be within 10 mm of the contralateral limb because this does not affect the functional parameters of gait [40] and produces a satisfactory result in most patients [2,57]. One study [53] in the orthopaedic literature suggests a LLD has no effect on the functional outcome of THA, but many surgeons perceive it as an important problem to avoid [6,12,22,24,29,58]. A shoe lift may not always be well accepted as an alternative [52].…”

Section: Resultsmentioning

confidence: 99%

“…LLD measurement was more accurate with the interteardrop line as a pelvic landmark instead of the ischial tuberosity because the teardrop has been described as a more consistent landmark less influenced by the position of the pelvis [16,58]. In patients with developmental dysplasia of the hip, the teardrop can be difficult to identify on an AP pelvic radiograph.…”

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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“…Nine of the 22 described the Williamson method [15][16][17][18][19][20][21][22] and 10 of the 22 papers used the Woolson method [23][24][25][26][27][28][29][30][31][32][33]. It is notable that while both methods are described as 'validated' there was very little documentation of the validation process.…”

Section: Introductionmentioning

confidence: 99%

Assessing Reproducibility for Radiographic Measurement of Leg Length Inequality after Total Hip Replacement

et al. 2012

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“…First, in the preoperative planning for total hip arthroplasty, the thickness map may provide assistance in the selection of an adequate prosthesis and determination bone graft (31). It can also be used for estimating the amount of femoral bone and joint cartilage that is removed during total hip replacement to avoid postoperative leg-length discrepancy (32).…”

Section: Discussionmentioning

confidence: 99%

An analysis algorithm for accurate determination of articular cartilage thickness of hip joint from MR images

Cheng

Jin

Zhao

et al. 2011

Magnetic Resonance Imaging

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Purpose: To test the accuracy of the most widely used technique based on edge detection for thickness measurement of the hip joint cartilage in MR images, and to improve the measurement accuracy by developing a new measurement method based on a model of the MRI process.Materials and Methods: MRI was performed in 3 normal cadaver hips, 25 hips of normal volunteers, and 25 hips of patients with osteoarthritis. In general, thickness was defined as the distance between the two sides of the hip cartilage along the normal directions of the cartilage surfaces. In this article this is referred to as the ''edge detection method.'' A theoretical simulation analysis revealed that the edge detection method considerably underestimated the cartilage thickness of the hip joint. A new measurement method based on a model of the MR imaging process was accordingly proposed for correcting the measurement errors.Results: In the experiment using the cadaver hips, anatomical measurement of cartilage thickness was used as reference standard. For measurements at 35 sites, the proposed model-based method gave results similar to those presented from anatomic section, while the edge detection method gave underestimation compared with the anatomic thickness. The underestimation biases for the edge detection method were consistent with the biases predicted by theoretical simulation. In the experiment using the hips of volunteers and patients, the edge detection result was an underestimation compared with the result generated by using the model-based method. Conclusion:The edge detection method underestimated the hip cartilage thickness in MR images. The proposed model-based method was more accurate than the edge detection method for thickness measurement of the hip cartilage.

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Results of a method of leg-length equalization for patients undergoing primary total hip replacement

Cited by 227 publications

References 7 publications

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

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

Assessing Reproducibility for Radiographic Measurement of Leg Length Inequality after Total Hip Replacement

An analysis algorithm for accurate determination of articular cartilage thickness of hip joint from MR images

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