Gender is Associated with Leg Length Discrepancy after Total Hip Arthroplasty
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 4, Issue 2
Abstract
Background: Leg length discrepancy after total hip arthroplasty (THA) is one of the most common complications. Patients with obvious limb-length change often have functional disability and an accompanying dissatisfation. Purpose to detect the association between gender and the Leg length discrepancy (LLD) after THA Methods: We retrospective reviewed 158 consecutive patients who underwent primary THA surgery at our institution from May 2016 to July 2017. LLD was measured for all cases on pevilc AP radiograph. Then, we compared LLD between the male and female groups. Results: The incidence of LLD in our study was 94.9% (150/158) with a mean discrepancy of 7.5mm(range from 0 to 46.3mm). The abduction angle, anteversion angle, percentage of cup in safe zone were not statistical significant difference between the two groups. The LLD was significantly more often in the range of -10mm to 10mm in the female than male groups (84.1% versus 64.7%, p=0.019), however, the association was not found between the other three range classifications and gender. Conclusion: Male gender is an independent risk factor for marked LLD. Identification of these patients allows the treating surgeon to pay more attention on the intraoperative osteotomy. Further, before surgery, we should emphasize the high probility of LLD after THA, especially to male patients. Leg length discrepancy after total hip arthroplasty is one of the most common complications [1]. The incidence of LLD in the literature was reported range from 93% to 99.5% and being lengthened was more common [2,3]. Several studies have showed that minor LLD (<5mm) after THA can seldom be perceived and 10 mm inequality of limb length can be tolerated by most of patients[4]. Patients with moderate LLD (10-20mm) may have mild discomfort but readily manageable by shoe correction. Patients with severe LLD (>20mm) often have functional disability and an accompanying dissatisfation. Those known adverse effect associated with LLD including spinal imbalance and back pain[5], sciatic nerve injury[6], gait disorders[3], dislocation, decreased anterior acetabular coverage [7] and increased rate of revision surgery and disfunction [8]. In order to improve intraoperative accuracy and to minimize the LLD, there are around 20 different methods were reported in the literaure, mainly contain many intraoperative navigation devices and multiple kinds of bone landmark [9-12]. However, the computer navigation system was not only cumbersome and expensive but also increase surgical time. And bone landmark for reference was not accurate and unreliable. In the literature, some patient-related factors, including previous trauma, skeletal dysplasias, soft tissue contractures, and previous surgery to the lower limbs were reported to be associated with leg length inequality [13-15]. But all these factor are relatively rare and little clinical value. Another study demonstrated that the preoperative hip flexion measured under general anaesthesia can be used to predict leg-length change after THA [16]. At our institution, we found a strange penomenon that male patients tend to have a more obvious LLD than females patients. Hence, we performed this study to investigate the association between gender and the LLD after THA. We hypthesis that the LLD in the male group is more obvious than the female group.
Authors and Affiliations
XiaoXiao Song, Chen Yao, Qiangqiang Li, Dongyang Chen, Lan Li, Qing Jiang
Keywords
Related Articles
- EP ID EP590867
- DOI 10.26717/BJSTR.2018.04.001012
- Views 167
- Downloads 0
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