Leg Length Discrepancy After Total Hip Replacement

INTRODUCTION In spite of improvements occurred in implant design, materials and fixation techniques, among many complications following total hip replacement (THR), leg length discrepancy (LLD) is very common but least explored. It can lead to serious complications converting an excellent surgery with rigid fixation to poor functional results. The desirability of lengthening of shortening, clinical and radiological method of assessment and their relation, correlation with functional outcome etc are some most controversial questions about LLD which are being effort to be answered in this study. MATERIAL & METHODS 108 cases of THR with any type implant and demographic and equivocal post-op protocol were assessed clinically (true and apparent) and compared with radiologically (pelvic, femoral and combined) measured LLD and finally, functional results correlated with measurement of Harris hip score. RESULTS Overall prevalence of LLD was above 90% but clinical and radiological assessment correlated poorly. Clinically lengthening (83%) was more common than shortening, with maximum lengthening in the range 1-10 mm. Radiologically combined (60%) variety outranged femoral while least being pelvic. Only 50% has LLD in range of 1-10 mm on radiologically assessment, but more than 90% cases has excellent to good functional results. CONCLUSION LLD though inev table but controllable complication following THR, effects adversely on functional outcome above the cut off limit of 2.0 cm. Preoperative templating and intra operative measurements by careful positioning and orientation of components can decrease LLD and improve the functional outcome.