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Changes in patient-perceived leg length discrepancy following total hip arthroplasty

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Leg length discrepancy (LLD) after total hip arthroplasty (THA) prevents functional recovery and reduces patient satisfaction. We investigated impact of changes in patient-perceived LLD on patient satisfaction and walking ability.

Methods

one hundred and forty-nine patients with unilateral hip osteoarthritis undergoing THA from 2014 to 2017, (125 women, 24 men; average age, 68.5 years) with an objective LLD < 1 cm were included. Outcome measures included the patient-perceived LLD, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, 10-m walking speed, and affected leg loading rate, assessed preoperatively and at 3 weeks, 3 months, and 1 year postoperatively.

Results

The absolute patient-perceived LLD (mean ± SD) (the number of patients with perceived LLD > 5 mm) were 6.4 ± 9.6 mm [88 patients (59%)] preoperatively; and 2.2 ± 4.0 mm [48 (32%); p < 0.001], 0.7 ± 2.3 mm [17 (11%); p < 0.001], and 0.4 ± 1.6 mm [10 (7%); p = 0.095] at 3 weeks, 3 months, and 1 year postoperatively, respectively. All outcome measures improved over time. One year postoperatively, a weak positive correlation between the patient-perceived LLD and WOMAC or 10-m walking speed (r = 0.24, 0.23, respectively) was found. The risk of patient-perceived LLD persisting > 1 year postoperatively was 5.5-fold higher in patients who exhibited it at 3 months and those with a WOMAC score > 10 at 3 months postoperatively, using multivariate logistic regression.

Conclusion

Achieving a post-THA objective LLD < 1 cm significantly reduced the patient-perceived LLD up to 3 months postoperatively. The residual patient-perceived LLD at 1 year postoperatively was predicted from the WOMAC score or the presence of patient-perceived LLD at 3 months after THA.

Level of evidence

Therapeutic level IV.

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Acknowledgements

We did not receive grants or outside funding in support of their research or preparation of this manuscript. We thank Yuichi Takeuchi, Yusuke Kimura, and Naoya Kumata for unifying the postoperative physical therapy, and Yoshito Minami, Takahiro Yamabe and Yuuki Shibata for the assistants of the orthopedic surgery in Shiraniwa Hospital.

Funding

We did not receive grants or outside funding in support of our research or preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shiraniwa Hospital Joint Arthroplasty Center, 6-10-1 Shiraniwadai, Nara, Ikoma-City, 630-0136, Japan

    Kentaro Iwakiri, Takashi Fujii & Akio Kobayashi

  2. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi Abeno-ku, Osaka, Osaka-City, 545-8585, Japan

    Yoichi Ohta, Yukihide Minoda & Hiroaki Nakamura

Authors
  1. Kentaro Iwakiri
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  2. Yoichi Ohta
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  3. Takashi Fujii
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  4. Yukihide Minoda
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  5. Akio Kobayashi
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  6. Hiroaki Nakamura
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Corresponding author

Correspondence to Kentaro Iwakiri.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This trial was registered as a trial with the University Hospital Medical Information Network (UMIN) registration number UMIN000034024.

Consent to participate

The study protocol was approved by the institutional review board, and all patients provided written informed consent to participate.

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Iwakiri, K., Ohta, Y., Fujii, T. et al. Changes in patient-perceived leg length discrepancy following total hip arthroplasty. Eur J Orthop Surg Traumatol 31, 1355–1361 (2021). https://doi.org/10.1007/s00590-021-02879-4

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  • DOI: https://doi.org/10.1007/s00590-021-02879-4

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