Determinants of Limb Length Discrepancy in Total Hip Arthroplasty A cohort Study in tertiary care hospital

Abstract

Background: Leg-length inequality (LLD) is a common cause of limping after Total Hip Arthroplasty (THA), leading to various issues like patient dissatisfaction, legal disputes, complications, and even the need for revision surgery. Achieving geometrically equal leg lengths in all patients may not always be feasible due to individual anatomical differences and complexities. Balancing stability and function are crucial, and in some cases, prioritizing stability may require sacrificing perfect leg-length equality. There is still a lack of consensus on the clinically significant threshold for LLD, and the perception of LLD decreasing with time after surgery lacks sufficient evidence. The absence of standardized criteria and assessment methods for LLD makes evaluating intraoperative LLD and stability challenging, as different tests rely on the surgeon's perspective. To ensure successful outcomes, a thorough understanding and measurement of LLD before, during, and after surgery is essential. Restoration of LLD and addressing its variations are vital aspects of THA to optimize patient satisfaction and functional results. Managing expectations and educating both patients and surgeons about the potential issue of leg-length discrepancy post-surgery is crucial for achieving successful outcomes. Objectives: The objectives of the study were to determine the determinants of (LLD) limb length discrepancy in total hip arthroplasty and identify influential variables affecting the change in LLD from preoperative to postoperative period and to assess xxiii the effect of LLD on functional outcomes using radiographic evaluation, subjective patient reported outcomes and objective clinical assessment.