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LIMB LENGTH DISCREPANCY AFTER TOTAL HIP ARTHROPLASTY



Abstract

We evaluated 100 patients in two separate groups of 50 patients for Limb Length Discrepancy after Charnley Total Hip Arthroplasty. The study was a retrospective analysis of the group considered. Group 1 included 50 consecutive patients with unilateral disease who underwent total hip arthroplasty between June 98 – June 99 without intraoperative measurement. Group II included 50 patients with unilateral disease who underwent total hip arthroplasty between June 98 – July 99 with pre-operative templating and intraoperative measurements.

Evaluation was undertaken with radiographs using the method of Williamson and Reckling. Two independent observers evaluated pre-operative radiographs and postoperative radiographs taken at a mean of 3 months (6 weeks – 6 months). The inter-oberserver variation was found in 9 preoperative radiographs and 15 postoperative radiographs in the 100 patients (p< 0.6). The mean age of the patients in Group I was 71 years and 4 months (52–83 years) with 24 males and 26 females. The mean age of patients in group II was 69 years and 7 months (41–82 years) with 25 males and 25 females. 23 patients (46%) in group I had a discrepancy of which 19 patients (38%) had a mean increase of o.4cm (0.1–0.8cm) and 4 patients (8%) had a mean decrease in length of 0.325cm (0.2–1.1cm). In group II 14 patients (28%) had a discrepancy with 9 patients (18%) had an mean increase of 0.41cm(0.1–1cm) and a mean decrease of 0.3cm(0.1–0.6cm).

The discrepancy found in our series of 100 patients in minimal. The discrepancy can be minimised to a further extend with pre operative templating and intraoperative measurements (p< 0.04). Our study supports the adoption of this to prevent limb length discrepancy after total hip arthroplasty.

The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at the Irish Orthopaedic Association, Secretariat, c/o Cappagh Orthopaedic Hospital, Finglas, Dublin