Leg Length Discrepancy after Total Hip Arthroplasty

ABSTRACT

Restoration of the hip biomechanics, including the femoral offset and leg length, are the desired goals when performing total hip arthroplasty. A leg length discrepancy following total hip arthroplasty is a significant source of back pain and sciatica, gait disorders, general dissatisfaction and dislocation. Significant lengthening of the leg can be a risk factor for nerve injury and it is a relatively common cause of litigation. There is a fundamental interrelationship between leg length and stability when performing hip arthroplasty. There are a multitude of situations in which achieving both stability and perfectly equal leg lengths is simply not possible. Stability is the primary objective, and the surgeon may need to sacrifice leg length equality on the altar of stability. Although a leg length discrepancy cannot be eliminated after hip arthroplasty, it can be minimized through a series of steps, including a physical examination, radiographic evaluation, preoperative templating and intraoperative confirmation of the preoperative plan.