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Leg length discrepancy and lower limb alignment after total hip arthroplasty in unilateral hip osteoarthritis patients

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Leg length discrepancy (LLD) following total hip arthroplasty (THA) is a leading cause of patient dissatisfaction. However, no reports have described the influence of lower limb alignment on LLD after THA. In the present study, we firstly investigated the change in lower limb alignment after THA. Secondly, we determined the influence of lower limb alignment on LLD after THA. Thirdly, we evaluated the influence of LLD in the entire lower leg on the clinical outcomes after THA.

Methods

We followed up with 54 unilateral hip osteoarthritis (OA) patients 1 year after THA. For the radiological assessment of LLD and lower limb alignment, we obtained anteroposterior radiographs of the pelvis and both lower legs in entirety in a standing position before and 1 year after THA. The Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) were also obtained to assess the clinical outcome.

Resuts

The alignment of the affected leg, which was more valgus than the unaffected leg before THA, tended toward varus after THA, and the discrepancy between the lower limb alignments on both sides decreased. However, the alignment discrepancies that remained after THA influenced the LLD measured on the radiograph of the entire lower leg, and this LLD influenced the clinical outcome as measured by the HHS and the WOMAC score.

Conclusions

LLD in the entire lower leg should be corrected for a better clinical outcome after THA.

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Acknowledgments

We thank the following people for their contributions: Yohei Yukizawa, Chie Aoki, Hyonmin Choe, Hiroyuki Ike, Takako Momose, Yushi Miyamae, Haruka Suzuki, Masamitsu Tomioka, So Kubota, Yurika Ata, Masatoshi Oba, and all of the participating orthopedic surgeons at Yokohama City University.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Hiroshi Fujimaki, Yutaka Inaba, Naomi Kobayashi, Taro Tezuka, Yasuhide Hirata & Tomoyuki Saito

Authors
  1. Hiroshi Fujimaki
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  2. Yutaka Inaba
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  3. Naomi Kobayashi
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  4. Taro Tezuka
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  5. Yasuhide Hirata
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  6. Tomoyuki Saito
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Corresponding author

Correspondence to Yutaka Inaba.

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Fujimaki, H., Inaba, Y., Kobayashi, N. et al. Leg length discrepancy and lower limb alignment after total hip arthroplasty in unilateral hip osteoarthritis patients. J Orthop Sci 18, 969–976 (2013). https://doi.org/10.1007/s00776-013-0457-3

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  • DOI: https://doi.org/10.1007/s00776-013-0457-3

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