Abstract
The aim of this postal survey was to determine the prevalence and impact of patient-perceived leg length discrepancy (LLD) at 5–8 years after primary total hip replacement (THR). A postal audit survey was undertaken of all consecutive patients who had a primary unilateral THR at one elective orthopaedic centre between April 1993 and April 1996. The questionnaire included the Oxford hip score (OHS) and questions about LLD. Questionnaires were received from 1,114 patients. In total, 329 THR patients (30%) reported an LLD, although radiographic analysis revealed that only 36% of these patients had anatomical LLD. Patients with a perceived LLD had a significantly poorer OHS (p < 0.001) and reported more limping than those patients without a perceived LLD. This study found that a third of patients perceived an LLD after THR and that perceived LLD was associated with a significantly poorer midterm functional outcome.
Résumé
Le but de cette étude est de déterminer l’impact et la perception des patients secondaires à une inégalité de longueur (LLD) entre 5 et 8 ans de recul après une prothèse totale de hanche. Matériel et méthode: Nous avons réalisé une enquête postale concernant une série consécutive de patients ayant bénéficié d’une prothèse totale de hanche unilatérale réalisée dans notre centre entre avril 1993 et avril 1996. Ce questionnaire incluait par ailleurs le score d’Oxford (OHS) et des questions concernant cette inégalité de longueur. Résultats: ces questionnaires ont été reçus par 1 114 patients. Au total 329 (30%) rapportaient une inégalité de longueur mais, l’analyse radiographique montrait que seulement 36% de ces 30% avaient une véritable inégalité de longueur anatomique. Les patients qui se plaignent d’une inégalité de longueur après prothèse totale de hanche ont un score d’OHS significativement plus bas que les autres (p < 0.001) et une boiterie de durée plus longue si on la compare à ceux qui ne se déclarent pas porteur d’une inégalité de longueur. En conclusion, cette étude montre qu’un tiers des patients se plaignent d’une inégalité de longueur après prothèse totale de hanche et que cette inégalité de longueur est associée à une résultat fonctionnel significativement plus bas que celui des patients sans inégalité de longueur.
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Wylde, V., Whitehouse, S.L., Taylor, A.H. et al. Prevalence and functional impact of patient-perceived leg length discrepancy after hip replacement. International Orthopaedics (SICOT) 33, 905–909 (2009). https://doi.org/10.1007/s00264-008-0563-6
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DOI: https://doi.org/10.1007/s00264-008-0563-6