Object
Title: Influence of the leg length discrepancy on the clinical outcome in patients after hip arthroplasty
Abstract:
Introduction: Leg length discrepancy (LLD) following total hip arthroplasty (THA) is a common problem and can result in a limp, lower back pain, nerve palsy, hip instability and general patient dissatisfaction. Aim of the study: The aim of this study was to determine the influence of LLD on the clinical outcome in patients after THA. The correlation between methods of preoperative LLD measurements and subjective LLD was assessed. The correlation between the hip offset and LLD and clinical outcomes was also investigated. Material and methods: 96 patients with unilateral osteoarthritis of the hip were prospectively studied before, 3, 6 and 12 months after surgery. The block test was used for a clinical evaluation and the full leg-lengths X-ray was used for an anatomical evaluation of LLD. The functional results of THA were measured by the Oxford Hip Score (OHS) questionnaire, frequency of limping and gait tests: Walking Speed (WS) and Timed Up and Go (TUG). Pain was measured by VAS scale. The Δ LLD index as the difference between postoperative and preoperative LLD was used to assess the correlation between the subjective and anatomical LLD. The coefficient of change in lower limb length (WZDK) measured as the quotient of Δ LLD / anatomical length of the affected limb before surgery was used to assess the correlation between the subjective and anatomical LLD. The hip offset was ; measured on the full leg-lengths X-ray as a sum of the femoral and acetabular offset. Results: The mean postoperative clinical and anatomical LLD was 3 mm and 5 mm, respectively. The correlation between clinical and anatomical LLD before surgery was average and improved to high after surgery. Significantly worse functional result measured by OHS was obtained in the group of patients with anatomically shortened legs, as well as in patients subjectively experiencing LLD. A significantly greater frequency of limping and a slower WS have been demonstrated in people with limb inequality. In people with an anatomical LLD of up to 5 mm, only 6% felt the limb inequality, as opposed to 43% over 5 mm. There was a significant difference in the Δ LLD index between the groups of patients with and without LLD, and it was 9 mm and 4 mm, respectively. It has also been shown that a 1,1% change in WZDK is not felt as LLD, while a 2% change is. There were no significant correlations between the hip offset and the clinical or subjective difference in limb length, as well as functional outcomes. Conclusions: The leg length discrepancy influences the clinical outcome after hip arthroplasty and anatomical LLD up to 5 mm is recommended. The subjective LLD, apart from the anatomical LLD, also depends on the Δ LLD index and WZDK ratio. The block test is recommended for the LLD clinical trial. Prior ; to surgery, patients should be informed of the possible difference in leg length and its consequences.
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Rada Dyscypliny Nauki medyczne
Promoter:
Wilk-Frańczuk, Magdalena ; Zieliński, Paweł
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Last modified:
Apr 8, 2024
In our library since:
Dec 13, 2022
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104
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57
All available object's versions:
http://dl.cm-uj.krakow.pl:8080/publication/4906
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| Edition name | Date |
|---|---|
| ZB-136007 | Apr 8, 2024 |
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