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Minimizing Leg-Length Inequality in Total Hip Arthroplasty: Use of Preoperative Templating and an Intraoperative X-Ray
Am J Orthop. 2008 January;37(1):18-23
Author and Disclosure Information
Aaron A. Hofmann, MD, Michael Bolognesi, MD, Amit Lahav, MD, and Stephen Kurtin, MD
Dr. Hofmann is Professor, Department of Orthopaedic Surgery, University of Utah Medical Center, Salt Lake City, Utah.
Dr. Bolognesi is Assistant Professor of Surgery, Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Dr. Lahav is Attending Orthopedic Surgeon, Milford Hospital, Milford, Connecticut.
Dr. Kurtin is Orthopedic Surgeon, North Phoenix Orthopedic Surgeons, Phoenix, Arizona.
Leg-length inequality after total hip arthroplasty remains a controversial issue. In the study reported here, we sought to determine whether significant leg-length discrepancies (>6 mm) can be minimized with use of an intraoperative x-ray. In each case, preoperative templating was carefully performed, an intraoperative pelvis x-ray was obtained to assess accuracy, and appropriate adjustments were made. Eighty-six consecutive primary total hip arthroplasties and their associated x-rays were retrospectively reviewed. Mean postoperative leg-length discrepancy was 0.3 mm (SD, 2.6 mm; range, –6 to +6 mm). No legs were lengthened or shortened by more than 6 mm. Significant leg-length discrepancies can be minimized with use of an intraoperative pelvis x-ray.