Abstract
Background
In some cases, patients feel a perceived leg length discrepancy (P-LLD) despite no
radiographic leg length discrepancy (R-LLD) after total hip arthroplasty (THA). We
aimed to investigate the rate of postoperative P-LLD and the factors that cause postoperative
P-LLD.
Methods
A retrospective study was conducted on 100 patients with R-LLD ≤5 mm after THA. Patients
were classified into two groups based on P-LLD post-THA: group P (with P-LLD) and
group E (without P-LLD). Relevant data on the general characteristics and radiological
findings between the two groups were compared.
Results
We observed that 25 & 75% of patients belonged to group P and group E, respectively,
with no significant difference in patient background. Postoperative Japanese Orthopedic
Association (JOA) classification of pain and activities of daily living scores were
significantly lower in group P than in group E (37.2 ± 3.9 vs. 39.1 ± 2.2, respectively;
P = 0.013, and 16.2 ± 4.2 vs. 18.2 ± 2.2, respectively; P = 0.011). The preoperative
pelvic oblique angle (POA) was significantly larger in group P than in group E (3.3 ± 2.3°
vs. −0.2 ± 2.1°; respectively; P < 0.01). The pelvis tilted toward the surgical side
was significantly higher in group P than in group E(88% vs 57%; respectively; P = 0.013).
The preoperative C7 coronal vertical axis (C7 CVA) was significantly larger in group
P than in group E (6.7 ± 14.7 mm vs. −0.2 ± 10.3 mm; respectively; P = 0.028). Multivariate
logistic analysis revealed that preoperative POA (OR, 3.71; 95% CI: 1.86–8.12; P < 0.01)
and the pelvis tilted toward the surgical side (OR, 4.14; 95% CI: 2.07–9.71; P = 0.022)
were independent risk factors for P-LLD after THA.
Conclusion
Even though there was no postoperative R-LLD, 25% of patients had P-LLD. A large preoperative
POA and the pelvis tilted toward the surgical side were independent risk factors for
P-LLD after THA.
Keywords
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Article info
Publication history
Published online: February 24, 2023
Accepted:
January 31,
2023
Received in revised form:
December 20,
2022
Received:
October 20,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
