Patients with advanced hip arthritis can present with multifactorial limb length discrepancies (LLDs) owing to bony shortening from growth arrest, proximal hip migration, soft-tissue contractures, and pelvic obliquity. The patient perceives an LLD that is a combination of true LLD and apparent LLD.
We retrospectively reviewed 7 cases with multifactorial mean perceived LLD of 7.7 cm (range, 3.6-11 cm) that underwent primary total hip arthroplasty and auxiliary soft-tissue procedures. Perceived LLD, true LLD, and apparent LLD were defined and were compared before and after surgery in this cohort of patients with a mean follow-up of 57.4 months.
The mean perceived LLD at final follow-up was 1.0 ± 0.9 cm compared with that of 7.7 ± 2.6 cm preoperatively (P < .05). Postoperative true LLD was 0.7 ± 0.8 cm compared with that of 3.2 ± 0.8 cm preoperatively (P < .05). At final follow-up, all 7 patients were ambulating without any assistive devices and were satisfied with their surgical outcome.
With careful preoperative clinical and radiographic assessments as well as planning for multifactorial perceived LLD, this can be adequately corrected with primary total hip arthroplasty and auxiliary soft-tissue procedures resulting in good radiologic and functional outcomes.