Multicenter survey about leg length discrepancy and total hip arthroplasty: preoperative and intraoperative management

Author:

Stimolo DavideORCID,Lo Giudice Salvatore,Matassi Fabrizio,Innocenti MatteoORCID,Civinini Roberto,Boniforti Filippo

Abstract

Abstract Background We created a multicenter survey for Italian orthopedic surgeons on how they approach leg length discrepancy (LLD) when dealing with primary total hip arthroplasty. Aim of the study was to show how surgeons manage LLD and follow the literature recommendations during clinical practice. Methods The survey was composed of 25 questions divided into four sections: 1—surgeon’s profile, 2—preoperative and 3—intraoperative evaluation, and 4—postoperative management. In this paper, we report results to answer Sects. 1 and 2. Absolute and relative frequencies of answers to Sects. 2 and 3 are reported. We divided the participants in subgroups based on the “surgeon’s profile” and evaluated difference in the answers given. Results Absolute and relative frequencies demonstrate low agreement among participants in all phases of LLD management. We demonstrated a statistically significant difference based on the surgeon’s profile regarding these questions: radiographic measure of LLD depending on working experience, p = 0.008; digital planning based on surgeons’ age, p < 0.001, and workplace, p = 0.026; intraoperative anatomical landmarks based on numbers of procedures per year, p = 0.020; and use of intraoperative X-rays based on working experience, p = 0.002. Conclusions LLD is a debated topic with no definitive recommendations. Many decisions still depend on tradition and surgeons’ preference.

Funder

Università degli Studi di Firenze

Publisher

Springer Science and Business Media LLC

Reference19 articles.

1. Konyves A, Bannister GC (2005) The importance of leg length discrepancy after total hip arthroplasty. J Bone Joint Surg [Br] 87(2):155–162

2. Edeen J, Sharkey PF, Alexander AH (1995) Clinical significance of leg-length inequality after total hip arthroplasty. Am J Orthop (Belle Mead NJ) 24(4):347–351

3. Flecher X, Ollivier M, Argenson JN (2016) Lower limb length and offset in total hip arthroplasty. Vol. 102, Orthopaedics and Traumatology: Surgery and Research, Elsevier Masson SAS. pp. S9–20.

4. Gurney B (2022) Leg length discrepancy [Internet]. Vol. 15, Gait and Posture. 2002. Available from: www.elsevier.com/locate/gaitpost

5. Faldini C (2023) Leg length discrepancy after primary total hip replacement, vol 107. Musculoskeletal Surgery. Springer Nature, Berlin, pp 1–5

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