Dataset Information

Influence of leg length inequalities on pelvis and spine in patients with total hip arthroplasty.

ABSTRACT:

Background

Leg length inequalities (LLIs) are a common finding in patients with a total hip arthroplasty (THA). Therefore, we compared the effects of simulated LLIs in patients with total hip arthroplasty (THA) with a matched control group.

Research question

Do LLIs lead to different effects on the musculoskeletal apparatus of patients with a THA then in a control group?

Methods

In 99 patients with a THA the effects of simulated LLIs were compared to a matched control group of 101 subjects without a hip arthroplasty. First, we compared methods for LLI quantification (tape measurements, pelvic x- ray and rasterstereography). Second, the effects of simulated LLIs on the spine and pelvis were evaluated in both groups using surface topography. LLIs of 5, 10, 15, 20 and 30 mm were simulated on both sides with a simulation platform. The changes of pelvic position (pelvic obliquity & pelvic torsion) and the effects on spinal posture (surface rotation & lateral deviation) were measured and analysed using a surface topography system.

Results

Mean LLI measured with a tape was 0.9 mm (SD +/- 14.8). Mean pelvic obliquity measured on x-rays was 1.2 mm (SD +/- 11.6) and with surface topography 0.9 mm (SD +/- 7.9). Simulated LLIs resulted in significant changes of pelvic position and spinal posture in the patient and control group. Interestingly, our study showed that simulated LLIs lead to greater changes in pelvic position (p<0.05) in patients with a THA.

Significance

This is the first study to demonstrate that LLIs might have a greater impact on the pelvic position of THA patients than in native hips, which could indicate that LLIs do need to be compensated differently in patients with THA than in patients without a THA.

SUBMITTER: Betsch M

PROVIDER: S-EPMC6711516 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Influence of leg length inequalities on pelvis and spine in patients with total hip arthroplasty.

Betsch Marcel M Michalik Roman R Graber Maximilian M Wild Michael M Krauspe Rüdiger R Zilkens Christoph C

PloS one 20190827 8

<h4>Background</h4>Leg length inequalities (LLIs) are a common finding in patients with a total hip arthroplasty (THA). Therefore, we compared the effects of simulated LLIs in patients with total hip arthroplasty (THA) with a matched control group.<h4>Research question</h4>Do LLIs lead to different effects on the musculoskeletal apparatus of patients with a THA then in a control group?<h4>Methods</h4>In 99 patients with a THA the effects of simulated LLIs were compared to a matched control group ...[more]

PMID: 31454389

Similar Datasets

Project description:BackgroundLeg-length discrepancy (LLD) after primary THA is not uncommon. Little is known, however, about the role of hip-sparing procedures for equalization of LLD after THA.Questions/purposesThe aim of this study is to report our experiences with these techniques in patients presenting at one institution over a 10-year period.MethodsWe retrospectively reviewed records at one institution to find patients who had sought surgical treatment for LLD after THA between January 2007 and August 2017. Patients who had LLD related to conditions other than the THA, such as bone loss or traumatic defects, were excluded. We recorded the time after THA, laterality, and LLD. Assessment of LLD was performed using clinical and radiographic examinations. Patient demographics and true LLD were recorded, as were prior conservative treatment, equalization procedure performed, final leg length after equalization surgery, time to healing, and complications.ResultsAfter exclusion of patients with LLD related to other causes, eight patients in whom conservative treatment had failed and who had undergone hip-sparing leg-length equalization surgery were included in the study. The average age was 44.6 years (range, 18 to 66 years). Seven of the patients were female. The pre-operative mean LLD was 3.1 cm (range 1.5 to 7 cm). In those who were long after THA, ipsilateral (THA-side) shortening of femur with a retrograde intramedullary nail (IMN; n = 1) or with a plate (n = 1) was performed. In those who were short after THA, ipsilateral femur lengthening with retrograde Precice nails (n = 2), ipsilateral tibial lengthening with Precice nails (n = 2), or contralateral femur shortening with a retrograde IMN (n = 2) was performed. The average time to full consolidation or union was 6.6 months (range, 2 to 19 months). Two patients had delayed union. All patients but one were satisfied with final results.ConclusionWe believe that hip-sparing equalization procedures can be part of the treatment algorithm of LLD after THA. These advancements in the field are promising and might expand the indications of lengthening and equalization procedures to include LLD after THA.

Dataset Information

Influence of leg length inequalities on pelvis and spine in patients with total hip arthroplasty.

Background

Research question

Methods

Results

Significance

Publications

Influence of leg length inequalities on pelvis and spine in patients with total hip arthroplasty.

Similar Datasets

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