Incidence of Leg-Length Discrepancy After Index Hinge Total Knee Arthroplasty.
LLD
TKA
hinge TKA
leg-length discrepancy
total knee arthroplasty
Journal
The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
06
08
2020
revised:
05
11
2020
accepted:
10
11
2020
pubmed:
23
12
2020
medline:
25
5
2021
entrez:
22
12
2020
Statut:
ppublish
Résumé
Leg-length discrepancies are not commonly associated with total knee arthroplasty (TKA); however, hinge TKA is a complex form of knee reconstruction where functionality of all knee ligaments is replaced by the TKA construct. The purpose of this study is to evaluate the incidence of leg-length discrepancies after unilateral index hinge TKA and association with patient outcomes. A retrospective review was performed of all patients who underwent unilateral index hinge TKA at a single academic institution from 1999 to 2019. Among 671 patients who underwent index hinge TKA, 188 (28%) had full-length standing anteroposterior hip-to-ankle radiographs available for review both preoperatively and postoperatively. All patients with a leg-length change ≥2 cm were also contacted with a standardized questionnaire to assess for complications. The mean age was 65 years, the mean body mass index was 33 kg/m The absolute mean and median change in leg lengths was 20 mm and 13 mm, respectively (range, 0-130 mm). Lengthening occurred in 119 (63%) patients compared with shortening in 69 (37%) patients. An absolute change in leg lengths ≥1 cm was observed in 109 (58%) patients, ≥2 cm in 63 (34%) patients, and ≥5 cm in 15 (8%) patients. Large changes in the leg length are common after hinge TKA, likely secondary to altered soft-tissue constraints. Surgeons should be cognizant of potential changes in the leg length in the setting of hinge TKA and incorporate this into preoperative planning and patient counseling. Level IV, therapeutic.
Sections du résumé
BACKGROUND
Leg-length discrepancies are not commonly associated with total knee arthroplasty (TKA); however, hinge TKA is a complex form of knee reconstruction where functionality of all knee ligaments is replaced by the TKA construct. The purpose of this study is to evaluate the incidence of leg-length discrepancies after unilateral index hinge TKA and association with patient outcomes.
METHODS
A retrospective review was performed of all patients who underwent unilateral index hinge TKA at a single academic institution from 1999 to 2019. Among 671 patients who underwent index hinge TKA, 188 (28%) had full-length standing anteroposterior hip-to-ankle radiographs available for review both preoperatively and postoperatively. All patients with a leg-length change ≥2 cm were also contacted with a standardized questionnaire to assess for complications. The mean age was 65 years, the mean body mass index was 33 kg/m
RESULTS
The absolute mean and median change in leg lengths was 20 mm and 13 mm, respectively (range, 0-130 mm). Lengthening occurred in 119 (63%) patients compared with shortening in 69 (37%) patients. An absolute change in leg lengths ≥1 cm was observed in 109 (58%) patients, ≥2 cm in 63 (34%) patients, and ≥5 cm in 15 (8%) patients.
CONCLUSION
Large changes in the leg length are common after hinge TKA, likely secondary to altered soft-tissue constraints. Surgeons should be cognizant of potential changes in the leg length in the setting of hinge TKA and incorporate this into preoperative planning and patient counseling.
LEVEL OF EVIDENCE
Level IV, therapeutic.
Identifiants
pubmed: 33349497
pii: S0883-5403(20)31209-2
doi: 10.1016/j.arth.2020.11.018
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1607-1610Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.