Multicenter survey about leg length discrepancy and total hip arthroplasty: preoperative and intraoperative management.
Complications
LLD
Leg length discrepancy
Survey
Total hip arthroplasty
Journal
Musculoskeletal surgery
ISSN: 2035-5114
Titre abrégé: Musculoskelet Surg
Pays: Italy
ID NLM: 101498346
Informations de publication
Date de publication:
05 Jul 2024
05 Jul 2024
Historique:
received:
14
01
2024
accepted:
15
05
2024
medline:
5
7
2024
pubmed:
5
7
2024
entrez:
5
7
2024
Statut:
aheadofprint
Résumé
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. 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. 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. LLD is a debated topic with no definitive recommendations. Many decisions still depend on tradition and surgeons' preference.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
LLD is a debated topic with no definitive recommendations. Many decisions still depend on tradition and surgeons' preference.
Identifiants
pubmed: 38967771
doi: 10.1007/s12306-024-00837-x
pii: 10.1007/s12306-024-00837-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Konyves A, Bannister GC (2005) The importance of leg length discrepancy after total hip arthroplasty. J Bone Joint Surg [Br] 87(2):155–162
doi: 10.1302/0301-620X.87B2.14878
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
pubmed: 7788314
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.
Gurney B (2022) Leg length discrepancy [Internet]. Vol. 15, Gait and Posture. 2002. Available from: www.elsevier.com/locate/gaitpost
Faldini C (2023) Leg length discrepancy after primary total hip replacement, vol 107. Musculoskeletal Surgery. Springer Nature, Berlin, pp 1–5
Tian R, Duan X, Kong N, Wang K, Yang P (2023) Precise acetabular positioning, discrepancy in leg length, and hip offset using a new seven-axis robot-assisted total hip arthroplasty system requires no learning curve: a retrospective study. J Orthop Surg Res 18(1):236
doi: 10.1186/s13018-023-03735-3
pubmed: 36964615
pmcid: 10037797
Laggner R, Oktarina A, Windhager R, Bostrom MPG (2023) Changes in leg length and hip offset in navigated imageless vs. conventional total hip arthroplasty. Sci Rep 13(1):171614
doi: 10.1038/s41598-023-44009-6
Kim MJ, Choi YH, Lee SB, Cho YJ, Lee SH, Shin CH et al (2022) Development and evaluation of deep-learning measurement of leg length discrepancy: bilateral iliac crest height difference measurement. Pediatr Radiol 52(11):2197–2205
doi: 10.1007/s00247-022-05499-0
pubmed: 36121497
Paley D (2003) Principles of deformity correction, 2nd edn. Springer-Verlag, Berlin
Ng VY, Kean JR, Glassman AH (2013) Current concepts review, limb-length discrepancy after hip arthroplasty. J Bone Joint Surg 95(15):1426–1436
doi: 10.2106/JBJS.L.00433
pubmed: 23925749
McWilliams AB, Grainger AJ, O’Connor PJ, Redmond AC, Stewart TD, Stone MH (2012) Assessing reproducibility for radiographic measurement of leg length inequality after total hip replacement. Hip Int 22(5):539–544
doi: 10.5301/HIP.2012.9751
pubmed: 23100154
Meermans G, Malik A, Witt J, Haddad F (2011) Preoperative radiographic assessment of limb-length discrepancy in total hip arthroplasty. Clin Orthop Relat Res 469(6):1677–1682
doi: 10.1007/s11999-010-1588-x
pubmed: 20878559
Tipton SC, Sutherland JK, Schwarzkopf R (2016) The assessment of limb length discrepancy before total hip arthroplasty. J Arthroplasty 31(4):888–892
doi: 10.1016/j.arth.2015.10.026
pubmed: 26614748
Clark CR, Huddleston HD, Schoch EP, Thomas BJ (2006) Leg-length discrepancy after total hip arthroplasty
Sculco PK, Cottino U, Abdel MP, Sierra RJ (2016) Avoiding Hip Instability and Limb Length Discrepancy After Total Hip Arthroplasty, vol 47. Orthopedic Clinics of North America. W.B. Saunders, Philadelphia, pp 327–334
Hofmann AA, Bolognesi M, Lahav A, Kurtin S (2008) Minimizing leg-length inequality in total hip arthroplasty: use of preoperative templating and an intraoperative X-ray. Am J Orthop (Belle Mead NJ) 37(1):18–23
pubmed: 18309380
McWilliams AB, Grainger AJ, O’Connor PJ, Redmond AC, Stewart TD, Stone MH (2013) A review of symptomatic leg length inequality following total hip arthroplasty. Hip Int 23(1):6–14
doi: 10.5301/HIP.2013.10631
pubmed: 23397200
Kuroda K, Kabata T, Maeda T, Kajino Y, Tsuchiya H (2014) Do we need intraoperative radiographs for positioning the femoral component in total hip arthroplasty? Arch Orthop Trauma Surg 134(5):727–733
doi: 10.1007/s00402-014-1962-3
pubmed: 24599549
Di Martino A, Stefanini N, Brunello M, Bordini B, Pilla F, Geraci G et al (2023) Is the direct anterior approach for total hip arthroplasty effective in obese patients? Early clinical and radiographic results from a retrospective comparative study. Medicina (Lithuania). 59(4):769
pmcid: 10145216