TY - JOUR
T1 - Leg-length inequalities following THA based on surgical technique
AU - Nam, Denis
AU - Sculco, Peter K.
AU - Abdel, Matthew P.
AU - Alexiades, Michael M.
AU - Figgie, Mark P.
AU - Mayman, David J.
PY - 2013/4
Y1 - 2013/4
N2 - Leg-length inequality after total hip arthroplasty (THA) is a source of patient morbidity and concern, potentially contributing to nerve palsies, low back pain, and abnormal gait mechanics. The purpose of this study was to compare the degrees of leg-length inequality in patients undergoing primary THA via 3 surgical approaches: anterior, conventional posterior, and posterior-navigated (ie, using computer navigation). The authors reviewed the most recent 90 patients who underwent primary unilateral THA performed by a senior surgeon using an anterior, conventional posterior, or posterior-navigated approach. Measurements of leg-length inequality of the operative extremity were performed using interischial and interteardrop reference lines. One-way analysis of variance demonstrated no statistical difference in postoperative absolute leg-length inequality using interischial (P=.11) and interteardrop (P=.90) reference lines between the 3 approaches. In addition, no significant difference existed in the number of outliers in each cohort when measured relative to the interteardrop reference line. When a leg-length inequality more than 5 mm was considered an outlier, 31.1%, 20.0%, and 23.3% of patients in the anterior, conventional posterior, and posterior-navigated groups, respectively, were outliers (P values range, .12 to .71). Mean±SD absolute-leg-length inequality relative to the interteardrop reference line in the anterior, conventional posterior, and posterior-navigated groups were 3.8±3.9, 3.9±3.0, and 3.9±2.7 mm, respectively. The anterior and posterior-navigated approaches demonstrated no superiority over the conventional posterior approach; all methods provided reliable leg-length equalization.
AB - Leg-length inequality after total hip arthroplasty (THA) is a source of patient morbidity and concern, potentially contributing to nerve palsies, low back pain, and abnormal gait mechanics. The purpose of this study was to compare the degrees of leg-length inequality in patients undergoing primary THA via 3 surgical approaches: anterior, conventional posterior, and posterior-navigated (ie, using computer navigation). The authors reviewed the most recent 90 patients who underwent primary unilateral THA performed by a senior surgeon using an anterior, conventional posterior, or posterior-navigated approach. Measurements of leg-length inequality of the operative extremity were performed using interischial and interteardrop reference lines. One-way analysis of variance demonstrated no statistical difference in postoperative absolute leg-length inequality using interischial (P=.11) and interteardrop (P=.90) reference lines between the 3 approaches. In addition, no significant difference existed in the number of outliers in each cohort when measured relative to the interteardrop reference line. When a leg-length inequality more than 5 mm was considered an outlier, 31.1%, 20.0%, and 23.3% of patients in the anterior, conventional posterior, and posterior-navigated groups, respectively, were outliers (P values range, .12 to .71). Mean±SD absolute-leg-length inequality relative to the interteardrop reference line in the anterior, conventional posterior, and posterior-navigated groups were 3.8±3.9, 3.9±3.0, and 3.9±2.7 mm, respectively. The anterior and posterior-navigated approaches demonstrated no superiority over the conventional posterior approach; all methods provided reliable leg-length equalization.
UR - http://www.scopus.com/inward/record.url?scp=84877779280&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877779280&partnerID=8YFLogxK
U2 - 10.3928/01477447-20130327-11
DO - 10.3928/01477447-20130327-11
M3 - Review article
C2 - 23590775
AN - SCOPUS:84877779280
SN - 0147-7447
VL - 36
SP - e395-e400
JO - Orthopedics
JF - Orthopedics
IS - 4
ER -