BACKGROUND Leg length discrepancy(LLD)following total hip arthroplasty(THA)is a common complaint,leading to decreased patient satisfaction.However,the effect of LLD before THA on outcomes and complications is not well...BACKGROUND Leg length discrepancy(LLD)following total hip arthroplasty(THA)is a common complaint,leading to decreased patient satisfaction.However,the effect of LLD before THA on outcomes and complications is not well defined.AIM To assess the effect of prior LLD on rates of falls,implant-related complications,stay length,readmissions,and implant survival following THA.METHODS A retrospective review of a nationwide insurance database was conducted from 2010 to 2021.All cases of THA and those with a prior diagnosis of LLD were identified.THA patients with LLD were matched to control patients 1:5 based on demographic and comorbidity profiles.Two-year fall rates and implant complications,lengths of stay,90-day readmissions,and time to revision were compared between cohorts.RESULTS A total of 2038 patients with LLD were matched to 10165 control patients.The LLD group showed significantly greater rates of falls[odds ratio(OR)=1.58;95%confidence interval(95%CI):1.24-2.01],dislocation(OR=2.61;95%CI:2.10-3.24),mechanical loosening(OR=4.58;95%CI:3.28-6.29),and periprosthetic fracture(OR=2.70;95%CI:1.96-3.72)compared to the control group(all P<0.001).Mean length of stay(LOS)was also significantly higher in the LLD group(3.1 days vs 2.8 days,P=0.034).No significant difference in 90-day readmission rates(7.75%vs 7.02%,P=0.244)was observed between the groups(P=0.244).Time to revision was significantly less in the LLD group(225 days vs 544 days,P<0.001).CONCLUSION LLD in patients having THA is related with significantly higher fall risk,rates of implant-related complications,LOS,and quicker time to revision.Identifying patients with LLD before their THA may help in identifying risks,better patient counselling,and more effective preoperative planning.However,the study have important limitations:Its design lacks information on the degree and cause of LLD,the time between diagnosis and surgery,and which leg with the discrepancy underwent the operation.Future well-designed studies should confirm the findings of this study.展开更多
Background：Total hip arthroplasty （THA） is one of the most effective treatments for phase Ⅲ and Ⅳ hip arthrosis.Lower limb length balancing is one of the determining factors of a successful surgery,particularly i...Background：Total hip arthroplasty （THA） is one of the most effective treatments for phase Ⅲ and Ⅳ hip arthrosis.Lower limb length balancing is one of the determining factors of a successful surgery,particularly in patients with developmental dysplasia of the hip （DDH）.The purpose of this study was to evaluate the postoperative change in intra-pelvic obliquity （intra-PO） angle in the coronal plane and its effects on leg length discrepancy （LLD） within 2 years.Methods：A total of 78 patients （70 females,8 males） were enrolled in this study.All patients were suffering from DDH with varying degrees of LLD.Pelvic plain radiographs were collected before and after the operation.The intra-PO angles were measured 0,0.5,1 and 2 years after THA.At the same time,postoperative LLD was measured with blocking test.Results：PO changed significantly in the first year after THA surgery （0 year vs.0.5 year,P 〈 0.01;0.5 year vs.1 year,P 〈 0.01）,and the changing value of intra-PO angle （△PO） slowed down substantially during the first 2 years after THA （0.5 year vs.0.5-1 year,P 〈 0.01;0.5-1 year vs.1-2 years,P 〈 0.01）.With the change in intra-PO angle,LLD also got narrow within the 1st year （0 year vs.0.5 year,P 〈 0.01;0.5 year vs.1 year,P 〈 0.01）.Elderly patients had a smaller intra-PO angle reduction （Group A vs.Group B,P =0.01;Group B vs.Group C,P〈 0.01）.Conclusions：Intra-PO angle and LLD gap narrowed with time after THA surgery.In particular,elderly patients had smaller change in intra-PO angle.展开更多
<span style="font-family:Verdana;">The purpose of this paper is to review relevant literature concerning limb length inequalities in adults and to make recommendations for assessment and intervention b...<span style="font-family:Verdana;">The purpose of this paper is to review relevant literature concerning limb length inequalities in adults and to make recommendations for assessment and intervention based on the literature and our own clinical experience. The research was carr</span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ied</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> out on PUB MED, Non-English articles and duplicates in the databases were not included. Limb length inequality and common classification criteria are defined and etiological factors are present. Common methods of detecting limb length inequality include model manual technics. </span><span style="font-family:Verdana;">This work has the purpose of describing a well standardized therapeutic in the form of practical guidance. The approach we describe provides standardized model evaluation for leg lower limb in order to be used in rehabilitation </span><span style="font-family:Verdana;">clinic.</span></span></span></span>展开更多
文摘BACKGROUND Leg length discrepancy(LLD)following total hip arthroplasty(THA)is a common complaint,leading to decreased patient satisfaction.However,the effect of LLD before THA on outcomes and complications is not well defined.AIM To assess the effect of prior LLD on rates of falls,implant-related complications,stay length,readmissions,and implant survival following THA.METHODS A retrospective review of a nationwide insurance database was conducted from 2010 to 2021.All cases of THA and those with a prior diagnosis of LLD were identified.THA patients with LLD were matched to control patients 1:5 based on demographic and comorbidity profiles.Two-year fall rates and implant complications,lengths of stay,90-day readmissions,and time to revision were compared between cohorts.RESULTS A total of 2038 patients with LLD were matched to 10165 control patients.The LLD group showed significantly greater rates of falls[odds ratio(OR)=1.58;95%confidence interval(95%CI):1.24-2.01],dislocation(OR=2.61;95%CI:2.10-3.24),mechanical loosening(OR=4.58;95%CI:3.28-6.29),and periprosthetic fracture(OR=2.70;95%CI:1.96-3.72)compared to the control group(all P<0.001).Mean length of stay(LOS)was also significantly higher in the LLD group(3.1 days vs 2.8 days,P=0.034).No significant difference in 90-day readmission rates(7.75%vs 7.02%,P=0.244)was observed between the groups(P=0.244).Time to revision was significantly less in the LLD group(225 days vs 544 days,P<0.001).CONCLUSION LLD in patients having THA is related with significantly higher fall risk,rates of implant-related complications,LOS,and quicker time to revision.Identifying patients with LLD before their THA may help in identifying risks,better patient counselling,and more effective preoperative planning.However,the study have important limitations:Its design lacks information on the degree and cause of LLD,the time between diagnosis and surgery,and which leg with the discrepancy underwent the operation.Future well-designed studies should confirm the findings of this study.
文摘Background：Total hip arthroplasty （THA） is one of the most effective treatments for phase Ⅲ and Ⅳ hip arthrosis.Lower limb length balancing is one of the determining factors of a successful surgery,particularly in patients with developmental dysplasia of the hip （DDH）.The purpose of this study was to evaluate the postoperative change in intra-pelvic obliquity （intra-PO） angle in the coronal plane and its effects on leg length discrepancy （LLD） within 2 years.Methods：A total of 78 patients （70 females,8 males） were enrolled in this study.All patients were suffering from DDH with varying degrees of LLD.Pelvic plain radiographs were collected before and after the operation.The intra-PO angles were measured 0,0.5,1 and 2 years after THA.At the same time,postoperative LLD was measured with blocking test.Results：PO changed significantly in the first year after THA surgery （0 year vs.0.5 year,P 〈 0.01;0.5 year vs.1 year,P 〈 0.01）,and the changing value of intra-PO angle （△PO） slowed down substantially during the first 2 years after THA （0.5 year vs.0.5-1 year,P 〈 0.01;0.5-1 year vs.1-2 years,P 〈 0.01）.With the change in intra-PO angle,LLD also got narrow within the 1st year （0 year vs.0.5 year,P 〈 0.01;0.5 year vs.1 year,P 〈 0.01）.Elderly patients had a smaller intra-PO angle reduction （Group A vs.Group B,P =0.01;Group B vs.Group C,P〈 0.01）.Conclusions：Intra-PO angle and LLD gap narrowed with time after THA surgery.In particular,elderly patients had smaller change in intra-PO angle.
文摘<span style="font-family:Verdana;">The purpose of this paper is to review relevant literature concerning limb length inequalities in adults and to make recommendations for assessment and intervention based on the literature and our own clinical experience. The research was carr</span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ied</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> out on PUB MED, Non-English articles and duplicates in the databases were not included. Limb length inequality and common classification criteria are defined and etiological factors are present. Common methods of detecting limb length inequality include model manual technics. </span><span style="font-family:Verdana;">This work has the purpose of describing a well standardized therapeutic in the form of practical guidance. The approach we describe provides standardized model evaluation for leg lower limb in order to be used in rehabilitation </span><span style="font-family:Verdana;">clinic.</span></span></span></span>
