A Simple Method to Minimize Leg Length Discrepancy in Elective or Traumatic Arthroplasty of the Hip

Introduction:
One of the most common complication of hip arthroplasty is leg length discrepancy, this is a cause of dissatisfaction or malfunction for the patient and legal consequences for the surgeon. Preoperative planning, and intraoperative measures has shown an effective, low cost and simple method to decrease LLD.

Materials and Methods:
A total of 74 patients, whom 42 had an elective hip arthroplasty, and 32 had a hip arthroplasty for fracture between 2017-2019 were enrolled in this study. All had preoperative template planning using a digital software planning. We measured the distance from the top of lesser trochanter to the tip of the femoral stem in the antero-posterior pelvic X-ray view before the operation and we compared it to same per-operative measure as a predictive tool for improving the choice of implants and decrease the risk of leg length discrepancy. The intraoperative measures from lesser trochanter to tip of stem (LTTIP) were retrospectively analyzed. Database was searched for demographic, clinical, and imaging data. Variables were compared using ANOVA and linear correlation.

Results:
The mean pre-operative LTTIP was 52.27±3.2 mm, the mean intraoperative LTTIP = 54±2.8 mm. 39 patients (53%) had a height

Conclusion:
The measure from the lesser trochanter to the tip of the stem may be a simple, cost effective, accurate pre-operative and per-operative tool to decrease the risk of LLD choosing the right implants as well for elective and traumatic hip arthroplasty.