Dr. Dhanush SM, Dr. Raju KP, Dr. Vani Ahuja and Dr. Savitha Rani BB
Introduction: Pelvic radiographs are helpful in assessing limb-length discrepancy (LLD) before and after Total Hip Replacement (THR), but are subject to variation. Different methods are used to determine LLDs. As a pelvic reference, both ischial tuberosities and the teardrops are used, and as a femoral reference, the lesser trochanter and center of the femoral head are used.
Methods: We evaluated 20 cases undergoing THR for degenerative arthritis at BGS GIMS Kengeri from July 2022 to January 2024. Radiological assessment was done for LLD using digital x-rays preoperatively and postoperatively (On digital X-ray AP view of hip, a line is drawn at the level of & parallel to inter teardrop area and intersecting the lesser trochanter on each side. Compare 2 points of intersection & measure difference to determine the amount of limb discrepancy). Functional assessment was done using Harris hip score.
Results: The majority (12 of 20; 60%) of limbs were lengthened in the course of THR. Before the surgery, leg length discrepancy of involved hip ranged from -2.1cm to 0 cm (mean, 0.865cm short) compared with unaffected side. After reconstruction, the leg length discrepancy ranged from -0.2 cm to 1.9cm (mean, 0.01 cm). The mean increase in leg length after surgery was 0.845cm.
Harris hip score preoperatively was poor in 11, fair in 9, which had improved post operatively to good in 11, fair in 7 and poor outcome in 2 patients. At 1 year follow up Harris hip score was excellent in 7, good in 9, fair in 2 and poor in 2 patients.
Conclusion: Use of radiological measurement of Limb Length Discrepancy using inter teardrop as pelvic reference and lesser trochanter as femoral reference is a reliable and cost effective method.
Pages: 01-05 | 217 Views 79 Downloads