Assessment of restoration of leg length and femoral offset after total hip arthroplasty

Background Total hip arthroplasty has proven to be one of the most successful operations done in orthopedic surgery. Preoperative planning, including meticulous history, examination, and preoperative templating, is quite important and must be done to all cases as a routine. Numerous studies used surrogates for clinical success rates that included satisfaction of the patient, reduced pain, improvement of function, and the absence of the need for further surgery. Minimizing leg-length discrepancy and restoring offset to normal is very important for good functional outcome, patient satisfaction, and quality of life. Aim of the study Radiological and functional assessment of restoring the leg length and hip offset after total hip replacement. Also, to compare different methods used to decrease leg-length discrepancy with the method used in this study. Patients and methods A prospective study of 50 patients (31 males and 19 females) with arthritic hips for various reasons undergoing either cemented or uncemented total hip arthroplasty. The mean age was 47 years old. Preoperative history and examination for all patients was done, preoperative and postoperative evaluation of offset and limb length was done for all patients, and preoperative and postoperative evaluation of hip function using Harris hip score (HHS) was done in addition to evaluation of abductor muscles’ power. Variable intraoperative methods were used to minimize the limb-length discrepancy (LLD) after the operation. Results There was a statistical significance between hip offset pre- and postoperative and between LLD preoperative and postoperative. HHS was improved postoperative. Conclusion Limb-length restoration is very important for improvement of HHS. The intraoperative clinical method is much effective to minimize LLD as other methods, although it is much easier to apply.