| Objective To explore a simple technique to improve the accuracy of controlling the leg length inequality in total hip arthroplasty.Method A comparative analysis was made of surgical cases of total hip arthroplasty performed by the same treatment team for unilateral primary or secondary end-stage hip disease from August 2018 to December 2020.Standard anterior and posterior radiographs of the pelvis were taken before and after surgery.They were divided into experimental group(n=40)and control group(n=42)according to whether the method of controlling the length of lower limbs was used intraoperatively.The difference of leg length between preoperative and postoperative was measured on plain radiographs of the pelvis.All patients were followed up for at least 3-6 months,and the Harris hip score was performed preoperatively and 3 months postoperatively.T-test and chi-square test were used to compare the preoperative and postoperative leg length difference,primary diagnosis,general information(age,BMI,gender),postoperative hospital stay,surgical side(left or right),postoperative complications,preoperative and postoperative hip function score and other data indexes between the two groups.Results Among the 82 patients,the experimental group included 18 males and 22 females,with 22 patients diagnosed as advanced necrosis of the femoral head preoperatively,8 as primary hip osteoarthritis,4 as dysplasia of the hip,and 6 as rheumatoid arthritis.In the experimental groups,the mean age was 62.63±11.10(years),BMI was 24.18±1.73,the mean postoperative hospital stay was 8.75±2.58(days),the mean preoperative leg length difference was 10.49±3.19(mm),the median was 9.9(range 5.1-19.7)mm,the mean postoperative leg length difference was 3.7±1.97(mm),the median was 3.3(range 0.8-9.3)mm,and the Harris hip score was 68.32±6.48 and85.93±6.61 preoperatively and 3 months postoperatively,respectively.The control group included 18 males and 24 females,22 of whom were diagnosed as advanced necrosis of the femoral head preoperatively,10 as primary hip osteoarthritis,5 as hip dysplasia,and5 as rheumatoid arthritis.In the control group,the mean age was 59.29±13.93 years old,BMI was 23.54±1.82,the mean postoperative hospital stay was 7.98±2.89(days),the preoperative mean leg length difference was 9.54±3.45(mm),the median was 9.8(range 3.6-19.5)mm,the postoperative mean leg length difference was 6.9±2.41(mm),the median was 6.3(range 2.6-12.3)mm,and the Harris hip score was 69.46±6.67 and84.61±5.47 preoperatively and 3 months postoperatively,respectively.There were 5cases of postoperative complications among the 82 patients,including 2 cases in the experimental group(both poor wound healing)and 3 cases in the control group(2 poor wound healing and 1 postoperative dislocation).The difference of leg length between the two groups was statistically significant(P < 0.001).Preoperative and postoperative leg length difference,preoperative and postoperative Harris score of hip joint in the experimental group were statistically significant(P < 0.001).There were significant differences in preoperative and postoperative leg length difference,preoperative and postoperative Harris score of hip joint in the control group(P < 0.001).There were no significant differences in preoperative leg length,disease type,age,BMI,gender,postoperative hospital stay,surgical side(left or right),postoperative complications,and preoperative and postoperative Harris hip score at the 3rd month(P value was 0.279,0.945,0.235,0.109,0.845,0.206,0.641,0.523,0.372,0.328,respectively)between the2 groups.Conclusion The method can effectively control the difference of leg length of both lower limbs after total hip arthroplasty in patients with primary or secondary end-stage hip disease.The method is simple,does not require specialized equipment,and is versatile enough to be used anywhere.In addition,it does not require any new skin incisions or additional costs. |
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