title: Leg length discrepancy and lower limb alignment after total hip arthroplasty in unilateral hip osteoarthritis patients.
abstract: BACKGROUND
  Leg length discrepancy (LLD) following total hip arthroplasty (THA) is a leading cause of patient dissatisfaction. However, no reports have described the influence of lower limb alignment on LLD after THA. In the present study, we firstly investigated the change in lower limb alignment after THA. Secondly, we determined the influence of lower limb alignment on LLD after THA. Thirdly, we evaluated the influence of LLD in the entire lower leg on the clinical outcomes after THA.
  
  
  METHODS
  We followed up with 54 unilateral hip osteoarthritis (OA) patients 1 year after THA. For the radiological assessment of LLD and lower limb alignment, we obtained anteroposterior radiographs of the pelvis and both lower legs in entirety in a standing position before and 1 year after THA. The Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) were also obtained to assess the clinical outcome.
  
  
  RESULTS
  The alignment of the affected leg, which was more valgus than the unaffected leg before THA, tended toward varus after THA, and the discrepancy between the lower limb alignments on both sides decreased. However, the alignment discrepancies that remained after THA influenced the LLD measured on the radiograph of the entire lower leg, and this LLD influenced the clinical outcome as measured by the HHS and the WOMAC score.
  
  
  CONCLUSIONS
  LLD in the entire lower leg should be corrected for a better clinical outcome after THA.
authors: Department of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors: Hiroshi
authors: H
authors: Fujimaki
authors: Yutaka
authors: Y
authors: Inaba
authors: Naomi
authors: N
authors: Kobayashi
authors: Taro
authors: T
authors: Tezuka
authors: Yasuhide
authors: Y
authors: Hirata
authors: Tomoyuki
authors: T
authors: Saito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D006801:Humans; D015994:Incidence; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011182:Postoperative Care; D011300:Preoperative Care; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome