title: Limb-length discrepancy after total hip arthroplasty: novel treatment and proposed algorithm for care.
abstract: Limb-length discrepancy after total hip arthroplasty (THA) leads to patient dissatisfaction and can be a cause of orthopedic surgery malpractice cases. Nonsurgical and surgical techniques exist to correct limb-length discrepancies. Two limb-lengthening methods were used to correct greater than 2-cm limb-length discrepancies after THA: lengthening over a femoral nail with an external fixator and lengthening with an intramedullary kinetic skeletal distractor. These techniques achieved equal length in less than 4 weeks, with both resulting in a healed distraction gap within 4 months. No patient had loss of proximal or distal joint motion, and mean Harris Hip Score was 90 points at final follow-up. No surgical complications were reported with the intramedullary skeletal kinetic distractor. Limb lengthening using an intramedullary skeletal kinetic distractor is a viable treatment option resulting in reliable lengthening, healing of the distraction gap, and progression to full weight bearing.
authors.forename: Rishi
authors.initials: R
authors.lastname: Thakral
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Johnson
authors.forename: Stacy C
authors.initials: SC
authors.lastname: Specht
authors.forename: Janet D
authors.initials: JD
authors.lastname: Conway
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
authors.forename: John E
authors.initials: JE
authors.lastname: Herzenberg
mesh_terms: D000465:Algorithms; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D007870:Leg Length Inequality / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome