title: The Exeter technique can lead to a lower incidence of leg-length discrepancy after total hip arthroplasty.
abstract: We evaluated an operative technique, described by the Exeter Hip Unit, to assist accurate introduction of the femoral component. We assessed whether it led to a reduction in the rate of leg-length discrepancy after total hip arthroplasty (THA). A total of 100 patients undergoing THA were studied retrospectively; 50 were undertaken using the test method and 50 using conventional methods as a control group. The groups were matched with respect to patient demographics and the grade of surgeon. Three observers measured the depth of placement of the femoral component on post-operative radiographs and measured the length of the legs. There was a strong correlation between the depth of insertion of the femoral component and the templated depth in the test group (R = 0.92), suggesting accuracy of the technique. The mean leg-length discrepancy was 5.1 mm (0.6 to 21.4) pre-operatively and 1.3 mm (0.2 to 9.3) post-operatively. There was no difference between Consultants and Registrars as primary surgeons. Agreement between the templated and post-operative depth of insertion was associated with reduced post-operative leg-length discrepancy. The intra-class coefficient was R ≥ 0.88 for all measurements, indicating high observer agreement. The post-operative leg-length discrepancy was significantly lower in the test group (1.3 mm) compared with the control group (6.3 mm, p < 0.001). The Exeter technique is reproducible and leads to a lower incidence of leg-length discrepancy after THA.
authors: University Hospital Crosshouse, Kilmarnock KA2 OBE, UK.
authors: M
authors: M
authors: Halai
authors: University Hospital Crosshouse, Kilmarnock KA2 OBE, UK.
authors: S
authors: S
authors: Gupta
authors: University Hospital Crosshouse, Kilmarnock KA2 OBE, UK.
authors: A
authors: A
authors: Gilmour
authors: University Hospital Crosshouse, Kilmarnock KA2 OBE, UK.
authors: R
authors: R
authors: Bharadwaj
authors: University Hospital Crosshouse, Kilmarnock KA2 OBE, UK.
authors: A
authors: A
authors: Khan
authors: University Hospital Crosshouse, Kilmarnock KA2 OBE, UK.
authors: G
authors: G
authors: Holt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007870:Leg Length Inequality / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies
keywords: arthroplasty; hip; limb length discrepancy; technique