title: Patients' perception of leg length discrepancy post total hip arthroplasty.
abstract: Perception of a leg length discrepancy post total hip arthroplasty (THA) is one of the most common sources of patient dissatisfaction and can have a direct influence on the considered success of the operation.This research examined postoperative perception of imposed limb discrepancies in a group of THA patients compared to a group of participants with no previous hip surgery. Two subgroups of THA patients were involved: those who did not perceive a difference in limb length following THA and those that did.Discrepancies were imposed in 2.5 mm increments. For discrepancies ≥5 mm, a significant number of participants were aware of a difference (74%). There was no significant difference in perception of imposed discrepancies between THA patients and participants with no previous hip surgery. THA patients who perceived a difference in their limb lengths postoperatively had significantly worse pain and oxford scores when compared to THA patients who perceived their limb lengths to be equal. Knowing the boundaries between LLDs that go undetected and those that patients are aware of could guide surgeons when evaluating the balance between correct soft tissue tension and the resulting unequal leg length. From these findings, discrepancies >5 mm are likely to be perceived. Whether this perception would lead directly to a negative outcome score and patient dissatisfaction is more complex to project and likely to be patient specific. Intraoperative methods to aid the controlled positioning of implanted components could help maintain and restore leg length to within an acceptable amount that patients cannot perceive.
authors.affiliation: Belfast Health and Social Care Trust, Belfast - UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Sykes
authors.affiliation: Belfast Health and Social Care Trust, Belfast - UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Hill
authors.affiliation: Queen's University, Belfast - UK.
authors.forename: John
authors.initials: J
authors.lastname: Orr
authors.affiliation: Belfast Health and Social Care Trust, Belfast - UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Humphreys
authors.affiliation: Belfast Health and Social Care Trust, Belfast - UK.
authors.forename: Aidan
authors.initials: A
authors.lastname: Rooney
authors.affiliation: Belfast Health and Social Care Trust, Belfast - UK.
authors.forename: Esther
authors.initials: E
authors.lastname: Morrow
authors.affiliation: Belfast Health and Social Care Trust, Belfast - UK.
authors.forename: David
authors.initials: D
authors.lastname: Beverland
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D016022:Case-Control Studies; D005080:Exercise Test / Q000379:methods; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007870:Leg Length Inequality / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D010465:Perception / Q000502:physiology*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D012016:Reference Values