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Dr Swanson
Leg Length Discrepancy
Wed Jun 30, 2004 5:45am

Post-op leg length discrepancy usually occurs due to post-op swelling, and sometimes tensioning of the abductor muscles if the prosthesis has more offset than the patient's pre-op offset; or if the leg was short to begin with and was lengthened to the appropriate length causing excessive tensioning of the abductor muscles-leading to pelvic obliquity. This phenomenon is called a "temporary functional post-op leg length discrepancy."

Permanent functional leg length discrepancies can also be seen in patients with pelvic obliquity, usually due to a spinal curvature. These leg length discrepancies are present when one measures the clinical leg lengths, but are absent when one measures the leg lengths off the x-rays. Most functional leg length discrepancies will correct themselves by 3 months or so. If it still feels like a discrepancy is present, it may be time to use a shoe lift. Any permanent discrepancy over 1cm is considered significant in orthopedic terms (although I think 1 cm is a lot and generally can get most patients within 1/4 inch).

Dr Swanson

  • Don't DespairPauline, Tue Jun 29 9:34am
    Donít despair about your early post-op leg length discrepancy. Permanent leg length discrepancy after hip replacement cannot properly be assessed before 6-8 weeks post-op and sometimes longer. Trauma ... more
    • Leg Length Discrepancy — Dr Swanson, Wed Jun 30 5:45am
      • Leg length Dis. Pain getting worseMargaret Smith, Thu Nov 2 9:37am
        It has now been 8 mnths since my RTH replacement I have a metal on metal hip done through the 2 incision mini hip aproach. I am 3/4" long on operative side. I am having increasing pain on standing... more
        • Leg Length DiscrepancyDr. Swanson, Mon Nov 6 5:20am
          Ms. Smith, From your radiographs, it appears that your right hip is approximately 1cm longer than the left. However, clinically, you feel like you have a much larger discrepancy. We call this a... more
      • 1.7 cm LLD following a THRerin, Fri Feb 24 10:13am
        I have an actual leg length discrepancy of 3/4 inch following a THR two years ago. I understand that there is an inherent risk of a LLD following a THR. I need to know what is an acceptable amount?... more
        • Re: 1.7 cm LLD following a THRPauline, Fri Feb 24 4:28pm
          Dr. Swanson addressed this issue in this post http://disc.server.com/discussion.cgi?disc=216603;article=187;title=Mini%20Total%20Hip%20Replacement%20by%20Todd%20V.%20Swanson%20M.D . Best Wishes,... more
      • Dr. Swanson, Thank you for your reply. If the discrepancy is still significant after a three month period, what is the next step to having it repaired? Should my orthopedic surgeon agree to do a... more
        • Dr Swanson's ReplyPauline, Tue Jul 13 11:02pm
          Susan, Dr Swanson has been teaching in Europe, however, I sent a SOS that we need his expertise here in the good old US of A and he provided this information. Most patients can accommodate a leg... more
          • leg length discrepancyDr. Swanson, Fri Jul 16 5:14pm
            I'm back in town. Pauline did a good job paraphrasing my response to leg length discrepancies. However, there is 1 error: only approximately 10-20% of my patients with leg length discrepancies... more
        • Answer the question please doctorKarl, Mon Jul 12 9:49pm
          My father has also experienced the discrepancy in leg length (2 cm) after THR in Atlanta, GA. He has been met with resistance from the doctor that performed the surgery and others with the only... more
          • Dr Swanson's RepllyPauline, Tue Jul 13 11:11pm
            Karl, Please see Dr Swanson's reply regarding revision to correct leg length discrepancy above. He also mentioned that in your father's case, age would be a definite factor in weighing the benefits... more
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