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Dr. Swanson
Leg Length Discrepancy
Mon Nov 6, 2006 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 “physiologic” leg length discrepancy rather than a true discrepancy. It may result from swelling, spasm, or contracture of the abductor muscles, sometimes from a curvature or lack of flexibility in the spine, or other reasons.

At any rate, the most important factor in the equation is what is most comfortable for you. If it is most comfortable with a ¾ inch shoe lift, that is probably what you need.

The discrepancy can be corrected surgically by shortening the femur around the femoral prosthesis. A ring of bone can be removed (like a napkin ring), and the femur shortened around the stem of the prosthesis. However, I would worry that if ¾ inch were removed, you might then feel that the right leg is too short. I would recommend only shortening the femur by 10-12mm or so. I expect your physiologic discrepancy will then correct itself (although in this area, there are no guarantees).

I might also add that I have had patients with physiologic leg length discrepancies that have taken a full year to resolve. It might be worth just waiting a bit longer initially just to see if any more of it corrects. You will still be left with a 1cm discrepancy, but this can usually be dealt with using a small shoe lift. If it corrects no further, then the options are a ¾ inch permanent shoe lift or femoral shortening surgery.

I hope this helps. Let me know if I can help any further.

Dr. Todd Swanson

  • 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 Discrepancy — Dr. Swanson, Mon Nov 6 5:20am
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