Revision surgery for leg length inequality after primary hip replacement

We discuss the surgical results of revision surgery for patients with refractory symptomatic leg length inequality (LLI) after primary hip replacement.

This is a retrospective review of 21 patients who underwent revision for LLI after primary total hip replacement. All of them were referred to a tertiary clinic between 2006 and 2015. Leg length was measured, to the nearest mm, using Woolson’s validated X-ray technique which references to centre of femoral rotation, the acetabular teardrop and the midpoint of the lesser trochanter. The post-operative clinical assessment using a modified D’Aubigne and Postel scoring system investigated the pain, function, and satisfaction after surgery.

The mean pre-revision LLI was 16.2 mm (8–30 mm). The mean post revision operation leg length inequality was 2.0 mm (12 mm short to 9 mm long). The mean post-operative D’Aubigne and Postel scores, achieved at a mean 12 months (6–30 months), were; pain 5.2 (3–6), function 4.6 (3–6) and satisfaction 4.4 (3–5). Following revision surgery 20 out of 21 (95%) patients were satisfied with the improvement in LLI.

Revision surgery for LLI, while it may not resolve all of the pain that the patient presents with, it is a successful treatment for patients who do not respond to conservative management of their LLI.