An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis
Background: Leg length and hip offset are important principles in total hip arthroplasty (THA). Patients may endorse leg length differences (LLD) postoperatively that may be anatomical or functional. The objective of this study was to determine the normal radiographic variation in leg length and hip...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344123000560 |
| _version_ | 1797736864139968512 |
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| author | Noel Bien T. Carlos, MS Nicholas P. Drain, MD Venkata Kalyan Byrapogu, MS Daniel Lippe, BS Rachel Romano, BS Sam Kuzmishin Darini Rajesh, BS Sophia Angele, BS Kenneth L. Urish, MD, PhD |
| author_facet | Noel Bien T. Carlos, MS Nicholas P. Drain, MD Venkata Kalyan Byrapogu, MS Daniel Lippe, BS Rachel Romano, BS Sam Kuzmishin Darini Rajesh, BS Sophia Angele, BS Kenneth L. Urish, MD, PhD |
| author_sort | Noel Bien T. Carlos, MS |
| collection | DOAJ |
| description | Background: Leg length and hip offset are important principles in total hip arthroplasty (THA). Patients may endorse leg length differences (LLD) postoperatively that may be anatomical or functional. The objective of this study was to determine the normal radiographic variation in leg length and hip offset in a preosteoarthritic population without a THA. Methods: A retrospective study was completed using data from the Osteoarthritis Initiative, a prospective longitudinal study. Patients at risk of developing or with early osteoarthritis without inflammatory arthritis or prior THA were included. Measurements were made from full limb length anterior-posterior (AP) radiographs. Multiple linear regression models were employed to predict side-to-side differences in LLD, Δ femoral offset (FO), Δ abductor muscle length (AML), Δ abductor lever arm, and Δ AP pelvic offset. Results: The mean radiographic LLD was 4.6 mm, with 12 mm within 1 standard deviation. No significant differences were detected between LLD and sex, age, body mass index, or height. The median radiographic differences in FO, AML, abductor lever arm, and AP pelvic offset were 3.2 mm, 4.8 mm, 3.6 mm, and 3.3 mm, respectively. Height was predictive of Δ FO, while both height and age were predictive of Δ AML. Conclusions: Radiographic leg length variations in a population without symptomatic or radiographic osteoarthritis exist. FO and AML are dependent on patient characteristics. Preoperative radiographic LLD is not predicted by age, gender, body mass index, or height. It should be stressed that anatomic reconstruction is one of the many goals of arthroplasty and can stand in conflict with the priority and primary goals of stability and fixation, which should be prioritized. |
| first_indexed | 2024-03-12T13:19:11Z |
| format | Article |
| id | doaj.art-1e18909bc7b341f4b257f3f777be5426 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-03-12T13:19:11Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-1e18909bc7b341f4b257f3f777be54262023-08-26T04:43:31ZengElsevierArthroplasty Today2352-34412023-08-0122101151An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing OsteoarthritisNoel Bien T. Carlos, MS0Nicholas P. Drain, MD1Venkata Kalyan Byrapogu, MS2Daniel Lippe, BS3Rachel Romano, BS4Sam Kuzmishin5Darini Rajesh, BS6Sophia Angele, BS7Kenneth L. Urish, MD, PhD8University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Arthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USAArthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USAUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Arthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USAArthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USA; Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USAArthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USA; University of Pittsburgh, Pittsburgh, PA, USAArthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USA; University of Pittsburgh, Pittsburgh, PA, USAArthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USA; University of Pittsburgh, Pittsburgh, PA, USAArthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USA; University of Pittsburgh, Pittsburgh, PA, USAArthritis and Arthroplasty Development Laboratory, Department of Orthopaedic Surgery, School of Medicine, Pittsburgh, PA, USA; University of Pittsburgh, Pittsburgh, PA, USA; Corresponding author. Magee Bone and Joint Center, Department of Orthopaedic Surgery, Department of Bioengineering, University of Pittsburgh, 300 Halket Street, Suite 1601B, Pittsburgh, PA 15213, USA. Tel.: +1 412 641 8609.Background: Leg length and hip offset are important principles in total hip arthroplasty (THA). Patients may endorse leg length differences (LLD) postoperatively that may be anatomical or functional. The objective of this study was to determine the normal radiographic variation in leg length and hip offset in a preosteoarthritic population without a THA. Methods: A retrospective study was completed using data from the Osteoarthritis Initiative, a prospective longitudinal study. Patients at risk of developing or with early osteoarthritis without inflammatory arthritis or prior THA were included. Measurements were made from full limb length anterior-posterior (AP) radiographs. Multiple linear regression models were employed to predict side-to-side differences in LLD, Δ femoral offset (FO), Δ abductor muscle length (AML), Δ abductor lever arm, and Δ AP pelvic offset. Results: The mean radiographic LLD was 4.6 mm, with 12 mm within 1 standard deviation. No significant differences were detected between LLD and sex, age, body mass index, or height. The median radiographic differences in FO, AML, abductor lever arm, and AP pelvic offset were 3.2 mm, 4.8 mm, 3.6 mm, and 3.3 mm, respectively. Height was predictive of Δ FO, while both height and age were predictive of Δ AML. Conclusions: Radiographic leg length variations in a population without symptomatic or radiographic osteoarthritis exist. FO and AML are dependent on patient characteristics. Preoperative radiographic LLD is not predicted by age, gender, body mass index, or height. It should be stressed that anatomic reconstruction is one of the many goals of arthroplasty and can stand in conflict with the priority and primary goals of stability and fixation, which should be prioritized.http://www.sciencedirect.com/science/article/pii/S2352344123000560Leg length discrepancyFemoral offsetTotal hip arthroplastyRadiographic variationOsteoarthritisHip biomechanics |
| spellingShingle | Noel Bien T. Carlos, MS Nicholas P. Drain, MD Venkata Kalyan Byrapogu, MS Daniel Lippe, BS Rachel Romano, BS Sam Kuzmishin Darini Rajesh, BS Sophia Angele, BS Kenneth L. Urish, MD, PhD An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis Arthroplasty Today Leg length discrepancy Femoral offset Total hip arthroplasty Radiographic variation Osteoarthritis Hip biomechanics |
| title | An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis |
| title_full | An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis |
| title_fullStr | An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis |
| title_full_unstemmed | An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis |
| title_short | An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis |
| title_sort | analysis of radiographic leg length discrepancy and hip offset in patients at risk of developing osteoarthritis |
| topic | Leg length discrepancy Femoral offset Total hip arthroplasty Radiographic variation Osteoarthritis Hip biomechanics |
| url | http://www.sciencedirect.com/science/article/pii/S2352344123000560 |
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