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Increasing the femoral neck offset
88%
3283/3740
Increasing the femoral neck length
1%
37/3740
Incomplete insertion of a cemented femoral stem
52/3740
Making a high femoral neck cut just below the femoral head
5%
184/3740
Bone grafting superior to the acetabulum to seat the cup more inferior
4%
164/3740
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Limb length discrepancy, especially operative limb lengthening, is a common complication following THA that can lead to patient dissatisfaction. Extending the femoral neck offset does not lengthen the limb. Rather it increases the horizontal distance of the stem away from the femoral head. This increases abductor tension improving stability. It should be noted that weakness of the abductors can result in patient sensation of leg lengthening in the absence of any true LLD. Bhave et al reviewed 78 patients who complained of poor function 3 months following THA. The patients were evaluated by physical exam, 3-D gait analysis, and isokinetic strength testing. Muscle weakness, muscle tightness, limb-length discrepancies, and limb malalignment were the most common findings. Maloney et al reviewed the etiologies, complications, and proper management of limb length discrepancy following THA. Careful pre-operative physical exam and pre-operative templating can be useful in mitigating post-operative leg length discrepancy. Illustration A demonstrates an example of extended femoral neck offset.
3.1
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