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Review Question - QID 995

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QID 995 (Type "995" in App Search)
All of the following interventions help restore anatomic limb length following total hip arthroplasty EXCEPT:

Preoperative templating

3%

67/2643

Use of an arthroplasty system incorporating variable neck lengths

4%

109/2643

Intraoperative assessment of limb length

5%

130/2643

Use of a modular arthroplasty system that allows variable femoral offset

85%

2235/2643

Clinical and radiographic preoperative assessment for limb length discrepancy

3%

88/2643

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Femoral offset can be decreased following total hip arthroplasty compared to the preoperative anatomy. A decrease in femoral offset moves the femur closer to the pelvis, which can result in impingement at the extremes of movement. Moving the femur medially also results in soft tissue laxity. Both of these problems can cause instability and possible dislocation. Increasing femoral offset, which moves the femur laterally, will decrease impingement and improve soft tissue tension resulting in better stability without lengthening the leg.

Bourne et al review techniques to restore femoral offset during total hip arthroplasty. Pre-operative templating, intra-operative assessment of limb length, and high offset femoral necks are helpful to replicate femoral offset.

Suh et al reviewed a series of THA's to evaluate how well preoperative templating corresponded with postoperative limb lengthening and femoral offset. They reported both parameters were on average within 2 mm of the preoperative template.

Line A in Illustration A demonstrates femoral offset. Illustration B compares neck length and femoral offset affect on limb length.

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