Double-Stitch Technique: A Simple and Effective Method to Minimize Limb Length Discrepancy after Total Hip Arthroplasty.

Abstract

Significant limb length discrepancy (LLD) after total hip arthroplasty (THA) is associated with limb, unremitting pain, neurological complications, and recurrent dislocations and has been a major cause of patient dissatisfaction and litigation against operating surgeon. The authors present a prospective study involving a double-stitch technique to prevent postoperative LLD after THA. Fifty patients undergoing primary THA over a period of 2 years were included in the study and were divided into two groups of 25 each. In Group I, double-stitch technique was used for intraoperative adjustment of preoperative radiological LLD, whereas in Group II, palpation and comparison of level of patella was used for assessment of LLD. Postoperative LLD and hip outcome scores were obtained and compared. Postoperative radiological LLD (mean ± standard deviation) was 2.72 ± 2.07 mm (range -5 mm to +6 mm) in Group I and +4.28 ± 7.2 mm (range -15 mm to +12 mm) in Group II. Nine patients in Group I and 2 patients in Group II had no true clinical leg lengths discrepancy postoperatively. Postoperative radiological LLD within 5 mm could be achieved in 24 patients in Group I and in 9 patients in Group II. The study indicates that double-stitch technique is a simple and effective method in reducing postoperative LLD following THA.