Multicenter survey about leg length discrepancy and total hip arthroplasty: postoperative management

TL;DR

This study surveyed Italian orthopedic surgeons on how they manage leg length discrepancy after hip surgery, finding that practice often differs from literature recommendations.

Contribution

The study provides insights into how surgeons manage leg length discrepancy post-hip arthroplasty, comparing adherence to literature across specialties.

Findings

Only four survey questions achieved over 70% agreement on a single answer.

Trauma surgeons and replacement surgery experts had higher odds of providing literature-based answers for 10 mm LLD at first follow-up.

Treatment decisions for LLD often deviate from literature recommendations, influenced by tradition.

Abstract

We created a Multicenter Survey for Italian orthopedics surgeons on how they approach leg length discrepancy when dealing with primary total hip arthroplasty. Aim of the study was to show how surgeons manage LLD and follow literature recommendations during clinical practice.

The Survey was composed of 25 questions divided in 4 sections: surgeon’s profile, preoperative and intraoperative evaluation, postoperative management. In this paper, we report the absolute and relative frequencies of answers to section on “postoperative management.” Then, regarding the treatment of residual LLD, we reported whether trauma surgeons and experts in replacement surgery had higher odds ratios for providing “literature-based” answers compared to orthopedics physicians.

Only four questions received more than 70% agreement on one of the answers. The OR for giving the “literature-based” answer, taking OP as the reference group was 1.57 for TR and 1.72 for RS for 10 mm LLD at first follow-up (FU) and 1.23 TR and 1.32 RS when 20 mm. When 10 mm LLD at 3 months FU the OR was 0.88 TR and 1.15 RS. The OR for treatment of LLD after the first examination of a new patient was 2.16 TR and 1.85 RS.

LLD is a debated topic with no definitive recommendations. Many decisions still depend on tradition. Treatment of LLD during clinical practice often differs from literature recommendations.

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