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Publication - Professor Ashley Blom

    The association of leg length and offset reconstruction after total hip arthroplasty with clinical outcomes

    Citation

    Bolink, SA, Lenguerrand, E, Brunton, LR, Hinds, N, Wylde, V, Heyligers, IC, Blom, AW, Whitehouse, MR & Grimm, B, 2019, ‘The association of leg length and offset reconstruction after total hip arthroplasty with clinical outcomes’. Clinical Biomechanics, vol 68., pp. 89-95

    Abstract

    Background: Restoring native hip anatomy and biomechanics is important to create a well-functioninghip arthroplasty. This study investigated the association of hip offset and leg length after hiparthroplasty with clinical outcomes, including patient reported outcome measures, the TrendelenburgTest and gait analysis.Methods: In 77 patients undergoing primary hip arthroplasty for osteoarthritis (age mean=65 SD=11years; BMI mean=27 SD=5 kg/m2), hip offset and leg length discrepancy were measured onanteroposterior radiographs. The Western Ontario & McMaster Universities Osteoarthritis Index, theTrendelenburg Test and gait were assessed preoperatively, and at 3 and 12 months postoperatively.An inertial measurement unit was used to derive biomechanical parameters, including spatiotemporalgait parameters and tilt angles of the pelvis. Relationships between radiographic and functionaloutcomes were investigated, and subgroups of patients with >15% decreased and increased femoraloffset were analysed separately.Findings: patient-reported function scores and clinical tests demonstrated a few significant, weakcorrelations with radiographic outcomes (Spearman’s ρ range =0.26-0.32; p<0.05). Undercorrection offemoral offset was associated with lower patient-reported function scores and with more stepirregularity as well as step asymmetry during gait. Postoperative leg length inequality was associatedwith increased frontal plane tilt angle of the pelvis during the Trendelenburg Test and increased sagittalplane motion of the pelvis during gait. Femoral offset subgroups demonstrated no significantdifferences for patient-reported function scores and outcomes of the Trendelenburg Test and gaitanalysis.Interpretation: Reduced hip offset and leg length dicrepancy following hip arthroplasty seem to bemarginally associated with worse clinical outcomes.

    Full details in the University publications repository