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Purpose <p>Post-operative LLD is a major concern after THA. The anterior approach on a standard table allows surgeons for a direct control of the leg length. Intra-operative radiography (IR) helps in assessment of hip biomechanics and anatomic parameters. The aim of this study is to evaluate the LLD after THA through anterior approach with or without a position table and with or without the use of intra-operative radiographs. The hypothesis is that leg length may be better control when IR and a standard table are used.</p> Methods <p>This is a single-centre retrospective comparative cohort study of three matched groups of 80 patients receiving anterior approach THA with three different techniques (Group A: positioning table with IR; Group B: standard table with IR; Group C: standard table without IR). Pre-operative and post-operative LLD was calculated. Age, sex, BMI, acetabular cup and femoral stem size, operative time, and blood loss were recorded.</p> Results <p>In Group A, 15 patients (19%) had a LLD greater than 5&#xa0;mm, and two patients (2,5%) had a LLD greater than 10&#xa0;mm. In Group B, 20 patients (25%) had a LLD greater than 5&#xa0;mm, and two patients (2,5%) had a LLD greater than 10&#xa0;mm. In Group C, 16 patients (20%) had a LLD greater than 5&#xa0;mm, and three patients (3,7%) had a LLD greater than 10&#xa0;mm. No statistically significant differences were found for LLD &gt; 5&#xa0;mm, for LLD &gt; 10&#xa0;mm, nor for the mean LLD between the three groups (<i>p  &gt; 0.05</i>). Mean operative time was statistically longer in Group B (<i>p  &lt; 0.05</i>).</p> Conclusion <p>Neither the use of a standard/positioning table neither the use of IR seemed to be superior in restoring leg length after anterior approach THA. Together with the contradictory results in literature, findings of the current study indicate that no technique is clearly superior to one other and surgeons’ experience may play the most relevant role.</p>

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“Intra-operative assessment of leg length discrepancy with anterior approach total hip replacement: a comparison between standard table, position table with and without intra-operative radiographs”

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月14日

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  • Edoardo Viglietta,
  • Simone Fenucci,
  • Raffaele Iorio,
  • Ariane Parisien,
  • George Grammatopoulos,
  • Paul Roy Kim,
  • Paul Edgar Beaulè

摘要

Purpose

Post-operative LLD is a major concern after THA. The anterior approach on a standard table allows surgeons for a direct control of the leg length. Intra-operative radiography (IR) helps in assessment of hip biomechanics and anatomic parameters. The aim of this study is to evaluate the LLD after THA through anterior approach with or without a position table and with or without the use of intra-operative radiographs. The hypothesis is that leg length may be better control when IR and a standard table are used.

Methods

This is a single-centre retrospective comparative cohort study of three matched groups of 80 patients receiving anterior approach THA with three different techniques (Group A: positioning table with IR; Group B: standard table with IR; Group C: standard table without IR). Pre-operative and post-operative LLD was calculated. Age, sex, BMI, acetabular cup and femoral stem size, operative time, and blood loss were recorded.

Results

In Group A, 15 patients (19%) had a LLD greater than 5 mm, and two patients (2,5%) had a LLD greater than 10 mm. In Group B, 20 patients (25%) had a LLD greater than 5 mm, and two patients (2,5%) had a LLD greater than 10 mm. In Group C, 16 patients (20%) had a LLD greater than 5 mm, and three patients (3,7%) had a LLD greater than 10 mm. No statistically significant differences were found for LLD > 5 mm, for LLD > 10 mm, nor for the mean LLD between the three groups (p  > 0.05). Mean operative time was statistically longer in Group B (p  < 0.05).

Conclusion

Neither the use of a standard/positioning table neither the use of IR seemed to be superior in restoring leg length after anterior approach THA. Together with the contradictory results in literature, findings of the current study indicate that no technique is clearly superior to one other and surgeons’ experience may play the most relevant role.