Intraoperative assessment of length and offset changes during total hip replacement

Authors

  • Guillermo Bonilla Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santafé de Bogotá, Bogotá, Colombia.
  • Gonzalo Pérez Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santafé de Bogotá, Bogotá, Colombia.
  • María Piedad Bautista Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santafé de Bogotá, Bogotá, Colombia. | Universidad de los Andes, Bogotá, Colombia.
  • Adolfo Llinás Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santafé de Bogotá, Bogotá, Colombia. | Universidad de los Andes. Fundación Cosme y Damián, Bogotá, Colombia.
  • José Navas Sanz de Santamaría Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santafé de Bogotá, Bogotá, Colombia. | Fundación Cosme y Damián, Bogotá, Colombia.

Keywords:

Arthroplasty Replacement Hip, Leg Length Inequality, Reproducibility of Results, Intraoperative Care

Abstract

Introduction: Restoration of lower limb length and offset after total hip replacement is critical to the success of the procedure. Some of the methods to re-establish these parameters are not accurate and have limitations.

Methods: We have developed a caliper that allows measurements of leg length and offset during arthroplasty. To validate concordance between the intra-operatory measurement and the post-operatory radiograph, the instrument was used in 39 total hip replacements.

Results: We found that the average differences in the leg length measurement was 0.05 mm and the average differences of the average offset was 2.43 mm, with a high level of agreement (κ = 0.96 for length and κ = 0.54 for offset).

Discussion: We note that the caliper is an accurate and useful intraoperative tool for the determination of length and offset when compared with post-operatory radiographs.

Downloads

Download data is not yet available.

References

1. Desai A, Barkatali B, Dramis A, Board TN. A simple intraoperative technique to avoid limb length discrepancy in total hip arthroplasty. Surgeon 2010 Apr; 8(2): 119-21.

2. Sarin VK, Pratt WR, Bradley GW. Accurate femur repositioning is critical during intraoperative total hip arthroplasty length and offset assessment. J Arthroplasty 2005 Oct; 20(7): 887-91.

3. Lakshmanan P, Ahmed S, Hansford R, Woodnutt DJ. Achieving the required medial offset and limb length in total hip arthroplasty. Acta Orthop Belg 2008 Feb; 74(1): 49-53.

4. Lecerf G, Fessy MH, Philippot R, Massin P, Giraudd F, Flechere X. Femoral offset: Anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 2009 May; 95(3): 210-9.

5. Abraham W, Dimon III H. Leg length discrepancy in total hip arthroplasty. Orthop Clin North Am 1992 Apr; 23(2): 201-9.

6. Davey J, O’Connor D, Burke D. Femoral component offset: Its effect on strain in bone cement. J Arthroplasty 1993 Feb; 8(1): 23-6.

7. Karachalios T, Hartofilakides G, Zacharakis N. A 12- to 18-year radiographic follow-up study of Charnley low-friction arthroplasty. The role of the center of rotation. Clin Orthop Relat Res 1993 Nov; (296): 140-7.

8. Lai KA, Lin CJ, Jou IM, Su FC. Gait analysis after total hip arthroplasty with leg-length equalization in women with unilateral congenital complete dislocation of the hip. Comparison with untreated patients. J Orthop Res 2001 Nov; 19(6): 1147-52.

9. Naito M, Ogata K, Asayama I. Intraoperative limb length measurement in total hip arthroplasty. Int Orthop 1999; 23(1): 31-3.

10. Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. J Arthroplasty 2002 Jun; 17(4 Suppl 1): 17-22.

11. Friberg O. Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine (Phila Pa 1976) 1983 Sep; 8(6): 643-51.

12. Love BRT, Wright K. Leg length discrepancy after total hip replacement. J Bone Joint Surg Br 1983; 65B: 103.

13. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am 1982 Dec; 64(9): 1295-306.

14. McGee HM, Scott JH. A simple method of obtaining equal leg length in total hip arthroplasty. Clin Orthop Relat Res 1985 Apr; (194): 269-70.

15. Ranawat CS, Rao RR, Rodriguez JA, Bhende HS. Correction of limblength inequality during total hip arthroplasty. J Arthroplasty 2001 Sep;16(6): 715-20.

16. McGrory BJ, Morrey BF, Cahalan TD, An KN, Cabanela ME. Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Joint Surg Br 1995 Nov; 77(6):865-9.

17. Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res 2001 Jul; (388): 125-34.

18. Bankston AB, Cates H, Ritter MA, Keating EM, Faris PM. Polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res 1995 Aug; (317): 7-13.

19. Takigami I, Itokazu M, Itoh Y, Matsumoto K, Yamamoto T, Shimizu K. Limb-length measurement in total hip arthroplasty using a calipers dual pin retractor. Bull NYU Hosp Jt Dis 2008; 66(2): 107-10.

20. Woolson ST, Hartford JM, Sawyer A. Results of a method of leg-length equalization for patients undergoing primary total hip replacement. J Arthroplasty 1999 Feb; 14(2): 159-64.

21. Jasty M, Webster W, Harris W. Management of limb length inequality during total hip replacement. Clin Orthop Relat Res 1996 Dec; (333):165-71.

22. Goodman SB, Huene DS, Imrie S. Preoperative templating for the equalization of leg lengths in total hip arthroplasty. Contemp Orthop 1992 Jun; 24(6): 703-10.

23. Hoikka V, Paavilainen T, Lindholm TS, Turula KB, Ylikoski M. Measurement and restoration of equality in length of the lower limbs in total hip replacement. Skeletal Radiol 1987; 16(6): 442-6.

24. Bose WJ. Accurate limb-length equalization during total hip arthroplasty. Orthopedics 2000 May; 23(5): 433-6.

25. Hofmann AA, Bolognesi M, Lahav A, Kurtin S. Minimizing leg-length inequality in total hip arthroplasty: use of preoperative templating and an intraoperative x-ray. Am J Orthop (Belle Mead NJ) 2008 Jan; 37(1):18-23.

26. Dastane M, Dorr LD, Tarwala R, Wan Z. Hip offset in total hip arthroplasty: quantitative measurement with navigation. Clin Orthop Relat Res 2011 Feb; 469(2): 429-36.

27. Manzotti A, Cerveri P, De Momi E, Pullen C, Confalonieri N. Does computer-assisted surgery benefit leg length restoration in total hip replacement? Navigation versus conventional freehand. Int Orthop 2011 Jan; 35(1): 19-24.

28. Brand RA, Yack HJ. Effects of leg length discrepancies on the forces at the hip joint. Clin Orthop Relat Res 1996 Dec; (333): 172-80.

Downloads

Published

2012-06-01

How to Cite

1.
Bonilla G, Pérez G, Bautista MP, Llinás A, Navas Sanz de Santamaría J. Intraoperative assessment of length and offset changes during total hip replacement. Rev. Colomb. Ortop. Traumatol. [Internet]. 2012 Jun. 1 [cited 2026 Mar. 16];26(2):129-34. Available from: https://revistasccotorg.biteca.online/index.php/rccot/article/view/631

Issue

Vol. 26 No. 2 (2012)

Section

Original research

License

Copyright (c) 2025 Sociedad Colombiana de Cirugía Ortopédica y Traumatología.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
Escanea para compartir
QR Code

Some similar items: