Leg-Length Discrepancy After Total Hip Arthroplasty: Comparison of Robot-Assisted Posterior, Fluoroscopy-Guided Anterior, and Conventional Posterior Approaches
Authors
El Bitar YF, Stone JC, Jackson TJ, Lindner D, Stake CE, Domb BG
DOI: Not available as DOI, PMID: 26046996
Purpose
To compare postoperative leg-length discrepancy (LLD) among three total hip arthroplasty (THA) approaches: robot-assisted posterior (RTHA), fluoroscopy-guided anterior (ATHA), and conventional posterior (PTHA).
Methods
Retrospective review of 155 THA cases by one surgeon from 2008 to 2012. LLD was measured on postoperative radiographs by two blinded observers with high inter- and intraobserver reliability.
Key Findings
- Mean LLD: RTHA 2.7 mm, ATHA 1.8 mm, PTHA 1.9 mm (statistically significant difference, P = .01).
- Percentage of patients with LLD >3 mm: RTHA 37.3%, ATHA 17.2%, PTHA 22% (no statistical significance).
- No patients had LLD ≥10 mm.
- All three approaches achieved clinically acceptable and comparable LLD accuracy.
Conclusion
Robot-assisted, fluoroscopy-guided anterior, and conventional posterior THA approaches are equally effective in minimizing leg-length discrepancy.
What This Means for Patients
Patients can expect similar leg-length outcomes regardless of surgical approach, reducing dissatisfaction related to leg length differences after hip replacement.