How big a discrepancy in leg length is acceptable after hip replacement surgery?I recently had total hip replacement. After four months of recovery I find that one leg is obviously much longer than the other, 1 inch more or less. When sitting, there a substantial difference in how far my knees jut out. When I asked my surgeon about it he gave me a little foam insert for the heel of my shoe and said it would be fine. But it hasn't been fine- lots of pain in the knee of the unaffected leg. Has anyone else experienced this. No chance of a bi-lateral hip replacement (which I am told could even things out) as my one hip replacement was the result of damage to the hip, the other hip is fine.
Patricia C
I have a friend who had to have all his shoes custom made after the surgery because there was such a big difference. It's so bad he wanted to sue by the attorney told him he wouldn't win because doctors are allowed to make mistakes.
formerly_bob
This is a relatively common problem with hip replacements. Sometimes it is temporary and requires physical therapy to stretch ligaments and muscles back to their original length. A difference of an entire inch is probably more than would occur from a temporary problem caused by inflammation or tightness.
Sometimes the problem only looks like there's differences in the leg lengths, and it's actually caused by a skewed pelvis or skewed spine. And sometimes, the docs miscalculated the leg length. It's difficult to get an accurate measurement of leg length within 1/4 to /2 inch unless an x-ray was taken of the entire leg.
It might be worthwhile getting your spine and pelvis examined to see if that could be causing or contributing to the problem. You could ask your orthopedic surgeon to do this evaluation, but this is something that chiropractors do very well, and their perspective is different from an ortho doc.
If the pelvis or spine are not skewed, and physical therapy doesn't work, then orthotic shoe inserts or custom shoes are the only option other than repeating the surgery to correct the error. You ortho doc could write up an order for you to be measured and fit for a better orthotic insert than a piece of felt. .
Kraftee
You may benefit from these links on the subject, from a website created by an ortho surgeon as a service to patients. It appears in [slightly fractured] English translation and is free of commercial content.
http://totaljoints.info/Long_leg_TH.htm
http://totaljoints.info/THPconstruction.htm#3
I've had both hips replaced and have a small LLD (about 3/8") which I treat successfully with an insert in my walking shoes. As has been mentioned by another answer, large discrepancies may need to be addressed by building up the shoe on the outside instead of inserts. Unfortunately building up the shoe is expensive.
Of course no one would consider replacing the opposite hip for no reason except to make the legs even! As mentioned in the links I've given you above, some discrepancies are "apparent" and others are "real". I would refrain from drawing conclusions about your LLD so soon after surgery. It takes time for the muscles that hold everything together to regain tone. Wait a few months before you go to the expense of having your shoes built up. If you've been given a script for PT, by all means do the exercises religiously.
I'll also point out that there is only so much a surgeon can do to insure equal LL. It is vital that there be enough tension on the muscles to hold the new ball and socket together, but not too much tension. The surgeon's goal is a stable hip joint.
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