Leg Length Discrepancy Assessment: Accuracy and Precision in Five Clinical Methods of Evaluation

1984 ◽  
Vol 5 (5) ◽  
pp. 230-239 ◽  
Author(s):  
Allyn L. Woerman ◽  
Stuart A. Binder-Macleod
Keyword(s):  
Leg Length Discrepancy ◽  
Leg Length ◽  
Length Discrepancy ◽  
Accuracy And Precision ◽  
Methods Of Evaluation ◽  
Clinical Methods

Comparison of Lifts Versus Tape Measure in Determining Leg Length Discrepancy

2014 ◽  
Vol 41 (8) ◽  
pp. 1689-1694 ◽  
Author(s):  
Maziar Badii ◽  
A. Nicole Wade ◽  
David R. Collins ◽  
Savvakis Nicolaou ◽  
B. Jacek Kobza ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Length Discrepancy ◽  
Tape Measure ◽  
Pelvic Radiograph ◽  
Clinical Methods

Objective.To evaluate the validity (accuracy) and reliability of 2 commonly used clinical methods, 1 indirect (lifts) and 1 direct (tape measure), for assessment of leg length discrepancy (LLD) in comparison to radiograph.Methods.Twenty subjects suspected of having LLD participated in this study. Two clinical methods, 1 direct using a tape measure and 1 indirect using lifts, were standardized and carried out by 4 examiners. Difference in height of the femoral heads on standing pelvic radiograph was measured and served as the gold standard.Results.The intraclass correlation coefficient assessing interobserver reliability was 0.737 for lifts and 0.477 for tape measure. The remainder of the analysis is based on the average of the measurements by the 4 examiners. Pearson correlation coefficients were 0.93 for the lifts and 0.75 for the tape measure method. Paired sample t tests showed difference in means of 2 mm (p = 0.051) for lifts and −5 mm (p = 0.007) for tape measure compared with radiograph. Sensitivity and specificity were 55% and 89% for lifts and 45% and 56% for tape measure, respectively, using > 5 mm as the definition for LLD. The wrong leg was identified as being shorter in 1 out of 20 subjects using lifts versus 7 out of 20 using tape measure.Conclusion.The indirect standing method of LLD measurement using lifts had superior validity, interobserver reliability, and specificity in comparison with radiograph over the direct supine method using tape measure. Both clinical methods underestimated LLD compared with radiograph.

Comparison of Precision for Manual versus Robotic-Assisted Total Hip Arthroplasty Performed by Fellows

2020 ◽  
Vol 4 (03) ◽  
pp. 117-123
Author(s):  
Ryan Smith ◽  
Ilya Borukhov ◽  
Emily Hampp ◽  
Matt Thompson ◽  
Zackary O. Byrd ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Hip Arthroplasty ◽  
Head Rotation ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Robotic Assisted ◽  
Total Hip ◽  
Length Discrepancy ◽  
Accuracy And Precision

AbstractAlthough various studies have shown that robotic-assisted total hip arthroplasty (RATHA) is associated with improved component positioning to plan and reduced intraoperative complications, there is still a learning curve for implementation even for experienced surgeons. This study assessed this learning curve for fellows during their training year, by comparing the accuracy and precision of acetabular component positioning, leg length, component offset, and center of rotation between manual THA (MTHA) and RATHA. Six fresh-frozen lower extremity specimens were utilized for surgical procedures performed by two adult reconstruction fellows who were halfway through their training year. The specimens were randomized to undergo one side with manual instrumentation and the contralateral side with RATHA. The final intraoperative surgical plan for rotation, cup orientation, leg length, and offset values were recorded and compared with the actual values measured by computed tomography (CT) scan. Using pre- and postoperative CT scans, the RATHA group was then compared with the MTHA group for accuracy and precision to plan. To assess differences in standard deviations of each measurement, 2-variances testing was performed using α = 0.05. To assess differences in central tendencies of each measurement for each group, Mann–Whitney U tests were performed using α = 0.05. RATHA exhibited significantly (p < 0.05) greater accuracy and precision to plan compared with MTHA in shell version (2.3 ± 1.2° vs. 7.8 ± 4.6°), shell inclination (2.1 ± 1.2° vs. 7.2 ± 3.2), and leg length discrepancy (0.8 ± 0.8 mm vs. 6.4 ± 3.7 mm). Center of head rotation was reported for each anatomical plane. There was no statistical difference in distance from original center of head rotation when considering the superoinferior, mediolateral, and anteroposterior planes as well as when combined as a total deviation in all three planes. The use of CT-guided preoperative planning and intraoperative robotic technology can help surgeons achieve desired implant placement. Results from this study indicate that with limited RATHA experience, surgeons in fellowship training were able to place THA components more accurately and precisely to plan for several important parameters compared with MTHA, namely shell inclination, shell anteversion, and leg length discrepancy.

Changes in patient-perceived leg length discrepancy following total hip arthroplasty

2021 ◽  
Author(s):  
Kentaro Iwakiri ◽  
Yoichi Ohta ◽  
Takashi Fujii ◽  
Yukihide Minoda ◽  
Akio Kobayashi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy

mobiLLD: Exploring the Detection of Leg Length Discrepancy and Altering Gait with Mobile Smart Insoles

2021 ◽  
Author(s):  
Denys J.C. Matthies ◽  
Don Samitha Elvitigala ◽  
Annis Fu ◽  
Deborah Yin ◽  
Suranga Nanayakkara
Keyword(s):  
Leg Length Discrepancy ◽  
Leg Length ◽  
Length Discrepancy

scholarly journals Epiphysiodesis for the treatment of tall stature and leg length discrepancy

2021 ◽  
Author(s):  
Madeleine Willegger ◽  
Markus Schreiner ◽  
Alexander Kolb ◽  
Reinhard Windhager ◽  
Catharina Chiari
Keyword(s):  
Surgical Planning ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Bone Age ◽  
Leg Length Discrepancy ◽  
Tall Stature ◽  
Complication Rates ◽  
Leg Length ◽  
Growth Prediction ◽  
Length Discrepancy

SummaryPainful orthopedic conditions associated with extreme tall stature and leg length discrepancy (LLD) include back pain and adopting bad posture. After failure of conservative treatment options, blocking of the growth plates (epiphysiodesis) around the knee emerged as gold standard in patients with tall stature and LLD in the growing skeleton. Surgical planning includes growth prediction and evaluation of bone age. Since growth prediction is associated with a certain potential error, adequate planning and timing of epiphysiodesis are the key for success of the treatment. LLD corrections up to 5 cm can be achieved, and predicted extreme tall stature can be limited. Percutaneous epiphysiodesis techniques are minimally invasive, safe and efficient methods with low complication rates. In general, a multidisciplinary approach should be pursued when treating children and adolescents with tall stature.

The effect of leg length discrepancy upon load distribution in the static phase (standing)

2014 ◽  
Vol 40 (4) ◽  
pp. 561-563 ◽  
Author(s):  
V. Swaminathan ◽  
M. Cartwright-Terry ◽  
J.D. Moorehead ◽  
A. Bowey ◽  
S.J. Scott
Keyword(s):  
Load Distribution ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Length Discrepancy ◽  
Static Phase

Leg length discrepancy after total hip arthroplasty

2004 ◽  
Vol 19 (4) ◽  
pp. 108-110 ◽  
Author(s):  
William J Maloney ◽  
James A Keeney
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy

scholarly journals Effect of Leg-length Discrepancy on Lower-limb Muscle Activities during Gait: Focus on Equinus Gait

2015 ◽  
Vol 30 (6) ◽  
pp. 961-965
Author(s):  
Yuichi HONDA ◽  
Eiichi SAKAKI ◽  
Hisayoshi YOSHIZUKA ◽  
Yasushi NAGAO
Keyword(s):  
Lower Limb ◽  
Leg Length Discrepancy ◽  
Lower Limb Muscle ◽  
Limb Muscle ◽  
Leg Length ◽  
Length Discrepancy
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