Dynamic leg length measurement is a valid method for detecting anatomic leg length discrepancy

2020 ◽  
pp. 1-11
Author(s):  
Sam Khamis
Keyword(s):  
Gait Cycle ◽  
Pearson Correlation ◽  
Reliability And Validity ◽  
Swing Phase ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Functional Changes ◽  
Length Discrepancy ◽  
Leg Length Difference ◽  
Analysis System

BACKGROUND: Even though the importance of leg length discrepancy (LLD), with its potential of causing several pathological conditions or gait deviations, is well known, measuring LLD is still challenging with limited reliability and validity. OBJECTIVE: To assess the capability of the dynamic leg length (DLL) measurement in detecting the presence of anatomic LLD. METHODS: A lower limb x-ray was performed on 15 participants with suspected LLD in addition to a gait analysis study using a motion analysis system to measure DLL (the absolute distance from the hip joint centre to the heel, to the ankle joint centre and to the forefoot). Average DLLs were compared between sides for symmetry by the paired t-test at 51 sample points during the gait cycle in conjunction with the differences between the sides based on the maximal stance phase and minimal swing phase DLLs. Differences were correlated with anatomic LLD by Pearson correlation. RESULTS: No significant differences in DLLs between sides throughout the gait cycle were found. Significant differences between sides were found between the maximal stance and minimal swing phase DLLs. CONCLUSIONS: DLL measurement is capable of detecting an anatomic leg length difference based on functional changes in leg length and functional discrepancy.

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.

scholarly journals A comparison of leg length discrepancy between direct anterior and anterolateral approaches in total hip arthroplasty

Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Henry Dunn ◽  
Geoff Rohlfing ◽  
Robert Kollmorgen
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Outcome Measurement ◽  
Pearson Correlation ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy ◽  
Observer Reliability ◽  
Overlay Technique

Abstract Background Leg length discrepancy (LLD) after total hip arthroplasty (THA) is a known source of complications and a leading cause of litigation (J Bone Joint Surg Br 87:155–157, 2005). There are limited studies investigating surgical approach combined with the use of fluoroscopy intraoperatively and their potential effects on LLD after THA. The purpose of this study was to compare the direct anterior (DA) approach utilizing a fluoroscopic overlay technique and anterolateral (AL) approach and their potential effect on LLD. Methods We retrospectively reviewed 121 patients who had undergone primary THA from September 1, 2016 to November 1, 2018 by either DA or AL approach by two separate surgeons. Leg length discrepancies were measured on pre-operative post-anesthesia care unit (PACU) and on post-operative low anterior/posterior (AP) pelvis plain radiographs by two investigators blinded to each other’s measurements. To confirm inter-observer and intra-observer reliability between LLD measurements amongst investigators, a Pearson correlation test was performed. The primary outcome measurement was leg length discrepancy (LLD). Results We observed LLD > 1.0 cm and LLD > 1.5 cm in the DA and AL groups. The DA approach group showed a mean LLD of 4.5 mm against 7.76 mm in the AL group (p < 0.00001). There was a significantly higher rate of LLD in the AL group as compared to the DA group (LLD> 1 cm (28% vs. 8%, p = 0.0037) and LLD > 1.5 cm (7% vs. 0%, p = 0.0096). The LLD measurements showed strong correlation in terms of inter-observer (r = 0.95) and intra-observer reliability (r = 0.99) between the two investigators (p < 0.001). Conclusion In our patient cohort, the DA approach with fluoroscopic overlay technique had less LLD in comparison with the AL approach, suggesting that intraoperative fluoroscopic use does have an impact on LLD.

scholarly journals Correlation between Gait Asymmetry and Leg Length Discrepancy—What Is the Role of Clinical Abnormalities?

2018 ◽  
Vol 8 (10) ◽  
pp. 1979 ◽  
Author(s):  
Sam Khamis ◽  
Barry Danino ◽  
Dror Ovadia ◽  
Eli Carmeli
Keyword(s):  
Lower Limb ◽  
Pearson Correlation ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Random Forest Classification ◽  
Length Discrepancy ◽  
Forest Classification ◽  
The Difference ◽  
Joint Center ◽  
The Impact

Reducing the effect of leg length discrepancy (LLD) on gait abnormalities while other abnormal conditions such as spasticity, joint contractures or weak muscle strength are exhibited is challenging. This study aimed to evaluate the impact of mild LLD on lower limb biomechanics, on participants with anatomic LLD with and without other clinical abnormalities. A motion capture system was utilized on 32 participants to measure lower limb kinematics and dynamic leg length (DLL) throughout the gait cycle, calculated as the absolute distance from the hip joint center, either to the heel, ankle joint center, or forefoot. The Pearson correlation coefficient found that LLD was associated with 5 kinematic variables only when LLD appeared with no other clinical abnormalities present (r = 0.574 – 0.846, p < 0.05). When clinical abnormalities were present, the random forest classification accuracy was lower (64% versus 80%), implying that the used kinematics are low predictors for anatomic LLD, revealing a higher asymmetrical clearance index (the difference between the maximal stance phase and the minimal contra-lateral swing phase DLL) and a different kinematic variable importance index. Clinical abnormalities in pathological gait will in all probability significantly affect gait deviations, affirming mild anatomic LLD as inconsequential. A functional measurement can offer a better estimate as to the side and extent of the functional 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
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