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.

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

Distance Between the Malleoli and the Ground

2017 ◽  
Vol 107 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Estela Gomez Aguilar ◽  
Águeda Gómez Domínguez ◽  
Carolina Peña-Algaba ◽  
José M. Castillo-López
Keyword(s):  
Drop Test ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
San Jose ◽  
Leg Length Inequality ◽  
Length Discrepancy ◽  
Navicular Drop ◽  
Tape Measure ◽  
Foot Posture ◽  
The Difference

Background: The aim of this work is to introduce a useful method for the clinical diagnosis of leg-length inequality: distance between the malleoli and the ground (DMG). Methods: A transversal observational study was performed on 17 patients with leg-length discrepancy. Leg-length inequality was determined with different clinical methods: with a tape measure in a supine position from the anterior superior iliac spine (ASIS) to the internal and external malleoli, as the difference between the iliac crests when standing (pelvimeter), and as asymmetry between ASISs (PALpation Meter [PALM]; A&D Medical Products Healthcare, San Jose, California). The Foot Posture Index (FPI) and the navicular drop test were also used. The DMG with Perthes rule (perpendicular to the foot when standing), the distance between the internal malleolus and the ground (DIMG), and the distance between the external malleolus and the ground were designed by the authors. Results: The DIMG is directly related to the traditional ASIS–external malleolus measurement (P = .003), the FPI (P = .010), and the navicular drop test (P &lt; .001). There are statistically significant differences between measurement of leg-length inequality with a tape measure, in supine decubitus, from the ASIS to the internal malleolus, and from the ASIS to the external malleolus. Conclusions: This new method (the DMG) is useful for diagnosing leg-length discrepancy and is related to the ASIS–external malleolus measurement. The DIMG is significantly inversely proportional to the degree of pronation according to the FPI. Conversely, determination of leg-length discrepancy with a tape measure from the ASIS to the malleoli cannot be performed interchangeably at the level of the internal or external malleolus.

The effectiveness and influencing factors of the ‘Y’ line technique in reducing the leg length discrepancy after total hip arthroplasty

2021 ◽  
Author(s):  
Wenshu Jin ◽  
Huaqiang Sun ◽  
Xudong Duan ◽  
Yange Gu ◽  
zhang zhao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lower Limb ◽  
Limb Length ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
X Ray ◽  
Length Discrepancy ◽  
Group A ◽  
Group B

Abstract Objective: To introduce a surgical technique (the ‘Y’ line technique) which is to control the leg length discrepancy (LLD) after total hip arthroplasty.Methods: A total of 350 patients were selected; 134 patients who were used the ‘Y’ line technique to control lower limb length were included in Group A and 166 patients treated with free hand methods to control lower limb length were included in Group B. 50 patients who were taken standard anteroposterior X-ray of bilateral hips preoperatively and used the ‘Y’ line technique during the operation were included in Group C. Results: The postoperative LLD of the three groups was statistically significant (p < 0.001). There were significant differences statistically in comparison between any two groups (P<0.01). Severe unequal length rates of the lower extremities (LLD > 10 mm) were 5.97% (8/134) in Group A, 14.3% (24/166) in Group B and 0% (0/50) in Group C – the difference was statistically significant (p < 0.001). There were significant differences between Group A and Group B, Group B and Group C (P < 0.05), but there was no significant difference between Group A and Group C (P = 0.078).Conclusion: The ‘Y’ line technique, which does not increase the operation time, can effectively reduce postoperative LLD. Insufficient internal rotation of the healthy lower extremity and the low projection position in the preoperative anteroposterior X-ray of bilateral hips were important factors affecting the accuracy of the ‘Y’ line technique.

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 Patient’s perception on leg length discrepancy after total hip arthroplasty in patients with unilateral Crowe type IV developmental dysplasia of the hip

2020 ◽  
Author(s):  
Yinqiao Du ◽  
Junmin Shen ◽  
Jingyang Sun ◽  
Chi Xu ◽  
Ming Ni ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy ◽  
Type Iv ◽  
The Difference ◽  
Dysplasia Of The Hip

Abstract Background: The study assessed the correlation among the patients’ perception on leg length discrepancy (LLD) after total hip arthroplasty (THA) in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH) and the four methods of measuring the leg length in the full-length standing anteroposterior radiographs. Methods: 60 patients with unilateral Crowe type IV DDH were recruited in this retrospective study between January 2012 and January 2019. Four methods of measurement were used: (1) TD-TP: distance between the inferior aspect of teardrop and the midpoint of tibial plafond (TP). (2) CH-TP: distance between the center of femoral head or acetabular cup and the TP. (3) GT-TP: distance between the apex of greater trochanter and the TP. (4) FL + TL: the sum of femoral length and tibial length. Results: Association was found among the patients’ perception on LLD with difference in TD-TP (OR, 1.157), and the difference in FL + TL (OR, 1.166). The area under the curve of the difference in FL + TL and the difference TD-TP (0.704 and 0.679) was significantly higher than those of the difference in CH-TP and the difference in GT-TP (0.564 and 0.483). With the calculated threshold of LLD set at 9.0 mm, the sensitivity and specificity of the difference in TD-TP and the difference in FL + TL were 57.7%, 79.4% and 61.5%, 79.4%, respectively.Conclusion: Patients’ perception on LLD had good correlation and reliability on the difference of FL + TL and the difference of TD-TP.

The Impact of Leg Length Discrepancy on Patient Satisfaction and Functional Outcome Following Total Hip Arthroplasty

2013 ◽  
Vol 28 (8) ◽  
pp. 1408-1414 ◽  
Author(s):  
Michael R. Whitehouse ◽  
Natalija S. Stefanovich-Lawbuary ◽  
Luke R. Brunton ◽  
Ashley W. Blom
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy ◽  
The Impact
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