{"id":4934,"date":"2025-11-19T10:57:11","date_gmt":"2025-11-19T10:57:11","guid":{"rendered":"https:\/\/www.chirurgiedelahanche.com\/blog\/corriger-inegalite-de-longueur-apres-prothese-de-hanche\/"},"modified":"2025-11-19T11:22:37","modified_gmt":"2025-11-19T11:22:37","slug":"correcting-leg-length-dicrepancy-after-total-hip-replacement","status":"publish","type":"post","link":"https:\/\/www.chirurgiedelahanche.com\/en\/blog\/hip-surgery\/correcting-leg-length-dicrepancy-after-total-hip-replacement\/","title":{"rendered":"Correcting a leg length discrepancy after total hip replacement"},"content":{"rendered":"

\"leg<\/p>\n

3D Planning : a solution to prevent leg length discrepancy<\/h2>\n

At Inside the Hip <\/i> , patients scheduled for hip replacement benefit from 3D CT-based preoperative planning<\/strong> followed by the design of a custom-made implant<\/strong><\/a>. Thanks to the precision of 3D imaging and custom manufacturing, the risk of leg length discrepancy after surgery is virtually eliminated or extremely low.<\/p>\n

Our team is regularly consulted by patients who did not have access to this technique and who have felt a leg length difference since their initial surgery. This sensation often appears immediately after the first postoperative mobilization : an impression that the knees are misaligned, a sense of imbalance, limping, or feeling as though one must \u201cclimb a small step\u201d with each stride. Such discrepancies may also cause lumbar or lumboradicular pain<\/strong>, as well as multiple muscular tensions<\/strong> due to compensatory postures.<\/p>\n

Possible adjustments after unhappy hip replacement<\/h2>\n

In some cases, this sensation resolves within a few weeks with rehabilitation and physiotherapy<\/strong>. Consultation with a podiatrist<\/strong> can help by creating a custom plantar orthotic<\/strong> to balance the lower limbs.<\/p>\n

However, orthotics alone cannot correct significant leg length discrepancies,<\/strong>\u00a0nor can they readjust altered muscular and joint tensions<\/strong> resulting from the surgical modification of hip mechanics.<\/p>\n

Imaging assessment : a key step in diagnosis<\/h2>\n

Radiological assessment is essential to quantify the leg length difference<\/strong>. Standing anteroposterior pelvic radiographs<\/strong>, both pre- and postoperatively, should be analyzed.<\/p>\n

An EOS full-body standing scan<\/strong> (spine and lower limbs) can measure bone segment lengths and assess the lumbopelvic-femoral balance<\/strong>.
\nHowever, the reference examination remains <\/strong>3D CT imaging<\/strong><\/a>, which allows precise geometric analysis.<\/p>\n

Unfortunately, many patients did not undergo preoperative CT imaging, making it difficult to obtain accurate measurements of native joint geometry.
\nWhen a preoperative CT scan is available, a postoperative scan can perfectly reveal the geometric changes induced by surgery. If not, a bilateral CT scan<\/strong> can compare the operated and non-operated hips to identify asymmetries.<\/p>\n

3D CT analysis to identify the cause of discrepancy<\/h2>\n

3D CT analysis is critical, as the sensation of leg length inequality often combines three interrelated mechanical issues <\/strong> :<\/p>\n

    \n
  • Excessive vertical lengthening<\/strong> (cranio-caudal axis)<\/li>\n
  • Uncontrolled variation of the medio-lateral offset<\/strong><\/li>\n
  • Uncontrolled change in femoral anteversion<\/strong> (axial plane)<\/li>\n<\/ul>\n

    Through detailed 3D analysis, it becomes possible to identify cup malposition<\/strong>, femoral stem malalignment<\/strong>, or inaccurate adjustment of soft-tissue tension<\/strong> related to the choice of prosthetic head.<\/p>\n

    Surgical options to correct leg length discrepancy<\/h2>\n

    Restoring an optimal lumbopelvic-femoral balance<\/strong> should never be neglected.
    \nTo achieve this, revision surgery<\/strong> may be considered, depending on the underlying cause:<\/p>\n

      \n
    • Replacement of the prosthetic head only<\/strong><\/li>\n
    • Revision of the acetabular cup<\/strong><\/li>\n
    • Replacement of the femoral stem<\/strong><\/li>\n<\/ul>\n

      Depending on the case, the revision can be performed through a direct anterior approach<\/strong>, which preserves muscle structures, or a posterior approach<\/strong>, allowing better access to the femur.
      \nIn certain complex cases, a custom-made revision implant<\/strong> may be required to restore the hip\u2019s native anatomy and symmetry.<\/p>\n

      Prevention: the key to long-term balance<\/h2>\n

      Preventing leg length discrepancy relies on a thorough preoperative clinical examination<\/strong> combined with 2D and 3D imaging<\/strong> (particularly preoperative CT).
      \nChoosing a custom-made implant<\/strong> ensures secure and precise adjustment of joint balance<\/strong>, which is essential for a natural gait and full functional recovery.<\/p>\n

      3D planning and custom implants are especially valuable for young, athletic patients<\/strong> or those with pre-existing spinal conditions<\/strong>, as these cases demand high precision and biomechanical harmony.<\/p>\n","protected":false},"excerpt":{"rendered":"

      After total hip replacement, some patients experience a feeling that one leg is longer or shorter than the other. This imbalance, sometimes causing instability, limping, or lower back pain, may result from a temporary adjustment issue or from an actual change in joint geometry. At Inside the Hip, a highly specialized center in Lyon, 3D planning and custom-made implants<\/strong> are used to eliminate this risk and restore perfect alignment of the pelvis and lower limbs for optimal functional recovery.<\/p>\n","protected":false},"author":35,"featured_media":4938,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[67],"tags":[],"class_list":["post-4934","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hip-surgery"],"acf":[],"yoast_head":"\nCorrecting a leg length discrepancy after total hip replacement | Paris and Lyon | Inside the Hip<\/title>\n<meta name=\"description\" content=\"After total hip replacement, some patients experience a feeling that one leg is longer or shorter than the other. 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