Gait analysis after total hip arthroplasty with leg-length equalization in women with unilateral congenital complete dislocation of the hip – comparison with untreated patients

• Published in: Journal of orthopaedic research Vol. 19; no. 6; pp. 1147 - 1152
• Main Authors: Lai, Kou-An, Lin, Chii-Jen, Jou, I-Ming, Su, Fon-Chin
• Format: Journal Article
• Language: English
• Published: Hoboken Elsevier Ltd 01.11.2001; Wiley Subscription Services, Inc., A Wiley Company; Blackwell Publishing Ltd
• Subjects: Adult; Arthroplasty, Replacement, Hip; Female; Gait; Hip Dislocation, Congenital - physiopathology; Hip Dislocation, Congenital - surgery; Humans; Leg Length Inequality - surgery
• ISSN: 0736-0266; 1554-527X
• DOI: 10.1016/S0736-0266(01)00032-8

Patients with Crowe Type-IV congenital dislocation of the hip (CDH) show significant clinical improvement after total hip arthroplasty (THA) because this surgery greatly reduces pain. Concomitant leg-length equalization in unilateral patients – a controversial procedure – theoretically should significantly improve these patients' ability to walk efficiently and comfortably. To understand the impact of leg-length equalization on these patients, we compared their gait parameters with those of untreated patients without pain but with leg-length discrepancy. Using a motion analysis system, three force platforms and computer calculation, the gait parameters during level walking of 22 women with unilateral Crowe Type-IV CDH were studied at an average of 58 months (27–98 months) following a successful cementless THA. The socket was placed in the best bone stock, which was close to the level of the true acetabulum. The leg-length discrepancy was equalized to within 2 cm in all patients. The Harris hip score averaged 94.8 (range, 88–100) at the time of the study. Nine women with untreated unilateral Crowe Type-IV CDH without major pain but with an average leg-length discrepancy of 4.7 cm (range, 2.5–6 cm) were also studied for comparison. The treated subjects (Group 1; THA and leg-length equalization) walked faster and had gait parameters with better bilateral symmetry than the untreated subjects (Group 2). We concluded that leg-length equalization in addition to THA in patients with unilateral Crowe Type-IV CDH significantly improves gait symmetry and efficiency.