actual leg length difference after THR
Posted , 7 users are following.
I am 14 months post THR.
As well as some residual pelvic obliquity and torsion (which I had prior to the op) I have an actual LLD of around 8mm (as measured on a chiropractic standing x-ray).
I am struggling with back ache on the non operated short leg side, (which may also be being caused by psoas issues and hip impingement on that side). I am tying to understand how much of this backache is being caused by the actual LLD, and whether anyone out there has had a similar LLD which they have managed to assimilate/absorb.
I started wearing orthotics a couple of months ago which did seem to help at first.
I am working hard at my mental attitude to all of this, and so am interested in empirical evidence re whether it is actually possible to deal with this amount of LLD after THR in a relatively pain free way. Once I believe it is possible, then I can relax into following the therapists advice in getting it sorted.
Any comments gratefully received.
2 likes, 8 replies
marie10553 LDW
Posted
Dear 4LDW,
I am sorry you are suffering but so grateful to hear about it because I have been complaining of this same issue for years to no avail! Doctors, chiropractors, podiatrists, ortho's have all dismissed my complaint. I have never been measured but I can walk evenly with one shoe off so I believe something is wrong. Now that I have THR therapists say a longer leg is common.
I just finished with PT and I told my therapist I wanted to try walking with only one shoe. When I stood up she said OMG!! Tomorrow she is measuring my leg lengths and it will become part of my record. I have hope for the first time in 30 yrs!!
t3chiman LDW
Edited
Hi LDW-
"...is actually possible to deal with this amount of LLD after THR in a relatively pain free way..."
Short answer: yes.
Longer answer:
Even healthy legs on normal people are of different lengths. After 50 years or so of rocking back and forth, it's quite common for people to complain of back aches. It's not just "getting old", it's the compensation mechanisms failing over time.
A person with a diseased hip faces similar issues, only of greater magnitude and earlier in life. As the bad hip crumbles, the opposite knee, the spine, and the sacroiliac joint compensate. The bad side leg can begin to shorten. It is common for THR candidates to have short leg syndrome.
Surgeons know all about this. They plan on adding some length to the operated side. They have a further incentive: adding a bit of tension to the weak muscles of a bad hip joint serves to stabilize the joint in the critical few weeks post-op.
Just how much length to add in the operating room is a surprisingly tough problem. Take a look at the THR surgery videos on the web. The conduct of such surgery does not lend itself to meticulous length comparisons between the (exposed) operative leg, and the (hidden) good leg. Another factor: the heavy dose of anesthesia relaxes the patient's back and hip muscles, possibly for the first time in years, making precise comparisons problematic. End result: patient ends up with the operated side leg a bit longer than the non-operated.
My own case is atypical. I have about a one half inch (12cm) LLD, operated side shorter. Given the amount (easily spotted by the physical therapist), I just went to a local shoemaker and had the sole of my walking shoe built up by that amount. It is still a bit short, so I sometimes augment it with an internal pad. Note that not all shoes can be altered this way; consult your local shoemaker for recommendations. I did not find it necessary to get medical grade orthotics or custom made shoes.
Hope this helps.
LDW t3chiman
Posted
how long before your back pain improved? or didnt it get started as you heel lifted immediately?
t3chiman LDW
Posted
"...how long before your back pain improved? or didnt it get started ..."
My back twisted to accommodate a stiff hip joint, didn't generate a lot of pain, mostly tired me out. I found that massage and warmth helps. Best treatment: a trip to Thailand. Sit on the warm sands of Southern Thailand, have the Thai women massage you. Nothing erotic, mind you, just a relaxing experience.
HTH
RichardKen LDW
Posted
Cheers Richard
renee01952 LDW
Posted
8 mm is not such a big difference ... I agree with t3chiman who wrote a great explanation ...
you also mentioned that you had this condition prior your THR surgery and I am assuming was treated by a chiropractor ...
did your OS tell you that the LLD would be corrected with THR surgery?
I am not sure what I can tell you, though ...
hope you get it sorted out and please come back here to let us know the outcome ...
big warm hug
renee
madla39168 LDW
Posted
Hello LDW,
I have LLD after hip replecement. My non operated leg is 12 to 15 mm
shorter I put insole in my shoes and it help me keep the balance and
not have sore back. I limp litle bit only if im tired .working in nursing home and standing on my feet 6 to 7 hours 5 days a week. My oposite hip
hurt but need to be done hopefully soon. I get used to have insole in my
shoe and least my back not hurting. Im 7 months after replacement and
when I find out if have LLD I was down , upset but now I'm more relax
and deal with LLD. Try insole it may help.
Good luck
Madla💗
PS least you are pain free.
Greglake madla39168
Posted
i had THR in Feb 2022 and noticed that leg was over a half inch shorter. Supposedly this goes away by 6 months, so i was told to wait before they will check it. now i get pain in the long leg upper thigh. its really weird to walk on a long leg and i notice we are not taken seriously. im trying various shoe heel inserts as they help, but with 1/2 inch added my leg is still short a little. im rebuked if i say that outside this patient page.