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Discrepancy in leg length after hip replacement

Posted , 67 users are following.

annette99709
annette99709

I had a total ceramic hip replacement 3 weeks ago and I have been left with an inch difference in the length of my operated leg the physio has advised me to get an insert for my shoe she said they sold them in boots the chemist but I can't see anything was wondering if anyone else has the same problem

5 likes, 106 replies

106 Replies

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  • wobbly1
    wobbly1 annette99709

    Posted

    I know this is gonna sound really daft but are you measuring your leg's with a tape measure or is it a fact that if you're limping you've got a leg length difderence. I know I have to have a left thr -when I'm ready, and I limp very badly - does this mean my legs are different lengths? I'm sorry this is a question and not a solution!!!
    • kaleani75551
      kaleani75551 wobbly1

      Posted

      Yes your legs length pre-op may be different.  Before i had my right hip fixed, my left leg was shorter and i was limping.  I could not understand why my pants always looked uneven when i looked in the mirror until the doctor told me that it was because cartilage in the shorter hip was completely worn out and was pushing or grinding the bone.   I had both hips replaced eventually.
  • ros007
    ros007 annette99709

    Posted

    Pre op I had an apparent 1" or more difference which developed over a few weeks.  My physio measured my legs using anatomical landmarks and said that the problem was in my pelvic geometry.  It is worth getting a professional to measure you as you can't do this for yourself.  If it is geometry then manipulation and exercise may help to correct it - I assume that they did this under the anaesthetic for me,  I am now having to work at it to stop the geometry going back because the muscle imbalance is still there as the muscle resting length changed while I was going through diagnosis and the pre-op process.

    If the discrepancy is real then you have to work out the best way of managing it. Insoles are cheap, Alterations to the soles can be more expensive if you have to pay but I would say are more comfortable. Insoles are good if you think that you may be able to reduce the discrepancy by exercise and manipulation because the sole changes are permanent.

    • christina4uk
      christina4uk ros007

      Posted

      I realize this is an old thread but would just like to comment that leg length discrepancy is best measured by a professional. Once the pelvis realigns the leg length may well be different. If fixed shoe inserts are used then these can cause problems. I am 14 weeks post hip replacement and I have been advised to only use my shoe lift while I need it and to readjust.  i go barefoot as much as possible to allow my body to naturally realign.   When I go out walking I use a minimum shoe lift for the unoperated leg.  I need a new 2nd hip replacement and until I have this there will be a leg length difference because of the bone on bone situation of unoperated leg.

       

  • james80413
    james80413 annette99709

    Posted

    Lots of controversy regarding leg lengths before and after hip arthroplasty.

    Google "PubMed: Discrepancy in leg length after hip replacement". At times in Pub Med you can get the whole article and at times a concise version. To the right of the Googled copy you may find, several similar scipts with conclusions.

  • joliejulie
    joliejulie annette99709

    Posted

    Hi, I have had both hips replaced and there was a gap of 7 months inbetween hip operations when one leg was considerably longer than the other, I found jelly heel lifts very helpful, you can make the inserts up to whatever height you want.  I bought them on the internet and they really helped me walk evenly until I got my 2nd hip done.  The inserts usually come from China and seem to take longer to arrive so I would order asap, they are only a few pounds and come with a lot of sections so you can add as many or few as you need and are made of silicon I think.  If you type in heel lifts to your favorite internet shopping website I'm sure they will come up.  Hope this is of some help.
    • kaleani75551
      kaleani75551 joliejulie

      Posted

      Same with me.  I had both hips done 10 months apart, and i also had  over 1 inch length discrepancy during the 10 months.  I purchased dr. Scholl's gel heels that you can find in any stores, i would use several of them stacked to put in the shoe of the shorter leg.  It did work...sort of.  It was very helpful for walking around the house and short distances, but i could not go for long hikes, like 2-3 miles.  
  • kay88399
    kay88399 annette99709

    Posted

    Hi, It is seven weeks since my THR and my operated leg seemed to be approx 1 centimetre longer, enough to cause back ache after a walk without crutches. I went to my Physio yesterday and her opinion is that the reason for the apparent discrepancy is that my pelvis is still quite stiff on operated side, and it is the way I am standing/holding myself, that makes one leg appear longer.  I think she has a point. Kay. 
  • ellen_68778
    ellen_68778 annette99709

    Posted

    Talk to your surgeon and follow his advice,otherwise I found myself totally confused as every therapist gave different advice about leg discrepancy /shoe lifts / exercise/amount of walking /speed of walking  etc .I am 23 months post op THR and have varying degrees of mild/ moderate pain .  Best advice I can give is Pace yourself and listen to your body ....rest when you need to and get on with life ! 
  • julia1968
    julia1968 annette99709

    Posted

    Some surgeons need to answer for their incompetence in measurement! Mr Maxwell has done the same to me but He has already operated on me twice & made me worse each time! Now I am being referred to a specialist hospital to see whether they suggest reoperating to lengthen shortened leg due to THR (I know people that have had this done) or whether to replace other side & get legs the same length. Wedges only work to some degree as difference in incline & weight distribution also ended up affecting my back, which I am also getting referred for - that said - 3 months post op & I'm back doing breastroke - totally different person in the water. People cant believe seeing the gymnast in the water transform back to a cripple as she gets out. I now take a raised flipflop & crutch with me sad
    • kaleani75551
      kaleani75551 julia1968

      Posted

      Thanks for the swimming encouragement, i need to get my act together and order goggles and swim hat at amazon.  I had both hips done 10 months apart and 2 different approaches but in between, i sufffered with a full inch length discrepancy and it was not easy, i am in California so flipflops are a must, and how do u put lifts in flipflops?  Anyways, it was a good thing that i needed to have both hips done..
    • julia1968
      julia1968 kaleani75551

      Posted

      I am living in flip flops at the moment with heel wedge stuck in with double sided tape lol x
  • julia1968
    julia1968 annette99709

    Posted

    old fashioned cobbler is in process of raising 5 pairs of my shoes at the base then incline/weight distribution should even out x 
  • juliette39133
    juliette39133 annette99709

    Posted

    Hi, I had ceramic the 5 years ago.I appeared to have a leg length discrepancy. In fact x Ray showed a very mis aligned pelvis. The top of my pelvis was much higher on one side. When sitting or standing, one leg was longer than the other. I was sent to physio for exercises to rebalance my gait and leg length.The simplest of these was actually to stretch the shorter leg every time I sat or lay down until it lined up with the longer leg. It felt weird but the muscles were all over the place. This in time almost completely solved the problem. I'm sure if I had taken to wearing inserts the problem would have remained. I had the other hip replaced 18 months ago and recovered quickly. However, last year I began to experience problems in walking and found I was limping again with awful pain in my knee.crazy and an not scan showed no abnormalities. Again i was sent to physio where weak muscles in the leg,hip and buttocks were diagnosed.I was given a gruelling set of exercises, which I have done religiously for several weeks. One exercise in particular made me weep at times because it was so hard to do. I have also started on a cross trainer for 15 minutes a day working slowly with quite high resistance concentrating on tightening the buttock and thigh muscles. I can already walk well again and the pain in the knee is much improved. In my opinion rehabilitation after replacement surgery is sadly neglected. In the time leading up to surgery we become semi invalids due to pain and stiffness and depression. It makes sense that those wasted muscles are going to need rehabilitating.
    • kaleani75551
      kaleani75551 juliette39133

      Posted

      You are absolutely 100% right.  I had both hips done too, 10 months apart (2nd one just over 8 wks ago)  and although the first 8 weeks were what i call normal, no pain - legs same length - walking almost daily close to two miles, suddenly 4 days ago it all went downhill, almost overnight, i developed pain in the groin.  It would be particularly painful after sitting down and in the evening after walking all day - back using the cane again, limping again and unable to really exercise normally.    I am taking one

      Advil almost every day.  I emailed my doctor, very unhappy about the situation, telling him that i thought these groin pains were all behind me and wondering the purpose of the surgeries.  He replied, angry with me this time, saying that i should be careful with exercise, not overdo, make sure i do iliopsoas tendon stretches to extend the tendon and all the rest in there that needs stretched...and essentially, that it takes months to be fully rehabilitated and people always expect too much too fast.

      so now, i have decreased my long hikes to just going around the block and honestly - i do not know how much it too much or not enough exercise any more.  But thanks for the physical therapy suggestion, i think i will look into that if things do not improve with me...soon.  The psoas and pelvis and length discrepancy are all connected.  My legs look the same length and doctor said they were, after my 2nd hip surgery.  The first surgery of my right hip had left me with a full inch difference, which has been corrected withe the 2nd one.

    • kay88399
      kay88399 juliette39133

      Posted

      Hi Juliette, I commented on this about a week ago.  Since my Physio pointed out that it is the way I am holding myself stiffly that is giving me the feeling of different leg lengths, I have been focussing on strengthening my pelvic area and glutes and already I am noticing the difference. There is now very little difference in leg length. I am 8 and a half weeks in now and still working on strength. I think it will be a while yet before I feel normal again, but feel I am going in the right direction. I agree that rehabilitation is hugely important and there is not enough emphasis given to it post op.
    • ros007
      ros007 kaleani75551

      Posted

      Pre-op I had a functional leg length discrepancy of about 1" although my physio assured me it was pelvis not femur.  Post op I was balanced and thrilled.  After a few weeks I became aware that when standing more of the weight went through the previous 'long leg'.  No physio easily accessible but I began some intensive work on my abductors  and various other muscles round the backside. I made sure that I kept the stretch in the adductor and internal rotator muscles and  I have managed to get the balance back.  But a day where I don't get round to those pesky exercises and I can sense the imbalance coming back.

      Oh boy, I forsee weeks to months of boring exercises but the alternative is far worse.  The one that achieved the most for me was to stand, pull up the pelvis on the non-operated side then lift the foot and hold the position while standing on the operated leg. Finish as soon as the hip starts to drop and don't try it too early in the rehab process.  I'm aiming for a full minute but haven't got there yet.

      I do think the NHS should take more post-op interest in our rehab.  I'm not saying we all need physio several times a week but the opportunity to go to exercise classes with a physio check-up every week or two would help to prevent problems developing in the future.

    • kaleani75551
      kaleani75551 ros007

      Posted

      I too feel that when standing my previously longer leg is getting more weight than the newly fixed leg.  My doctor never even mentioned physical therapy, which by the way is not accessible to me either, would have to drive for 45 minutes. He only suggested i do psoas stretches at home.  I do my home PT religiously and it incudes hip abduction plus now leg stretches.  When you say "pull up the pelvis" how do u do this exactly?

       

    • ros007
      ros007 kaleani75551

      Posted

      Stand up straight, feet slightly apart, put hands on hips or on unoperated one if you need to steady yourself. Use your muscles to slightly lift your unoperated hip, this will transfer some extra weight to your operated leg as well. Then try to keep the relative position of your hands or increase the relative height of the unoperated side when you lift your foot of the ground. Hold.

      If you have weak abductors the relative height of your unoperated side will drop slightly and as you tire that side will tend to drop as well. The same weakness causes difficulty in walking up slopes and a 'waddling' type gait. So concentrating on your hip angle while you stand on the operated leg makes sure you work the right set of muscles rather than compensating for their weakness. NOT an exercise for early rehab though - you might just do the first bit with both feet on the ground then.

    • juliette39133
      juliette39133 kaleani75551

      Posted

      Hi, I had to read your post several times to get it right. You were walking miles a day just weeks after a hip replacement? Wow! I do seriously think you may be overdoing it. Take it easy. Wouldn't it be great if the hospitals had a post op group with physical therapists there to offer help? In GB we are thrown out of hospital after three days and left to get on with it. It's a miraculous operation if successful because I was a depressed cripple. I am never going to be my former yoga practitioner self but at least I don't have people asking me why I'm limping now. Must go and do my exercises (again)!
    • kaleani75551
      kaleani75551 juliette39133

      Posted

      Well i thought that walking long distance was recommended if i had no pain and no limp, in other words, if I felt like a normal human being, and that was me beginning at week 4-5 post surgery.  I thought i was doing good for my body and new hips.  And actually, if remember well, my doctor and even the PT (u call it physio) were saying 'if you can do, do it'.  The problem is that there is a limit to how much you can do, even if you feel 100% well, but no one told me about it.  If it were not for forums here in America and overseas, there is much info that i would not know.  God bless forums everywhere!
    • tracy_86068
      tracy_86068 kaleani75551

      Posted

      I am in the exact same situation as you. I'll have more time to chat tomorrow nite. I want to compare.

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