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Still 2 cm leg length diff, no change after 5 months

Posted , 8 users are following.

sknapper33
sknapper33

Hello hipsters,

My leg length difference hasn’t seemed to have changed one bit since Op Oct 28th 2014. My standing xray said there was a 5 mm difference (about 1/5“), and my doctor’s surgery notes said they found a very good fit with no leg length difference. Yet I have a functional 2cm = ¾” difference. My operated leg is longer. I measure height while standing on one leg then the other. Plus last week a Physio measured 2cm diff from greater trocanter to ankle.

I’m 58 and active and wanted to get this ‘fixed’ before I was crippled, so I was in reasonably good shape pre surgery. I guess I can live with 1/4“ difference, but ¾” is a lot. I am doing Physio (PT) and have seen many doctors and have already had a 2nd opinion (who said just wait it out and I’ll be happy eventually).

I know there are people out there who have had this type of issue.  I saw a post (which I can’t find now) that said that finally after one year, their leg lengths had resolved. But is it feasible to expect it to still resolve if there has been no change in 5 months? Possibly the standing xray is faulty, and possibly the doc isn’t willing to take any blame… I think I will go for a 3rd opinion soon as I am getting fed up. I’ve been patient. A leg length difference isn’t the worst, but I was hoping to hike and backpack and rock climb for a long while yet and that doesn’t sound likely at this point.

Thanks – and thanks to this group. I‘ve been lurking for months and have replied a bit, but this is my first actual post. I’m going to cross post on that ‘other’ forum as well.

Sandy

2 likes, 17 replies

17 Replies

  • lynnsfave
    lynnsfave sknapper33

    Posted

    Get a 3rd opinion!  Don't ever let a doctor tell you to live with it or that you'll get used to it.  Jerks.  My op report said my legs started out about 2mm difference, and at the end of the surgery were even.  My difference in reality was 1-1/2".  I knew it as soon as I walked the first time.  My X-rays showed about 15mm. Then I asked to be measured clinically ... with a tape measure ... from bony hip bone to ankle bone. Same as I had measured ... 1-1/2".  Messed up every muscle and nerve in my body!  Get your X-rays and medical reports and go to another doctor.  Don't let them give you any b.s. about your living with it, or having your shoes built up.  My THR was last year.  My revision was last month.  My legs are closer to even now.  I'm so glad I went through the surgery again.  It was my best decision.  Good luck.
    • sally36012
      sally36012 lynnsfave

      Posted

      Do you mean that you had a revision  only in order to adjust the leg length?

       

    • sknapper33
      sknapper33 lynnsfave

      Posted

      Thanks for advice. I knew it right away too - a few hours after surgery as soon as I walked. I gave the doc hell in the hospital but have since been trying to be an adult about it. He said that if there really is a porblem, he fixes it by cutting a slice out of my femur instead of a redo. I'm leary of both methods. I'm not fragile but not particularly big boned and the thought of them hacking out the current part and replacing sounds scary.
    • lynnsfave
      lynnsfave sally36012

      Posted

      My LLD (leg length discrepancy) was due to the fact the surgeon put in the wrong size!  I have an abnormally wide femur neck, and the surgeon didn't measure.  The revision surgeon took out the wrong size and put in the correct size.  The result of my LLD was my shoulders hurt, my middle and lower back hurt, my thighs hurt, my knee hurt because I tended to walk with that leg bent so I wouldn't walk cock-eyed, my coccyx (tail bone) hurt because the surgery curved my spine, and I had sciatica.  I was in for injections in several parts of my body every few months.  I had to have the revision because I refused to build up my shoes.  The LLD would never get better.
    • lynnsfave
      lynnsfave sknapper33

      Posted

      The first thing to do is have the doctor measure your femur neck.  Maybe he put in the wrong size, like what happened to me.  Cutting the femur bone sounds a little drastic (although in 1999 I had a notch taken out of each femur bone and they were realigned ... but that was drastic!).  There are probably a lot of reasons for LLD, but first thing to do is find out what size your femur neck is to be sure the correct size (whether neck, head or stem) was implanted.
  • Mikey123
    Mikey123 sknapper33

    Posted

    Get a chiropracter to check that your hips are perpendicular to your spine.  If not , ask him to adjust them.  Mine was 1 1/4 inch higher on the injured side and so my foot was off the floor by the same a mount.  It fits with what you describe.

    The doctors can overlay the X-ray of the implanted hip over the X-ray of the good hip.  If they are the same the problem is else where.

    Some implants have variable stems of different lengths and angles to adjust for differences.

    There is also a problem with some implants that can move down the femur if you put too much weight on it too soon.  Or perhaps if you are too heavy.  Some implants have a lip that alllows them to rest on the solid bone at the top of the cut.   Lynnsfave gave you good advice if that route is necessary.

    Mikey

    • sknapper33
      sknapper33 Mikey123

      Posted

      Thank you Mikey, I'm glad the chiro worked for you. I have seen 2 chiros and both say my pelvis is fine and I don't have an alignment issue. My doc called this pelvic obliquity, but the 2 chiros and 3 PTs and an osteopath (DO) all disagree.

      I have both before and after Xrays and they don't line up perfectly, although i not sure if anyone's does. There is a definite offset (longer length stem) , which my doc noted in his surgical notes. PLus the top of the CUP is clearly higher then the old cup (maybe 1/2"), however, the center of the old and new balls seem to be at the same height.

      I don't see a lip on the implant. I weigh 145 (5'7'). I don't think the implant moved.

      OK - sounds like I should get my 3rd opinion and see if I can show the measurements i just made and make sense of it. Thanks again.

  • valerie190541
    valerie190541 sknapper33

    Posted

    Hi Sandy, I had my thr in October 14 and I also have 1" leg difference, I now have problems with my thigh hurting and have been told I now need a knee replacement, I just hope it doesn't make my leg any longer.  I have been given a uplift in the heel of my short leg which does help but any higher than that you need a built up shoe.  I went to the chiropractor who put my pelvis back as during the operation it quite often gets put out, which did help, so this might help you.

    Hope you get walking soon.

    Valerie

  • dene32609
    dene32609 sknapper33

    Posted

    hi

    i had to have a shoe made up 1 3/4 inchs  then when i had the other hip done i think i am level 1 good thing it made me a bit taller 

    biggrin

    • valerie190541
      valerie190541 dene32609

      Posted

      Hi, I was thinking the same, although my leg is shorter than the hr leg I think I will  eventually have to have the other one done so it may end up the same.  I used to be 5.2" and now when they measured me standing on the hr leg I am 5.2" but the unoperated side is only 5.1" so probably due to arthritis I have shrunk, hence the leg difference.

      best wishes Valerie

  • sally36012
    sally36012 sknapper33

    Posted

    I had both hips replaced around 20 years ago (dysplasia) when I was in my 40's. I ended up with one longer leg but I didn't get on with the shoe raisers and somehow I learned to walk without any limp and have had  20 good, painfree years - walking, cycling, playing a bit of tennis, swimming etc. The leg difference never bothered me.

    Then 6 months ago I had terrible sciatica in the shorter leg and when it got better, I had x rays and the hip surgeon said I needed urgent revisions. The prostheses on both sides have damaged my bones and made holes.

    For me the leg length didn't seem to matter - gave me no pain and no limp.

    So when they say that it will settle down and won't matter, they may be right.

    Personally, I wouldn't have a revision to change the leg length - there is a bit more risk with revisions, they are more complex (bone grafts?) and don't last as long. Revisions of revisions are even more difficult.

    Our bodies are amazing...  maybe your body will adjust ok to the different leg lengths.  Good luck with it all.

     

  • DawnDedee
    DawnDedee sknapper33

    Posted

    Hi Sandy,

    I do not know which country you live in, but here in the USA, I have found excellent results for second, in your case third, opinions at notable teaching hospitals/universities. There you have residents/ students who need to do their best in order to graduate and receive Good references and they are guided by their knowledgeable teachers. Also, they are up to speed about every new modern approach.

    Again, this is based on my experience here in the US, but I have found more than once that for second opinions it is best to go far from your home so you can get out of the circle of doctors who think alike, who play golf together and who will not step on another doctors toes because of friendships which ultimately leaves the patient to suffer.

    This may sound extreme, or snobby, but it is the reality of my life experiences.

    I feel for you in your situation and I pray that you will find the avenue in which your problem can be solved.

    Hugs

    💛 Dawn, USA

    • sknapper33
      sknapper33 DawnDedee

      Posted

      Thanks Dawn, That is certainly good advice and I know you are right about going to another town. I'ver tried a few other docs within a 3 hour radius, but the docs who folks have referred me to will not see me until I am at least 1 year out. I have my third opinion set up with A DO surgeaon who is young (ish) and maybe has not started hob nobbing with the whole doctor circle yet. I live in Blacksburg, Va, US. Thanks again - I've followed your posts, hope you are doing ok.
    • DawnDedee
      DawnDedee sknapper33

      Posted

      I am doing well thank you. And thanks for asking. I hope you get your answers.
  • mary5832
    mary5832 sknapper33

    Posted

    I'm so glad you " did" post Sandy.  I am just 4 weks post0-op and noticed the first day after my surgery that my leg was longer.  I mentioned that to my nurse in the hospital and she just replied "that happens".  Oh well , I am pain free at long last 2 years of walking with a cane and the last year with 2 canes while still taking hydramorphone for the pain while working.  No I am pill popping free!  The operation was a success in that sense!!  

    We'll see at this time next year how I feel.  I hope you can continue hiking and enjoying the outdoors!!  

    I envy you... Hey, maybe be I can go back to hiking??

    Mary

    • lynnsfave
      lynnsfave mary5832

      Posted

      Yiy didn't say how much longer your leg is. Mine was 1-1/2", enough to cause pain in other muscles and nerves.  Hopefully yours isn't significant.  Nobody has legs exactly the same, so what we're born with, we're used to.  It's when they change the length signficantly that our body goes out of whack and it affects our muscles and nerves that start to cause us pain.  If the wrong size was implanted, as was my case, it can be fixed.
    • sknapper33
      sknapper33 mary5832

      Posted

      Hi Mary, Yup - we'll see 1 year down the road. I decided to hold out and keep working on PT instead of the 3rd opinion for now. I'm hiking twice a week about 3-4 miles for now, but hope to increase that.

      I didn't start hiking until I got a 1/2" lift at about 4.5 months so that I wouldn't mess up my muscles. After months of docs telling me I shouldn't wear a lift because my body would then get used to it and not try to correct the situation, I decided that a lift was ok. I have a functional 3/4" diff and am using a 1/2" lift. I plan to use this for a while then try a 1/4" in a few months to see if I 'readjust'. But, not being able to walk distance was a real detriment for health and self confidence.

      I don't see why you couldn't start hiking again. I bought a pair of PacerPoles for hiking. I like them better then your standard hiking pole.You can google them.

      Good luck to us both!

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