Effects of lower limb length discrepancy on spinopelvic compensation following total hip arthroplasty in patients with developmental dysplasia of the hip

Abstract

Abstract Background Limited research has examined the impact of lower limb length discrepancy (LLLD) alteration on spinopelvic compensation in individuals with developmental dysplasia of the hip (DDH). This study aimed to investigate the effects of LLLD on spinopelvic compensation following total hip arthroplasty (THA) and elucidate the complex biomechanical adaptations in the spinopelvic structures. Methods A retrospective review of DDH patients undergoing THA from January 2014 to December 2021 categorized individuals with Crowe type I and II into the low dislocation group (LDG, n = 94) and those with Crowe type III and IV into the high dislocation group (HDG, n = 43). Demographic data, as well as preoperative, postoperative, and last follow-up imaging data, including lower limb length (LLL), sacral obliquity (SO), iliac obliquity (IO), hip obliquity (HO), Cobb angle, apical vertebral translation (AVT), and coronal decompensation (CD), were collected for analysis. Results Patients in the LDG had a significantly higher surgical age and shorter disease duration (P0.05). The variation in LLLD correlated significantly with the variations in SO, IO, and HO (P0.05). The variation in LLLD correlated significantly with the variations in SO, IO, HO, and CD (P<0.05). Conclusions THA effectively reduces LLLD in patients with DDH, and the variation in LLLD correlates meaningfully with the recovery of spinopelvic compensatory mechanisms.

Keywords

• Lower limb length discrepancy (LLLD)
• Developmental dysplasia of the hip (DDH)
• Total hip arthroplasty (THA)
• Coronal decompensation (CD)
• Compensation