Leg-Length Discrepancy After Total Hip Arthroplasty: Comparison of Robot-Assisted Posterior, Fluoroscopy-Guided Anterior, and Conventional Posterior Approaches
Authors: El Bitar YF, Stone JC, Jackson TJ, Lindner D, Stake CE, Domb BG
PMID: 26046996
Purpose
To compare postoperative leg-length discrepancy (LLD) among robot-assisted posterior, fluoroscopy-guided anterior, and conventional posterior THA approaches.
Methods
- Retrospective review of 155 THA cases by a single surgeon.
- Radiographic LLD measured by blinded observers.
Key Findings
- Mean LLD: RTHA 2.7 mm, ATHA 1.8 mm, PTHA 1.9 mm (significant difference).
- Percentage with LLD >3 mm: RTHA 37.3%, ATHA 17.2%, PTHA 22% (not statistically significant).
- No LLD ≥10 mm in any group.
- All approaches produced clinically acceptable and comparable LLD.
What Does This Mean for Providers?
- Robot-assisted, fluoroscopy-guided anterior, and conventional posterior THA approaches similarly minimize clinically relevant LLD.
- Selection of approach can be based on surgeon preference and patient factors without major concern for LLD differences.
- Maintain attention to intraoperative leg length assessment regardless of technique.