Minimizing Leg-Length Inequality in Total Hip Arthroplasty: Use of Preoperative Templating and an Intraoperative X-Ray

Leg-length inequality after total hip arthroplasty remains a controversial issue. In the study reported here, we sought to determine whether significant leg-length discrepancies (>6 mm) can be minimized with use of an intraoperative x-ray. In each case, preoperative templating was carefully performed, an intraoperative pelvis x-ray was obtained to assess accuracy, and appropriate adjustments were made. Eighty-six consecutive primary total hip arthroplasties and their associated x-rays were retrospectively reviewed. Mean postoperative leg-length discrepancy was 0.3 mm (SD, 2.6 mm; range, –6 to +6 mm). No legs were lengthened or shortened by more than 6 mm. Significant leg-length discrepancies can be minimized with use of an intraoperative pelvis x-ray.