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Abstract Leg length discrepancy (LLD) has been well described as a common complication following total hip arthroplasty (THA). The presence of LLD has been associated with back pain, increased risk of nerve injury and dislocation, poor patient satisfaction, and the need for revision surgery. It has been cited as a major cause of litigation following THA. In the literature, there is continuing debate about the importance of LLD and its clinical effect. Careful preoperative measurement and assessment, as well as preoperative and postoperative patient education, are important factors in achieving an acceptable result. However, after total hip arthroplasty, equal leg length should not be guaranteed. Rather, the patient should be given a realistic assessment of what can reasonably be expected. Placement of the implants: restoration of the centre of rotation of the hip joint is an important goal of THR to ensure normal gait and function. Correct use and selection of implants can restore the biomechanics of the hip with appropriate femoral offset and leg length. Correction of limb length inequality (LLI) without compromising hip stability remains one of the intraoperative challenges in THR. The incidence is difficult to ascertain but evidence suggests that some lengthening occurs in as many as 30% of patients following THR, due most commonly to malpositioning of the femoral component, and less commonly the acetabular component. The objectives of total hip arthroplasty (THA) include pain relief, improved mobility and stability of the hip, normal mechanics of the hip joint, and, when possible, equality of leg length. In general, obtaining pain relief and improving stability take precedence over restoring equal leg Summary 100 length. However, leg lengthening may be required to provide a stable hip joint after reconstruction arthroplasty. To prevent postoperative leg length discrepancy and its attendant problems, it is important to understand the various components of leg length assessment related to THA, including preoperative planning, intraoperative measurement, and post-operative management. With minimally invasive techniques and smaller incisions, the need for accurate placement of implants is heightened. |