A functional discrepancy between the two lower extremities is a complication of total hip arthroplasty. It can lead to patient dissatisfaction, early implant failure and lawsuits.
Manifestations:
(1) pain in the back or hips
(2) abnormal gait
(3) dislocation or early failure of the prosthesis
(4) pelvic X-rays showing increased tilt or abnormal measurements (such as distances between the inferior margin of the acetabular teardrop, the most prominent point of the lesser trochanter and the center of rotation of the femoral head)
Risk factors:
(1) excess loss of bone from the femoral diaphysis
(2) incorrect angle for the femoral head and neck
(3) inadequate surgical planning
(4) emergency surgery (insufficient time to check for discrepancy during surgery)
Management:
(1) minor discrepancies can be compensated with orthotics
(2) reoperation
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