Erschienen in:
31.10.2019 | Original Paper
A low-volume surgeon is an independent risk factor for leg
length discrepancy after primary total hip arthroplasty: a case-control
study
verfasst von:
Yuji Kishimoto, Hiroko Suda, Takahiro Kishi, Toshiaki Takahashi
Erschienen in:
International Orthopaedics
|
Ausgabe 3/2020
Einloggen, um Zugang zu erhalten
Abstract
Purpose
Leg length discrepancy (LLD) is one of the bothersome complications
that reduce patient satisfaction after total hip arthroplasty (THA). This study
aimed to investigate the independent risk factors of LLD after primary
THA.
Methods
This is a case-control study of 163 THAs for 163 patients at our
institution between April 2015 and March 2018. The relevant data about the
general characteristics of the patients (age, sex, body mass index, and
diagnosis), surgery (surgical approach, type of femoral stem fixation, and
surgeon volume), and radiological findings (Dorr classification and
pre-operative LLD) were reviewed to identify the risk factors of ≥ 5 mm
post-operative LLD according to radiological measurement and to calculate odds
ratios (OR) via logistic regression analysis.
Results
The median (interquartile) absolute value of post-operative LLD was
3.9 (2.3–7.4) mm, and 57 (35.0%) patients had LLD of ≥ 5 mm. After controlling
for possible confounders, a low-volume surgeon was considered the only
independent risk factor of post-operative LLD (adjusted OR: 8.26; 95% confidence
interval: 3.48, 19.60; P < 0.001). Among
the 103 patients performed by high-volume surgeons, 82 (79.6%) had LLD of < 5
mm, whereas among the 60 patients performed by low-volume surgeons, only 24
(40.0%) achieved LLD of < 5 mm (P <
0.001).
Conclusion
A low-volume surgeon is associated with an increased risk of a
post-operative LLD after primary THA, and the importance of measurements should
be recognized to prevent post-operative LLD and achieve optimal outcomes.
Moreover, surgeons must inform patients about the risk of developing LLD
pre-operatively.