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LLD post THA
Has anyone experienced a significant leg length discrepancy following a THA? My back is taking the brunt of this. I'm told it's normal, but my LLD is over an inch!
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After my hip replacement, my left leg is 3 cm shorter I am very upset
@ndreyer Welcome to Mayo Connect. Uneven leg length is a not uncommon result of hip replacement surgery. It is sometimes unavoidable if the joint was very damaged before replacement, and insertion of the properly shaped femur head and acetabular cup make the leg longer. One of my best friends is still adjusting, one year after her replacement (due to a broken femur head.) Now she only has issues if she is very tired.
Another thing to know is that most of us have some discrepancy in the lengths of our legs naturally or have developed them as joints wear, but our bodies have accommodated to them.
I have had five hip replacements and/or major revisions. Each one presented a new challenge as far as length. On my fourth surgery, the orthopedic surgeon tried to reduce the discrepancy between my legs by using a shorter stem, smaller ball and acetabular cup. That was a problem! The muscles and tendons were too long for the smaller implant and it dislocated.
Instead, intensive physical therapy and gait training taught my body to accommodate the difference. As I was adjusting, I used progressively thinner lifts in the shoe on the shorter leg, until I no longer needed any (took about 2 years.)
Have you talked to the physical therapist about gait training and using a heel lift in your shoe?
Sue
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4 ReactionsI'm sure you are!
Were you given the standard response of "that's normal?"
My surgeon also blamed my scoliosis of my back and my pelvic obliquity.
Another surgeon told that even if those were true, it's the surgeon's job to return you to normal!
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1 Reaction5 surgeries!?!? Wow!
I am seeing a PT now and a 9 mm heel lift helps a little.
My old hip was really deteriorated, but this LLD is killing my back. What kind of therapy did you engage in? Were there lot's of core exercises?
Lots of stretching, balancing, core exercises, walking - in water and on land. Also a lot of stretches and strength work for thighs, glutes, adductors and abductors.
The body will adjust - slowly. My pelvis is now more even too.
I'm not sure what the second surgeon meant about it being the surgeon's job to return you to normal - there is a limit to what adjustments can be made to the hip that will correct scoliosis. But a good chiro or PT may be able to help level your pelvis through adjustments and targeted exercises.
Here's another question - was your surgery done using an anterior or posterior approach? And, is it possible your other hip will need replacement?
Sue
Hi Sue,
I already do lots of stretching. I had another PT tell me my SI joint was not in alignment. He claimed that he corrected it and the measurements backed him up, but it still feels way off balance. He did eliminate that SI joint pain! The surgeon used the anterior approach. I had the other hip (L) done five years ago with excellent results using the posterior approach. I did not return to him because he was really backed up on his schedule...wish I had waited. Another surgeon from same (successful with me) practice claims he could do a revision and correct the LLD, but I am skeptical.
Yes, according to my ortho, the anterior approach can give less precise results than the posterior because the field of view is smaller. Having had 5 hip surgeries, I too would be hesitant to get a revision, but if nothing else relieves your pain, maybe it is time to consider it. Just know that in my experience, you are pretty much going to go through all the same healing and rehab as the full replecement.
Sue
This may be a long post, however I have been trying to find somewhere and a group that I can speak to that can relate to what I have going on currently
I had a spinal fusion C7-T1 in 2022 the nerve was impinged and it was debilitating pain. After the spinal fusion I started to have issues in what I believed to be my left hip. I went to doc and was sent to ortho had x-rays and hip was " bone on bone " i was in some pain with this as well as healing from my spine. I had replacement June of 2024. I was in ALOT of pain from the hip replacement surgery and in fact was in bed for two full weeks with deep pain, and controlled by medication and some home therapy and so on. I started using the walker and was getting to where I could work again LIMITED of course this is a long story short of course. After about a month or so I told my family , friends etc that my surgery ( left leg ) felt so much shorter , and it was causing me to walk w a significant limp. I was told this is normal , give it time, the muscle has to " fully heal " blah blah and so on. I was then told after I went to a orthotic and was advised i was in fact about 1/2" shorter on the left leg that i could try lifts. My surgoen office gave me 4-5 stick in lifts all different sizes ( to me at that time why would we not try to give me the correct lift as I was still healing ) and said at this point it is still healing and come back in 2 months if not better. I did not get better in these two months in fact now i was miserable and still am currently. I went my pcp and he sent me out to see another hip surgeon for a second opinion and he mentioned , that yes he could see i had LLD and still needed to heal and come back first of year and i did still limping and he said lets do an injection in your trochanteric muscle, i thought at this point if i could get some relief i would choose to say ok. one day later i was at work and had the most intense debilitating pain that was in my lower back all the way across which caused me in bed for 3 days w ice and tears i called mutliple times they said you may want to go see your spine surgeon as this is nothing to do with hip
to date i have seen my spine surgeon and now need another fusion and more spine surgeries as the first fusion was not done fully or correctly and the lld with limp has sped up this process of pain in now my spine and lower back even though they all tell me the LLD and limp " has nothing to do with my new onset and current onset of spine issues again "
I had a recent MRI of hip and i have " an overlying fluid collection that could be trochanteric bursitis, seroma or hardware loosening or infection ( thats worrisome ) and I was advised also from spine surgeon ( second opinion as well ) that i again have nerve impingment that was never released in the first spine fusion that is reason for the numbness in left hand to never come back since 22 and now new numbness in right hand this all started in right hand since the hip and limp
so so sorry for this long post i am lost i am scared and i am confused i have been blown off ignored and to be felt like i dont matter I can no longer do things i used to do i am an active 56 year old and have yes in fact gained alot of weight as i hurt when i walk, exercise or just do anything
anyone experience anything like this and told this is all " normal "
I also want to add that the surgeon for my hip NEVER sent me to PT not until I was complaining about my LLD and pain and a significant limp. also was told from second opinion hip surgeon that the cup overhang he sees is 3-5 mm off what does this mean and how long do i need to keep going to doctors and MRI and cat scans and still no better in fact worse each day we are doing on a year w painful LLD and now deep deep hip pain and spine pain now
just desperate for someone to hear me and help me i want my life back
and MRI shows insertional teninopathy of the right hamstring what is this