LLD post THA

Yes
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

I'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!

5 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