Sunday, November 7, 2010
Hip Replacement Complication: Short Leg Syndrome
A common problem after hip replacement surgery that I have to deal with is short leg syndrome. I am asked by the doctors involved, or the patients, to give a lift to the short leg. I will discuss the treatment of short legs in many posts, and there are several links below. I will use this patient I saw yesterday to drive home the point. Due to right hip pain, Shirley had a right hip replacement 4 years ago, and 6 years ago she had had a low back fusion at L4/L5. Following the right hip replacement, her back began to be painful again. Presently, she would describe her pain as level 8 on a scale of 0 to 10. She was sent by her pain management specialist, a physiatrist who felt she had one leg longer. After hip replacement surgery, it is tough to get accurate landmarks with palpation, so I routinely order a Standing AP Pelvic xray to get the hip joint heights, the slant of the base of the spine (sacral base unleveling), the lowering of multiple pelvic landmarks, and the lean of the spine to the right or left. In this case, the spine leans to the left, the sacral base drops to the left, and the left hip joint is approximately 7/8 inches shorter than the right. Lift therapy has just been initiated and we have a long haul in front of us after 4 years post surgery.