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Saturday, July 19, 2014

Short Leg after Hip Replacement: Email Advice

This AP Pelvic Standing Xray is not that of the patient in question
Recently had THR (total hip replacement) surgery and experiencing severe Short Leg Syndrome - Should I go to my surgeon and suggest correcting this asap?


Dr Blake's comment: 

     Thanks so very much for your email and I am sorry for your predicament. We experience a feeling of one leg being longer for many reasons which include tight muscles, weak muscles, pelvic tilts, limping from pain, and true short legs. A slight short leg structurally can be magnified in feeling by one or two of the other problems produced by the surgical treatment. I relie on the Standing AP Pelvic xray in normal stance to give me as much information on the structural difference in hip heights that your body must deal with when you walk, and the pelvic tilts, including any sacral base unevenness at the base of the spine. You take this information and combine it with the data collected from a physical therapist on muscle tightness and weakness patterns to further get a strong picture on what is going on. Then you ascertain if gait is influenced by pain, weakness, tightness, or spinal sway above. Spinal Sway places severe stress on the operated hip and documented as limb dominance to one side. In summary, most of my patients I see following hip replacement have a combination of structural shortness and functional shortness (related to muscles, scar, pain, scoliosis, etc). It can take a good year post hip replacement to gradually work out the problems. As a podiatrist, I can measure things, and make observations, but relie on PTs and physiatrists, chiropractors, and osteopaths to help me in treatment. Surgeons are smart, but you really need a non surgeon spine specialist to help you work through the functional part before imparting on perhaps hasty and unnecessary surgery. That being said, you must start at the beginning with a standing AP Pelvic xray and get that interpreted. Hope this helps you. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.