Leg length inequality after primary total hip arthroplasty

This paper presents an overview of our current understanding of the problem of leg length inequality after primary total hip replacement. We discuss the definition, explore why some patients are affected by this condition and others are not, and review the techniques of measurement on X-ray. We review three key papers from the literature, techniques available for the surgeon to prevent this problem, describe the clinical assessment of a patient with LLI, and their conservative or surgical management. We report on our lessons learnt from the management of these patients and give some thought to the future.