Influence of Surgical Positioning on Pelvic Limb Discrepancy after Primary Total Hip Arthroplasty

Abstract

Introduction: Leg length discrepancy (LLD) is one of the main causes of dissatisfaction after total hip arthroplasty (THA). It has been suggested that surgical positioning may influence its occurrence. Objective: To determine whether there is an association between surgical positioning (lateral decubitus vs supine) and radiological leg length discrepancy after primary THA. Methods: Retrospective cross-sectional study of 47 patients undergoing primary THA in 2024 with lateral approach. Radiological discrepancy was evaluated on AP pelvic radiographs. Significant discrepancy was defined as >5 mm. Chi-square test was used to compare proportions (p<0.05). Results: 57% of patients in lateral decubitus and 58% in supine presented discrepancy >5 mm. No significant association was found between surgical position and discrepancy (p=0.88). Most patients (83%) had discrepancies <10 mm without clinical relevance. Conclusions: Surgical positioning did not significantly influence radiological discrepancy after primary THA. These findings align with current reports emphasizing additional factors such as preoperative discrepancies, surgical approach, and intraoperative measurements.

Recibido: 25/08/2025

Aprobado: 05/03/2026