How To Measure Uneven Leg Length? - Knee & Hip Problems Message Board

omaggi · 06-07-2005, 08:09 AM

Thanks to everybody who replied to my question about postponing THR. Based largely on your replies, I have decided to go forward with the surgery as scheduled (September).

Meanwhile, my 'bad' leg is shorter because of cartilage loss in the hip. I had a shoe repair place build up the shorter heel on two pairs of walking shoes, plus I've been trying inserts of various heights inside the shoe, but I can't get it quite right.

I'd like to know the exact leg-length difference to make walking as easy as possible between now and surgery. And after surgery, my doctor tells me that the THR leg will be longer than the other one, so I'll need to build up the other-side shoes.

My doctor measured the difference with a ruler on a x-ray, but I don't think I was standing exactly stright when the x-ray was taken becuase addign what he measured doesn't give enough height. He suggested experimenting with inserts because he doesn't know where else to send me.

From reading various posts of the board, I'm seeing that unequal leg lengths is a fairly common problem with bad hips, so I'm wondering where some of you all went to get measured ... podiatrist?? ... physical therapist?? ... orthopedic shoe store?? ... radiologist (measuring on an x-ray)?? ... or ????

Thanks in advance for any help or advice.

Ripanco · 06-07-2005, 09:02 AM

Hi OMaggi,

I have always had my leg length checked both standing and lying down by different orthopedic caregivers. This included chiro, many PTs, 3 different orthopedic drs, a spine specialist. They do you standing and see how your hips look. Most of them put their hands on my pelvis and seem to eyeball how level it is. Then lying down, they pull both legs until they seem to be in a natural state and eye ball that. They hold the feet both together closely to see if they are at the same distance and apart. I have never been measured with a ruler, so can't help you there.

I am not sure why your dr says your new hip will make your leg longer unless you have no cartilage in both like me. They have the ability to make some adjustment in leg length with the length of stem they use. I know for me, the mix up that caused my second surgery was when my surgeon did not like the length of the second leg with the ball that he used. He asked for a ball that added a little more lenght to the stem. Unfortunatly for me, he was given a ball made of an incompatable material to my stem!!

A small leg length discrepancy is not too bad, may people have it, but if it is enough it can cause lots of other problems, including in your spine. So I think I would talk to maybe a poditrist or someone that specializes in orthotics. I am surprised your surgeon can't refere you to anyone, but I would do some looking/asking around. Good, custom orthotics can make a big difference. I think you would want the kind that are made for you from cast imprint. You stand on a special foam block, both feet, and they make the orthotic to fit.

Congrats on deciding to go ahead with your surgery. It is a new lease on life for me!! If I can give you one word of advice? Get prepared as much as possible. Start now to get in as best a physical condition as you can. Make your body strong. Learn as much as you can about the procedure and what to expect. I 'trained' for my surgery, much like I train for an athletic competion and the payoff was huge. I set a hospital record for a bilateral stay (2 DAYS) and find my recovery to be a breeze.

Do you know yet what the approach will be and what material you are getting? Hopefully your dr will tailor that to your individual needs.

I definalty think I am slightly taller now, can tell when kissing hubby

legtoolong · 06-16-2005, 10:25 AM

Hi,
I have had both hips replaced and the second left me with a 3/4" difference in length. It is a long story, so check my other posts. I found that the PT was the most helpful in telling me how much to correct, but even he said it was a trial and error process of finding out what feels good to me. I did find some clear plastic lifts that are layered so you can take off just a milimeter at a time. Search the internet for shoe lifts and you will find them. I have changed how much I use several times getting it right. Hope this helps. I wouldn't have any more shoes altered before surgery--it is too expensive and will definitely be different after surgery.

likefinewine · 06-19-2005, 08:33 PM

Hi again.......I was told last week by physio that a leg length difference after surgery is normal because the muscles have been severed so are loose.....they will tighten up with exercise and return to normal.

hipster sister · 07-07-2005, 09:11 AM

I noticed a difference in leg length right after my THR and reported it to my dr. at my 3-week postop visit. He measured leg length from hip to ankle both sides and said they were of even length, but what I could be experiencing is something called pelvic obliquity (feels more like antiquity). It's about compensating for sore muscles. It's all adjusted in the past 3-4 months, and now I feel my operated leg is shorter and not longer! The surgeon told me it takes a year to realign, readjust, relearn walking. His PA said 2 years. I'm going with what she said! Neither lifts not inserts are warranted in my case, but I'm wondering if this difference is worsening the problem with the muscle soreness I'm experiencing. I just cannot seem to stretch out.