Stimolo D, Lo Giudice S, Matassi F, Innocenti M, Civinini R, Boniforti F
School of Human Health Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
Department of Orthopaedics and Traumatology, AOU Careggi, Largo Piero Palagi 1, 50139, Florence, Italy.
Musculoskelet Surg. 2025 Mar;109(1):89-96. doi: 10.1007/s12306-024-00855-9. Epub 2024 Aug 7.
We created a Multicenter Survey for Italian orthopedics surgeons on how they approach leg length discrepancy when dealing with primary total hip arthroplasty. Aim of the study was to show how surgeons manage LLD and follow literature recommendations during clinical practice.
The Survey was composed of 25 questions divided in 4 sections: surgeon's profile, preoperative and intraoperative evaluation, postoperative management. In this paper, we report the absolute and relative frequencies of answers to section on "postoperative management." Then, regarding the treatment of residual LLD, we reported whether trauma surgeons and experts in replacement surgery had higher odds ratios for providing "literature-based" answers compared to orthopedics physicians.
Only four questions received more than 70% agreement on one of the answers. The OR for giving the "literature-based" answer, taking OP as the reference group was 1.57 for TR and 1.72 for RS for 10 mm LLD at first follow-up (FU) and 1.23 TR and 1.32 RS when 20 mm. When 10 mm LLD at 3 months FU the OR was 0.88 TR and 1.15 RS. The OR for treatment of LLD after the first examination of a new patient was 2.16 TR and 1.85 RS.
LLD is a debated topic with no definitive recommendations. Many decisions still depend on tradition. Treatment of LLD during clinical practice often differs from literature recommendations.
我们针对意大利骨科医生开展了一项多中心调查，内容涉及他们在进行初次全髋关节置换术时如何处理肢体长度差异。本研究的目的是展示外科医生在临床实践中如何处理肢体长度差异以及遵循文献建议。
该调查由25个问题组成，分为4个部分：外科医生简介、术前和术中评估、术后管理。在本文中，我们报告了“术后管理”部分答案的绝对频率和相对频率。然后，关于残余肢体长度差异的治疗，我们报告了与骨科医生相比，创伤外科医生和置换手术专家给出“基于文献”答案的优势比是否更高。
只有四个问题在其中一个答案上获得了超过70%的认同。以骨科医生作为参照组，在首次随访（FU）时，对于10毫米的肢体长度差异，创伤外科医生给出“基于文献”答案的优势比为1.57，置换手术专家为1.72；当肢体长度差异为20毫米时，创伤外科医生为1.23，置换手术专家为1.32。在术后3个月时，对于10毫米的肢体长度差异，创伤外科医生的优势比为0.88，置换手术专家为1.15。在对新患者进行首次检查后处理肢体长度差异的优势比，创伤外科医生为2.16，置换手术专家为1.85。
肢体长度差异是一个存在争议的话题，没有明确的建议。许多决策仍然依赖于传统。临床实践中对肢体长度差异的处理往往与文献建议不同。
