Guest guest Posted April 4, 2004 Report Share Posted April 4, 2004 6 weeks post op lbhr my operatered leg seems to be a bit longer than the other has any one else experienced this could it be due to spine and years of limping etc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2004 Report Share Posted April 30, 2004 > Hi > > I have had similar problems and expectations. My leg was16mm shorter before the resurfacing. It is now about 7mm shorter. That’s how much was possible to achieve due to the bad condition of my hip (I have posted in March about this †" you can check the posts as I believe I had explained that in greater detail then). > > Essentially, you can adjust leg length more/better with THR as you (rather, the OS) can choose how deep to insert the prosthesis shaft into the femur. With resurfacing you are restricted by the skeletal geometry. I don’t want to bore you to death with technical drawings and details but imagine the pelvic bone with the acetabulum as a piece which is fixed and then imagine the femur (with its head) slotted into the acetabulum. In many cases of OA the latter has shifted upwards as the separating cartilage (approx. 5-10 mm) has worn away or disintegrated. With long-term OA the femur head rubbing against the acetabulum (bone-on-bone) can and does often lead to compression and deformity of either or both parts with cysts forming where these parts connect. Now, the OS has to firstly make the acetabulum neat and nearly perfectly spherical (to a specific diameter) in order to fit TIGHTLY the respective component of the prosthesis †" so, you probably lose a lit bit more of the length there while he ‘shaves’ away the damaged/imperfect parts. Then the same, but usually more drastically, happens to the femur head. So, you lost quite a bit more length. Then the OS fits the 2 parts of the prosthesis and their size (mainly thickness) adds to the leg length. But that’s all that the OS and the prosthesis can do for you †" try to replace the lost bits of tissue with the prosthesis thickness. However, if due to extensive damage a lot of tissue has been wasted/lost not much can be done as the prosthesis thickness is proportional to the diameter rather than to the lost tissue, I understand (I assume the thickness is mainly determined by stress measurements and pressure and/or production/weight parameters). There’s nothing else that can be done using this technique and these implants. Any tinkering with additional thickness of either component would alter the body’s skeletal geometry as it would push your femur outwards in order to push it downwards as the femur sits ideally at 230 degrees to the vertical line going through your acetabulum. So, in theory, you could ‘push’ the leg further down, but you would be ‘pushing’ it away from the other leg as well. I assume that the accompanying problems must have been deemed unacceptable by professionals who designed the prosthesis and the operating protocols. > > I was also told not to worry about the leg length discrepancy of 7- 8mm as both the OS and the physiotherapist believe there is still more adjustment to be had/made through physiotherapy (stretching contracted muscle/tendon groups; re-alignment of the pelvic bone etc.). I was also told that very few people have symmetrical leg lengths anyway regardless of OA (as no one seems to have identical size left & right foot) and that discrepancies of up to 5mm do not require treating. > > I hope this helps. > > Regards > Dan > > * +44 (0)7974 981-407 > * +44 (0)20 8501-2573 > @ dan.milosevic@i... > _____ > > From: gard4279 [mailto:gardau@c...] > Sent: 30 April 2004 04:39 > To: surfacehippy > Subject: Leg Length > > After sending my x-rays for evaluation, I was contacted today and > was told that, even though I am a candidate for resurfacing, it > could not impact my leg length discrepency. > > This surgeon, who uses the Corin product, is highly touted on this > site. > > Previous postings led me to believe that leg length issues could be > corrected so, naturally, I was very dissappointed to get this > response. > > Has anyone else had leg length issues corrected through > resurfacing? What system and surgeon was used in your procedure? > > Are other systems (, BHR, etc) more suited to correct leg > length issues? > > Any input is greatly appreciated. > > Thanks. > > , I have been looking into this leg length issue since I started investigating hip re-surfacing several months ago. My particular disorder, Protrusio Acetabulum, or " Otto Pelvis " presents as a very deep acetabulum with the head of the femur gravitating upwards... anyway, a resurfacing to correct my problem would require making the acetabulum not so deep and bringing the femur out into a more normal allignment.....thus making that leg quite a bit longer than the non- operated one. It seems that the Birmingham-McMinn prosthesis has an assortment of heads to accomodate problems such as mine. Bone grafting into the acetabulum can also be used. I'm looking into a bilateral procedure so I won't have to deal with this issue at all if I can whip myself into shape. Hope this helps...I've definitely heard that the Birmingham is more accomodating. Susie > > > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2004 Report Share Posted April 30, 2004 > Hi > > I have had similar problems and expectations. My leg was16mm shorter before the resurfacing. It is now about 7mm shorter. That’s how much was possible to achieve due to the bad condition of my hip (I have posted in March about this †" you can check the posts as I believe I had explained that in greater detail then). > > Essentially, you can adjust leg length more/better with THR as you (rather, the OS) can choose how deep to insert the prosthesis shaft into the femur. With resurfacing you are restricted by the skeletal geometry. I don’t want to bore you to death with technical drawings and details but imagine the pelvic bone with the acetabulum as a piece which is fixed and then imagine the femur (with its head) slotted into the acetabulum. In many cases of OA the latter has shifted upwards as the separating cartilage (approx. 5-10 mm) has worn away or disintegrated. With long-term OA the femur head rubbing against the acetabulum (bone-on-bone) can and does often lead to compression and deformity of either or both parts with cysts forming where these parts connect. Now, the OS has to firstly make the acetabulum neat and nearly perfectly spherical (to a specific diameter) in order to fit TIGHTLY the respective component of the prosthesis †" so, you probably lose a lit bit more of the length there while he ‘shaves’ away the damaged/imperfect parts. Then the same, but usually more drastically, happens to the femur head. So, you lost quite a bit more length. Then the OS fits the 2 parts of the prosthesis and their size (mainly thickness) adds to the leg length. But that’s all that the OS and the prosthesis can do for you †" try to replace the lost bits of tissue with the prosthesis thickness. However, if due to extensive damage a lot of tissue has been wasted/lost not much can be done as the prosthesis thickness is proportional to the diameter rather than to the lost tissue, I understand (I assume the thickness is mainly determined by stress measurements and pressure and/or production/weight parameters). There’s nothing else that can be done using this technique and these implants. Any tinkering with additional thickness of either component would alter the body’s skeletal geometry as it would push your femur outwards in order to push it downwards as the femur sits ideally at 230 degrees to the vertical line going through your acetabulum. So, in theory, you could ‘push’ the leg further down, but you would be ‘pushing’ it away from the other leg as well. I assume that the accompanying problems must have been deemed unacceptable by professionals who designed the prosthesis and the operating protocols. > > I was also told not to worry about the leg length discrepancy of 7- 8mm as both the OS and the physiotherapist believe there is still more adjustment to be had/made through physiotherapy (stretching contracted muscle/tendon groups; re-alignment of the pelvic bone etc.). I was also told that very few people have symmetrical leg lengths anyway regardless of OA (as no one seems to have identical size left & right foot) and that discrepancies of up to 5mm do not require treating. > > I hope this helps. > > Regards > Dan > > * +44 (0)7974 981-407 > * +44 (0)20 8501-2573 > @ dan.milosevic@i... > _____ > > From: gard4279 [mailto:gardau@c...] > Sent: 30 April 2004 04:39 > To: surfacehippy > Subject: Leg Length > > After sending my x-rays for evaluation, I was contacted today and > was told that, even though I am a candidate for resurfacing, it > could not impact my leg length discrepency. > > This surgeon, who uses the Corin product, is highly touted on this > site. > > Previous postings led me to believe that leg length issues could be > corrected so, naturally, I was very dissappointed to get this > response. > > Has anyone else had leg length issues corrected through > resurfacing? What system and surgeon was used in your procedure? > > Are other systems (, BHR, etc) more suited to correct leg > length issues? > > Any input is greatly appreciated. > > Thanks. > > , I have been looking into this leg length issue since I started investigating hip re-surfacing several months ago. My particular disorder, Protrusio Acetabulum, or " Otto Pelvis " presents as a very deep acetabulum with the head of the femur gravitating upwards... anyway, a resurfacing to correct my problem would require making the acetabulum not so deep and bringing the femur out into a more normal allignment.....thus making that leg quite a bit longer than the non- operated one. It seems that the Birmingham-McMinn prosthesis has an assortment of heads to accomodate problems such as mine. Bone grafting into the acetabulum can also be used. I'm looking into a bilateral procedure so I won't have to deal with this issue at all if I can whip myself into shape. Hope this helps...I've definitely heard that the Birmingham is more accomodating. Susie > > > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2004 Report Share Posted April 30, 2004 > > Hi > > > > I have had similar problems and expectations. My leg was16mm > shorter before the resurfacing. It is now about 7mm shorter. > That’s how much was possible to achieve due to the bad condition of > my hip (I have posted in March about this †" you can check the posts > as I believe I had explained that in greater detail then). > > > > Essentially, you can adjust leg length more/better with THR as you > (rather, the OS) can choose how deep to insert the prosthesis shaft > into the femur. With resurfacing you are restricted by the skeletal > geometry. I don’t want to bore you to death with technical > drawings and details but imagine the pelvic bone with the acetabulum > as a piece which is fixed and then imagine the femur (with its head) > slotted into the acetabulum. In many cases of OA the latter has > shifted upwards as the separating cartilage (approx. 5-10 mm) has > worn away or disintegrated. With long-term OA the femur head rubbing > against the acetabulum (bone-on-bone) can and does often lead to > compression and deformity of either or both parts with cysts forming > where these parts connect. Now, the OS has to firstly make the > acetabulum neat and nearly perfectly spherical (to a specific > diameter) in order to fit TIGHTLY the respective component of the > prosthesis †" so, you probably lose a lit bit more of the length > there while he ‘shaves’ away the damaged/imperfect parts. Then > the same, but usually more drastically, happens to the femur head. > So, you lost quite a bit more length. Then the OS fits the 2 parts > of the prosthesis and their size (mainly thickness) adds to the leg > length. But that’s all that the OS and the prosthesis can do for > you †" try to replace the lost bits of tissue with the prosthesis > thickness. However, if due to extensive damage a lot of tissue has > been wasted/lost not much can be done as the prosthesis thickness is > proportional to the diameter rather than to the lost tissue, I > understand (I assume the thickness is mainly determined by stress > measurements and pressure and/or production/weight parameters). > There’s nothing else that can be done using this technique and > these implants. Any tinkering with additional thickness of either > component would alter the body’s skeletal geometry as it would push > your femur outwards in order to push it downwards as the femur sits > ideally at 230 degrees to the vertical line going through your > acetabulum. So, in theory, you could ‘push’ the leg further > down, but you would be ‘pushing’ it away from the other leg as > well. I assume that the accompanying problems must have been deemed > unacceptable by professionals who designed the prosthesis and the > operating protocols. > > > > I was also told not to worry about the leg length discrepancy of 7- > 8mm as both the OS and the physiotherapist believe there is still > more adjustment to be had/made through physiotherapy (stretching > contracted muscle/tendon groups; re-alignment of the pelvic bone > etc.). I was also told that very few people have symmetrical leg > lengths anyway regardless of OA (as no one seems to have identical > size left & right foot) and that discrepancies of up to 5mm do not > require treating. > > > > I hope this helps. > > > > Regards > > Dan > > > > * +44 (0)7974 981-407 > > * +44 (0)20 8501-2573 > > @ dan.milosevic@i... > > _____ > > > > From: gard4279 [mailto:gardau@c...] > > Sent: 30 April 2004 04:39 > > To: surfacehippy > > Subject: Leg Length > > > > After sending my x-rays for evaluation, I was contacted today and > > was told that, even though I am a candidate for resurfacing, it > > could not impact my leg length discrepency. > > > > This surgeon, who uses the Corin product, is highly touted on this > > site. > > > > Previous postings led me to believe that leg length issues could be > > corrected so, naturally, I was very dissappointed to get this > > response. > > > > Has anyone else had leg length issues corrected through > > resurfacing? What system and surgeon was used in your procedure? > > > > Are other systems (, BHR, etc) more suited to correct leg > > length issues? > > > > Any input is greatly appreciated. > > > > Thanks. > > > > > > , I have been looking into this leg length issue since I started > investigating hip re-surfacing several months ago. My particular > disorder, Protrusio Acetabulum, or " Otto Pelvis " presents as a very > deep acetabulum with the head of the femur gravitating upwards... > anyway, a resurfacing to correct my problem would require making the > acetabulum not so deep and bringing the femur out into a more normal > allignment.....thus making that leg quite a bit longer than the non- > operated one. It seems that the Birmingham-McMinn prosthesis has an > assortment of heads to accomodate problems such as mine. Bone > grafting into the acetabulum can also be used. I'm looking into a > bilateral procedure so I won't have to deal with this issue at all if > I can whip myself into shape. Hope this helps...I've definitely > heard that the Birmingham is more accomodating. Susie ....also ...I've just heard that the Birmingham resurfacing device has just been acquired by and Nephew (aprox. 2 days ago)here in the states and will soon be available!. > > > > > > > > > > > > _____ > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2004 Report Share Posted April 30, 2004 Dear , I don't know the extent of your discrepancy or if you're a bilateral candidate, but I would consult with some more surf surgeons (De Smet, I think, is known for adjusting length) before throwing in the surgical sponge. Cindy on this list, I believe, has a leg length problem rectified via resurfacing & she was done in the U.S. And anyone who reads this regularly knows that my leg was (inadvertently) made longer as a result of surfing. So it can be done. It's true that THRs are much more suitable for adjusting and addressing frank leg length problems, but they also come with a bunch of other risks. If you think resurfacing is right for you, I would get a couple other opinions from docs who pride themselves on correcting for length. A lot of the folks stateside are new at it and haven't had a lot of experience yet in helping patients who present with a more elaborate set of problems than normal. That said, if you're talking a substantial difference, of say, 3 inches, I would think that a THR is probably the most logical solution to get you plumb. Good luck, Sheila > After sending my x-rays for evaluation, I was contacted today and > was told that, even though I am a candidate for resurfacing, it > could not impact my leg length discrepency. > > This surgeon, who uses the Corin product, is highly touted on this > site. > > Previous postings led me to believe that leg length issues could be > corrected so, naturally, I was very dissappointed to get this > response. > > Has anyone else had leg length issues corrected through > resurfacing? What system and surgeon was used in your procedure? > > Are other systems (, BHR, etc) more suited to correct leg > length issues? > > Any input is greatly appreciated. > > Thanks. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2004 Report Share Posted April 30, 2004 I had leg length problems before I had mine done. My left leg, the one that was resurfaced, was an inch shorter than my other leg. It was possible to get the leg length made up by extending the stem of the femur however they could not extend it as much as necessary so instead I was given a double socket. This is where instead of putting one socket they put two. One socket sits inside of the other and it has made my legs equal length. This is not a very commonly performed procedure but I am very much in favor of it. a > After sending my x-rays for evaluation, I was contacted today and > was told that, even though I am a candidate for resurfacing, it > could not impact my leg length discrepency. > > This surgeon, who uses the Corin product, is highly touted on this > site. > > Previous postings led me to believe that leg length issues could be > corrected so, naturally, I was very dissappointed to get this > response. > > Has anyone else had leg length issues corrected through > resurfacing? What system and surgeon was used in your procedure? > > Are other systems (, BHR, etc) more suited to correct leg > length issues? > > Any input is greatly appreciated. > > Thanks. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2004 Report Share Posted May 2, 2004 Hi Cindy, Interested in what you said about not crawling....... My son didn't crawl but has perfectly good hips.........He just stood up and walked just before he was 9 months old.......... However, from what I have understood over the years the activity of crawling is very important to kniting hemispheres in brains and there is some evidence that babies who don't crawl end up with hassles dealing with the structure of language as reading and writing.......... so he ended up with troubles of another sort later when he went to school.......... Just wondering if you had any of these later from not crawling..........?? Edith LBHR Dr. L Walter Syd Aust 8/02 > > I was born with both hips completely dislocated, although it wasn't > discovered until I was nearly 18 months old. No, I did not crawl, stand, > or walk, and the Dr. told my mother that I was just slow. It is the > activities of crawling, standing, and walking that really help develop a > good deep socket. My hips finally settled into not the actual socket, but > higher up on my pelvis and made pseudo-acetabulum (fake sockets). So in my > resurfacing surgeries, Dr. Boyd put the metal acetabular component where > it should have been originally, thus " dropping the sockets " . Think of it > as someone hanging a picture too high on the wall. You move the nail down > to where it should have been, and the picture hangs where it should be. Am > I clear as mud now? > > Cindy > C+ 5/25/01 and 6/28/01 Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.