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Gary A Knutson - One of the best experts on this subject based on the ideXlab platform.
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Examination of two subjects with severe, quantified anatomic Leg Length Inequality using unloaded “functional” Leg checks
Clinical Chiropractic, 2006Co-Authors: Gary A KnutsonAbstract:Summary Objective To describe two asymptomatic subjects with severe, quantified anatomic Leg Length asymmetry, and visualize how that asymmetry affects unloaded, prone and supine, Leg checks. Clinical features Two male subjects: one young (14) with Leg Length Inequality of 29 mm, the other older (40) with Leg Length Inequality of 48 mm. Intervention and outcome Photographs were taken of the subjects in a variety of positions, demonstrating their pelvic obliquity and how that affected Inequality in the prone and supine Leg checks. Conclusions A large magnitude anatomic Leg Length Inequality (LLI) did not have a significant effect on visual asymmetry in prone and supine Leg checks. By logical extension, smaller magnitudes of anatomic Leg Length Inequality may not affect unloaded Leg check tests. This hypothesis requires further testing.
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Anatomic and functional Leg-Length Inequality: A review and recommendation for clinical decision-making. Part I, anatomic Leg-Length Inequality: prevalence, magnitude, effects and clinical significance
Chiropractic & Osteopathy, 2005Co-Authors: Gary A KnutsonAbstract:Background Leg-Length Inequality is most often divided into two groups: anatomic and functional. Part I of this review analyses data collected on anatomic Leg-Length Inequality relative to prevalence, magnitude, effects and clinical significance. Part II examines the functional "short Leg" including anatomic-functional relationships, and provides an outline for clinical decision-making. Methods Online database – Medline, CINAHL and MANTIS – and library searches for the time frame of 1970–2005 were done using the term "Leg-Length Inequality". Results and Discussion Using data on Leg-Length Inequality obtained by accurate and reliable x-ray methods, the prevalence of anatomic Inequality was found to be 90%, the mean magnitude of anatomic Inequality was 5.2 mm (SD 4.1). The evidence suggests that, for most people, anatomic Leg-Length Inequality does not appear to be clinically significant until the magnitude reaches ~ 20 mm (~3/4"). Conclusion Anatomic Leg-Length Inequality is near universal, but the average magnitude is small and not likely to be clinically significant.
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Anatomic and functional Leg-Length Inequality: A review and recommendation for clinical decision-making. Part I, anatomic Leg-Length Inequality: prevalence, magnitude, effects and clinical significance
Chiropractic & osteopathy, 2005Co-Authors: Gary A KnutsonAbstract:Leg-Length Inequality is most often divided into two groups: anatomic and functional. Part I of this review analyses data collected on anatomic Leg-Length Inequality relative to prevalence, magnitude, effects and clinical significance. Part II examines the functional "short Leg" including anatomic-functional relationships, and provides an outline for clinical decision-making. Online database – Medline, CINAHL and MANTIS – and library searches for the time frame of 1970–2005 were done using the term "Leg-Length Inequality". Using data on Leg-Length Inequality obtained by accurate and reliable x-ray methods, the prevalence of anatomic Inequality was found to be 90%, the mean magnitude of anatomic Inequality was 5.2 mm (SD 4.1). The evidence suggests that, for most people, anatomic Leg-Length Inequality does not appear to be clinically significant until the magnitude reaches ~ 20 mm (~3/4"). Anatomic Leg-Length Inequality is near universal, but the average magnitude is small and not likely to be clinically significant.
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anatomic and functional Leg Length Inequality a review and recommendation for clinical decision making part i anatomic Leg Length Inequality prevalence magnitude effects and clinical significance
Chiropractic & Manual Therapies, 2005Co-Authors: Gary A KnutsonAbstract:Background Leg-Length Inequality is most often divided into two groups: anatomic and functional. Part I of this review analyses data collected on anatomic Leg-Length Inequality relative to prevalence, magnitude, effects and clinical significance. Part II examines the functional "short Leg" including anatomic-functional relationships, and provides an outline for clinical decision-making.
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Anatomic and functional Leg-Length Inequality: A review and recommendation for clinical decision-making. Part II, the functional or unloaded Leg-Length asymmetry
Chiropractic & Osteopathy, 2005Co-Authors: Gary A KnutsonAbstract:Background Part II of this review examines the functional "short Leg" or unloaded Leg Length alignment asymmetry, including the relationship between an anatomic and functional Leg-Length Inequality. Based on the reviewed evidence, an outline for clinical decision making regarding functional and anatomic Leg-Length Inequality will be provided. Methods Online databases: Medline, CINAHL and Mantis. Plus library searches for the time frame of 1970–2005 were done using the term "Leg-Length Inequality". Results and Discussion The evidence suggests that an unloaded Leg-Length asymmetry is a different phenomenon than an anatomic Leg-Length Inequality, and may be due to suprapelvic muscle hypertonicity. Anatomic Leg-Length Inequality and unloaded functional or Leg-Length alignment asymmetry may interact in a loaded (standing) posture, but not in an unloaded (prone/supine) posture. Conclusion The unloaded, functional Leg-Length alignment asymmetry is a likely phenomenon, although more research regarding reliability of the measurement procedure and validity relative to spinal dysfunction is needed. Functional Leg-Length alignment asymmetry should be eliminated before any necessary treatment of anatomic LLI.
Martin H. Stone - One of the best experts on this subject based on the ideXlab platform.
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Revision surgery for Leg Length Inequality after primary hip replacement.
Hip international : the journal of clinical and experimental research on hip pathology and therapy, 2018Co-Authors: Anthony B. Mcwilliams, Anastasios Lampropoulos, Martin H. StoneAbstract:Background We discuss the surgical results of revision surgery for patients with refractory symptomatic Leg Length Inequality (LLI) after primary hip replacement. Methods This is a retrospective review of 21 patients who underwent revision for LLI after primary total hip replacement. All of them were referred to a tertiary clinic between 2006 and 2015. Leg Length was measured, to the nearest mm, using Woolson's validated X-ray technique which references to centre of femoral rotation, the acetabular teardrop and the midpoint of the lesser trochanter. The post-operative clinical assessment using a modified D'Aubigne and Postel scoring system investigated the pain, function, and satisfaction after surgery. Results The mean pre-revision LLI was 16.2 mm (8-30 mm). The mean post revision operation Leg Length Inequality was 2.0 mm (12 mm short to 9 mm long). The mean post-operative D'Aubigne and Postel scores, achieved at a mean 12 months (6-30 months), were; pain 5.2 (3-6), function 4.6 (3-6) and satisfaction 4.4 (3-5). Following revision surgery 20 out of 21 (95%) patients were satisfied with the improvement in LLI. Conclusion Revision surgery for LLI, while it may not resolve all of the pain that the patient presents with, it is a successful treatment for patients who do not respond to conservative management of their LLI.
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Hip surgeons and Leg Length Inequality after primary hip replacement.
Hip international : the journal of clinical and experimental research on hip pathology and therapy, 2018Co-Authors: Faye A Loughenbury, Anthony B. Mcwilliams, Anthony C. Redmond, Todd D. Stewart, Martin H. StoneAbstract:Background:This study reports the results of 2 separate surveys of British Hip Society (BHS) members relating to Leg Length Inequality (LLI) after primary total hip replacement (THR).Survey 1:Inves...
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Leg Length Inequality after primary total hip arthroplasty
Orthopaedics and Trauma, 2018Co-Authors: Faye A Loughenbury, Anthony B. Mcwilliams, Matthew Smith, Hemant Pandit, Martin H. StoneAbstract:Abstract 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.
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Unilateral total hip replacement patients with symptomatic Leg Length Inequality have abnormal hip biomechanics during walking
Clinical biomechanics (Bristol Avon), 2015Co-Authors: Anthony B. Mcwilliams, Zhongmin Jin, John Fisher, Martin H. Stone, Anthony C. Redmond, Todd D. StewartAbstract:article i nfo Background: Symptomatic Leg Length Inequality accounts for 8.7% of total hip replacement related claims made against the UK National Health Service Litigation authority. It has not been established whether symptomatic Leg Length Inequality patients following total hip replacement have abnormal hip kinetics during gait. Methods: Hip kinetics in 15 unilateral total hip replacement patients with symptomatic Leg Length Inequality during gait was determined through multibody dynamics and compared to 15 native hip healthy controls and 15 'successful' asymptomatic unilateral total hip replacement patients. Finding:Moresignificant differences from normal were found insymptomaticLeg Length Inequality patients than in asymptomatic total hip replacement patients. The Leg Length Inequality patients had altered functions defined by lower gait velocity, reduced stride Length, reduced ground reaction force, decreased hip range of motion, re- duced hip moment and less dynamic hip force with a 24% lower heel-strike peak, 66% higher mid-stance trough and 37% lower toe-off peak. Greater asymmetry in hip contact force was also observed in Leg Length Inequality patients. Interpretation: These gait adaptions may affect the function of the implant and other healthy joints in symptom- atic Leg Length Inequality patients. This study provides important information for the musculoskeletal function and rehabilitation of symptomatic Leg Length Inequality patients. © 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license
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A review of symptomatic Leg Length Inequality following total hip arthroplasty.
Hip international : the journal of clinical and experimental research on hip pathology and therapy, 2013Co-Authors: Anthony B. Mcwilliams, Anthony C. Redmond, Todd D. Stewart, Andrew J. Grainger, Philip O'connor, Martin H. StoneAbstract:Leg Length Inequality (LLI) following total hip replacement is a complication which features increasingly in the recent literature. The definition of LLI is complicated by lack of consensus regarding radiological measurement, clinical measurement and the incomplete relationship between LLI and associated symptoms. This paper reviews 79 reports relating to LLI post hip replacement, detailing definitions and classification and highlighting patient populations prone to symptomatic LLI. While there is no universal definition of LLI, there is a broad consensus that less than 10 mm of difference on AP view plain radiographs is clinically acceptable. There are few techniques described that consistently produce a postoperative LLI of less than this magnitude. Where postoperative LLI exists, Lengthening appears to cause more problems than shortening. In cases of mild LLI, non-surgical management produces adequate outcomes in the majority of cases, with functional LLI cases doing better than those with true LLI. Operative correction is effective in half of cases, even where nerve palsy is present, and remains an important option of last resort. Poor outcomes in patients with LLI may be minimised if individuals at risk are identified and counselled appropriately.
Neil A. Segal - One of the best experts on this subject based on the ideXlab platform.
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Brief Report: Leg Length Inequality and Hip Osteoarthritis in the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative.
Arthritis & rheumatology (Hoboken N.J.), 2018Co-Authors: Chan Kim, Neil A. Segal, Nancy E. Lane, Michael C Nevitt, Ali Guermazi, Jingbo Niu, Margaret Clancy, Irina Tolstykh, Pia M. Jungmann, William F. HarveyAbstract:Author(s): Kim, Chan; Nevitt, Michael; Guermazi, Ali; Niu, Jingbo; Clancy, Margaret; Tolstykh, Irina; Jungmann, Pia M; Lane, Nancy E; Segal, Neil A; Harvey, William F; Lewis, Cora E; Felson, David T | Abstract: OBJECTIVE:Studies suggest that persons with a Leg Length Inequality (LLI) of ≥2 cm have an increased risk of developing knee osteoarthritis (OA) in that limb. The present study was undertaken to examine whether LLI also confers an increased risk of hip OA. METHODS:Using long limb radiographs from subjects in the Multicenter Arthritis Study (MOST) and the Osteoarthritis Initiative (OAI), we measured LLI and scored hip radiographs that were obtained at baseline and 3-5-year follow-up. The associations of LLI of ≥1 cm and LLI of ≥2 cm with radiographic hip OA were examined cross-sectionally and longitudinally, assessing risk in shorter limbs and longer limbs compared to limbs from subjects with no LLI. We carried out logistic regression analyses with generalized estimating equations and adjusted for age, sex, body mass index, height, and cohort of origin. RESULTS:There were 1,966 subjects from the MOST and 2,627 subjects from the OAI. Twelve percent had LLI of ≥1 cm and 1% had LLI of ≥2 cm. For LLI ≥1 cm, the adjusted odds ratio for prevalent hip OA in the shorter Leg was 1.47 (95% confidence interval [95% CI] 1.07-2.02) and for LLI ≥2 cm, it was 2.15 (95% CI 0.87-5.34). For LLI ≥1 cm, the odds of incident hip OA in the shorter Leg were 1.39 (95% CI 0.81-2.39) while for LLI ≥2 cm, they were 4.20 (95% CI 1.26-14.03). We found no increased risk of hip OA in longer limbs. CONCLUSION:Our findings suggest that, as with knee OA, Legs that are at least 2 cm shorter than the contralateral Leg are at increased risk of hip OA.
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Association of Leg-Length Inequality with knee osteoarthritis: a cohort study.
Annals of internal medicine, 2010Co-Authors: William F. Harvey, Mei Yang, T.d.v. Cooke, Neil A. Segal, Nancy E. Lane, Cora E. Lewis, David T. FelsonAbstract:BACKGROUND: Leg-Length Inequality is common in the general population and may accelerate development of knee osteoarthritis. OBJECTIVE: To determine whether Leg-Length Inequality is associated with prevalent, incident, and progressive knee osteoarthritis. DESIGN: Prospective observational cohort study. SETTING: Population samples from Birmingham, Alabama, and Iowa City, Iowa. PATIENTS: 3026 participants aged 50 to 79 years with or at high risk for knee osteoarthritis. MEASUREMENTS: The exposure was Leg-Length Inequality, measured by full-limb radiography. The outcomes were prevalent, incident, and progressive knee osteoarthritis. Radiographic osteoarthritis was defined as Kellgren and Lawrence grade 2 or greater, and symptomatic osteoarthritis was defined as radiographic disease in a consistently painful knee. RESULTS: Compared with Leg-Length Inequality less than 1 cm, Leg-Length Inequality of 1 cm or more was associated with prevalent radiographic (53% vs. 36%; odds ratio [OR], 1.9 [95% CI, 1.5 to 2.4]) and symptomatic (30% vs. 17%; OR, 2.0 [CI, 1.6 to 2.6]) osteoarthritis in the shorter Leg, incident symptomatic osteoarthritis in the shorter Leg (15% vs. 9%; OR, 1.7 [CI, 1.2 to 2.4]) and the longer Leg (13% vs. 9%; OR, 1.5 [CI, 1.0 to 2.1]), and increased odds of progressive osteoarthritis in the shorter Leg (29% vs. 24%; OR, 1.3 [CI, 1.0 to 1.7]). LIMITATIONS: Duration of follow-up may not be long enough to adequately identify cases of incidence and progression. Measurements of Leg Length, including radiography, are subject to measurement error, which could result in misclassification. CONCLUSION: Radiographic Leg-Length Inequality was associated with prevalent, incident symptomatic, and progressive knee osteoarthritis. Leg-Length Inequality is a potentially modifiable risk factor for knee osteoarthritis. PRIMARY FUNDING SOURCE: National Institute on Aging.
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associations of Leg Length Inequality with prevalent incident and progressive knee osteoarthritis a cohort study
Annals of Internal Medicine, 2010Co-Authors: William F. Harvey, Mei Yang, T.d.v. Cooke, Neil A. Segal, Nancy E. Lane, Cora E. Lewis, David T. FelsonAbstract:Background Leg Length Inequality is common in the general population and may accelerate development of knee osteoarthritis.
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Leg-Length Inequality is not associated with greater trochanteric pain syndrome
Arthritis Research & Therapy, 2008Co-Authors: Neil A. Segal, Mei Yang, David T. Felson, William Harvey, James C Torner, Jeffrey R Curtis, Michael C NevittAbstract:Introduction Greater trochanteric pain syndrome (GTPS) is a common condition, the pathogenesis of which is incompletely understood. Although Leg-Length Inequality has been suggested as a potential risk factor for GTPS, this widely held assumption has not been tested. Methods A cross-sectional analysis of greater trochanteric tenderness to palpation was performed in subjects with complaints of hip pain and no signs of hip osteoarthritis or generalized myofascial tenderness. Subjects were recruited from one clinical center of the Multicenter Osteoarthritis Study, a multicenter population-based study of community-dwelling adults aged 50 to 79 years. Diagnosis of GTPS was based on a standardized physical examination performed by trained examiners, and technicians measured Leg Length on full-limb anteroposterior radiographs. Results A total of 1,482 subjects were eligible for analysis of GTPS and Leg Length. Subjects' mean ± standard deviation age was 62.4 ± 8.2 years, and 59.8% were female. A total of 372 lower limbs from 271 subjects met the definition for having GTPS. Leg-Length Inequality (difference ≥ 1 cm) was present in 37 subjects with GTPS and in 163 subjects without GTPS ( P = 0.86). Using a variety of definitions of Leg-Length Inequality, including categorical and continuous measures, there was no association of this parameter with the occurrence of GTPS (for example, for ≥ 1 cm Leg-Length Inequality, odds ratio = 1.17 (95% confidence interval = 0.79 to 1.73)). In adjusted analyses, female sex was significantly associated with the presence of GTPS, with an adjusted odds ratio of 3.04 (95% confidence interval = 2.07 to 4.47). Conclusion The present study found no evidence to support an association between Leg-Length Inequality and greater trochanteric pain syndrome.
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Leg Length Inequality is not associated with greater trochanteric pain syndrome
Arthritis Research & Therapy, 2008Co-Authors: Neil A. Segal, William F. Harvey, Mei Yang, David T. Felson, James C Torner, Jeffrey R Curtis, Michael C NevittAbstract:Introduction Greater trochanteric pain syndrome (GTPS) is a common condition, the pathogenesis of which is incompletely understood. Although Leg-Length Inequality has been suggested as a potential risk factor for GTPS, this widely held assumption has not been tested.
Terje Terjesen - One of the best experts on this subject based on the ideXlab platform.
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Leg Length Inequality and rotational deformity after traction treatment of femoral shaft fractures in children
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin ny raekke, 1998Co-Authors: Nordbø T, Terje Terjesen, Svein SvenningsenAbstract:87 patients who experienced femoral shaft fracture at the age of two to 14 years were reviewed, on average, seven (three to 12) years after the injury occurred. Three methods of treatment had been used: Bryant skin traction, and skeletal traction using either the Weber table or the Braun frame. Patients two to three years of age at the time of injury had significantly less Leg Length Inequality than those aged four to ten years. The reason was that in the youngest group, where which 16 out of 21 patients had been treated with skin traction, the effect of traction was less efficient and there was therefore a larger overlap of the fragments at fracture healing than in the older group, where all patients had had skeletal traction. Among ten to 14 year olds there was also less Leg Length Inequality than among four to ten year olds. This was because of lack of growth stimulation in the oldest patients after fracture healing. The results indicate that an initial overlap of approximately 10 mm should be aimed at in patients under 11 years of age, whereas overlap should be avoided in older patients. Rotational deformity, defined as side difference in anteversion angle of 15 degrees or more, occurred in seven patients (8%), but none of them had any complaints. We conclude that traction treatment gives good results, with few complications. Over-growth remains a significant problem in children under 11 years of age.
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The effect on low back pain of shortening osteotomy for Leg Length Inequality
International Orthopaedics, 1992Co-Authors: I. Rossvoll, S. Junk, Terje TerjesenAbstract:This study evaluates the effect on low back pain of shortening osteotomy in patients with Leg Length Inequality (LLI). Twenty-two patients were followed up after an average of 5 years. The mean preoperative LLI was 32 mm and was 4.3 mm at follow up. The degree of low back pain was significantly reduced after the operation. Le but de cette étude est d'évaluer l'effet sur la lombalgie d'une ostéotomie de raccourcissement, chez des sujets présentant une inégalité des membres inférieurs (IMI). Vingt-deux sujets, ayant subi une ostéotomie de raccourcissement pour IMI, ont été examinés avec un recul moyen de 5 ans. L'IMI pré-opératoire était en moyenne de 32 mm (de 19 à 55). L'IMI moyenne au dernier examen était de 4.3 mm (de 1 à 9). L'intensité de la lombalgie avait fortement diminué après l'opération.
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The effect on low back pain of shortening osteotomy for Leg Length Inequality
International orthopaedics, 1992Co-Authors: I. Rossvoll, S. Junk, Terje TerjesenAbstract:This study evaluates the effect on low back pain of shortening osteotomy in patients with Leg Length Inequality (LLI). Twenty-two patients were followed up after an average of 5 years. The mean preoperative LLI was 32 mm and was 4.3 mm at follow up. The degree of low back pain was significantly reduced after the operation.
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Leg Length Inequality measured by ultrasound and clinical methods
European journal of radiology, 1992Co-Authors: Stanislaw Junk, Terje Terjesen, Ivar Rossvoll, Martinus Bra˚tenAbstract:Abstract Leg Length Inequality (LLI) was determined by ultrasound and two clinical methods in 100 subjects without previous disorders of the lower extremities. The mean LLI by ultrasound was 4.1 mm (range: 0–16 mm). An LLI of 10 mm or more was found in 4% of the subjects. The mean inter-observer variation by ultrasound was 0.9 mm (range: ÷5–8 mm), which was significantly less than that obtained by clinical methods. The 95% confidence interval of inter-observer variation (±2 SD) by ultrasound was ± 5 mm and this interval is assumed to represent the accuracy of the method. Because LLI measurement by ultrasound is more reliable than clinical methods, ultrasound is recommended for routine use in clinical practice.
Michael C Nevitt - One of the best experts on this subject based on the ideXlab platform.
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Brief Report: Leg Length Inequality and Hip Osteoarthritis in the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative.
Arthritis & rheumatology (Hoboken N.J.), 2018Co-Authors: Chan Kim, Neil A. Segal, Nancy E. Lane, Michael C Nevitt, Ali Guermazi, Jingbo Niu, Margaret Clancy, Irina Tolstykh, Pia M. Jungmann, William F. HarveyAbstract:Author(s): Kim, Chan; Nevitt, Michael; Guermazi, Ali; Niu, Jingbo; Clancy, Margaret; Tolstykh, Irina; Jungmann, Pia M; Lane, Nancy E; Segal, Neil A; Harvey, William F; Lewis, Cora E; Felson, David T | Abstract: OBJECTIVE:Studies suggest that persons with a Leg Length Inequality (LLI) of ≥2 cm have an increased risk of developing knee osteoarthritis (OA) in that limb. The present study was undertaken to examine whether LLI also confers an increased risk of hip OA. METHODS:Using long limb radiographs from subjects in the Multicenter Arthritis Study (MOST) and the Osteoarthritis Initiative (OAI), we measured LLI and scored hip radiographs that were obtained at baseline and 3-5-year follow-up. The associations of LLI of ≥1 cm and LLI of ≥2 cm with radiographic hip OA were examined cross-sectionally and longitudinally, assessing risk in shorter limbs and longer limbs compared to limbs from subjects with no LLI. We carried out logistic regression analyses with generalized estimating equations and adjusted for age, sex, body mass index, height, and cohort of origin. RESULTS:There were 1,966 subjects from the MOST and 2,627 subjects from the OAI. Twelve percent had LLI of ≥1 cm and 1% had LLI of ≥2 cm. For LLI ≥1 cm, the adjusted odds ratio for prevalent hip OA in the shorter Leg was 1.47 (95% confidence interval [95% CI] 1.07-2.02) and for LLI ≥2 cm, it was 2.15 (95% CI 0.87-5.34). For LLI ≥1 cm, the odds of incident hip OA in the shorter Leg were 1.39 (95% CI 0.81-2.39) while for LLI ≥2 cm, they were 4.20 (95% CI 1.26-14.03). We found no increased risk of hip OA in longer limbs. CONCLUSION:Our findings suggest that, as with knee OA, Legs that are at least 2 cm shorter than the contralateral Leg are at increased risk of hip OA.
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Leg-Length Inequality is not associated with greater trochanteric pain syndrome
Arthritis Research & Therapy, 2008Co-Authors: Neil A. Segal, Mei Yang, David T. Felson, William Harvey, James C Torner, Jeffrey R Curtis, Michael C NevittAbstract:Introduction Greater trochanteric pain syndrome (GTPS) is a common condition, the pathogenesis of which is incompletely understood. Although Leg-Length Inequality has been suggested as a potential risk factor for GTPS, this widely held assumption has not been tested. Methods A cross-sectional analysis of greater trochanteric tenderness to palpation was performed in subjects with complaints of hip pain and no signs of hip osteoarthritis or generalized myofascial tenderness. Subjects were recruited from one clinical center of the Multicenter Osteoarthritis Study, a multicenter population-based study of community-dwelling adults aged 50 to 79 years. Diagnosis of GTPS was based on a standardized physical examination performed by trained examiners, and technicians measured Leg Length on full-limb anteroposterior radiographs. Results A total of 1,482 subjects were eligible for analysis of GTPS and Leg Length. Subjects' mean ± standard deviation age was 62.4 ± 8.2 years, and 59.8% were female. A total of 372 lower limbs from 271 subjects met the definition for having GTPS. Leg-Length Inequality (difference ≥ 1 cm) was present in 37 subjects with GTPS and in 163 subjects without GTPS ( P = 0.86). Using a variety of definitions of Leg-Length Inequality, including categorical and continuous measures, there was no association of this parameter with the occurrence of GTPS (for example, for ≥ 1 cm Leg-Length Inequality, odds ratio = 1.17 (95% confidence interval = 0.79 to 1.73)). In adjusted analyses, female sex was significantly associated with the presence of GTPS, with an adjusted odds ratio of 3.04 (95% confidence interval = 2.07 to 4.47). Conclusion The present study found no evidence to support an association between Leg-Length Inequality and greater trochanteric pain syndrome.
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Leg Length Inequality is not associated with greater trochanteric pain syndrome
Arthritis Research & Therapy, 2008Co-Authors: Neil A. Segal, William F. Harvey, Mei Yang, David T. Felson, James C Torner, Jeffrey R Curtis, Michael C NevittAbstract:Introduction Greater trochanteric pain syndrome (GTPS) is a common condition, the pathogenesis of which is incompletely understood. Although Leg-Length Inequality has been suggested as a potential risk factor for GTPS, this widely held assumption has not been tested.