Unexpected consequences from hip surgery

Cases of one leg being shorter than the other

CHICAGO – More than 300,000 hip replacement surgeries are performed each year and by 2030 that number is expected to nearly double. However, as those numbers grow, so do the chances of complications, like one leg being longer or shorter than the other.

Chuck Westendorf had a huge difference in the length of his legs just after a total hip replacement surgery; imagine a 1½ inch difference in his limbs.

"I knew I couldn't live like that," he said.

Westendorf is not alone. Studies show leg length inequalities are a preventable mistake that account for nearly five percent of all medical errors.

"It's a growing problem and a growing surgical procedure," explained Henry Finn, MD, FACS, Chief of Surgery at Weiss Memorial Hospital, Medical Director of the Chicago Center for Orthopedics at Weiss, and professor of Orthopedic Surgery at the University of Chicago.

Finn says about a third of hip replacement patients will have an obvious difference in lengths, which may lead to hip and back pain.

His best advice is to know your surgeons level of experience and ask the right questions.

"What do they do to assure that their leg lengths are going to be as close as possible?" Finn advised.

He also says that if there is a problem, early intervention is critical.

Westendorf came to see Finn just a few weeks after his surgery at another hospital.

"The leg is over lengthened, the femur is pushed down," Finn said.

"I feel just blessed being able to have an opportunity to live a normal day,"  said Westendorf.

"It's overwhelming. It brings tears to our eyes every time. We just feel like we owe his life to Dr. Finn for what he did for him," said Gwen Westendorf, Chuck's wife.

Now, he's free to walk tall again.

In some cases, a heel lift may be all that's needed to fix a minor discrepancy in leg length. If it's an obvious difference, Finn recommends having revision surgery within the first six weeks if possible, so the bone hasn't had a chance to fuse.

Other complications from hip replacement surgery include chronic back pain, shoulder pain, hip dislocation, and sciatica—that can make standing or sitting nearly impossible.

Additional Information:

A hip replacement surgery is a procedure that removes the hip joint then replaces it with an artificial joint. The replacement prostheses' has a ball attachment that is composed of ceramic, plastic, or metal. These components are created for the body to accept them and they do not wear down. Patients who undergo hip replacement surgery have experienced joint damage in the hip due to an injury, arthritis, or both. After the procedure is done, patients can expect to attend physical therapy, but after that patients will notice a relief of pain and a greater range of motion in the hip than before. (Source: mayoclinic.com/health/hip-replacement/MY00235/)

CAUSES:  Before thinking about surgery, your doctor may recommend other treatments, like pain medications, exercise, physical therapy, and use of a walker or cane.  If these treatments are not enough, hip replacement may be the right decision.  Conditions that may damage the hip joint, sometimes necessitating hip replacement surgery include:

  • Broken hip
  • Osteoarthritis
  • Bone tumor
  • Rheumatoid arthritis

(Source: mayoclinic.com/health/hip-replacement/MY00235/DSECTION=why-its-done)

RISKS:  Unequal legs are the most common complaint by patients after surgery with over lengthening the most common problem.  Sometimes the leg may seem long immediately after surgery when they are both actually equal length.  An arthritic hip can develop contractures that make the leg behave like it is short.  When these are relieved with replacement surgery and normal motion and function are restored, the body feels that the limb is no longer than it was.  If the legs are equal, this resolves within a month or two after surgery.  If the legs are truly unequal, it will not.  A shoe lift for the short leg or a corrective operation may be needed (only in extreme cases).  True leg length inequality is caused by improper implant selection.  The femoral component may be too large and stick out of the femur further than needed.  Stiffness in the lower back from previous fusion surgery or arthritis seems to magnify the perception of leg length inequality.  (Source: news-medical.net/health/Hip-Replacement-Problems.aspx)