No relationship between mild limb length discrepancy and spine, hip or knee degenerative disease in a large cadaveric collection

• Published in: Orthopaedics & traumatology, surgery & research surgery & research, 2018-09, Vol.104 (5), p.603-607
• Main Authors: Liu, Raymond W., Streit, Jonathan J., Weinberg, Douglas S., Shaw, Jeremy D., LeeVan, Elyse, Cooperman, Daniel R.
• Format: Article
• Language: English
• Subjects: Degenerative joint disease; Epiphyseodesis; Limb deformity; Limb length discrepancy; Osteoarthritis
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2017.11.025

Although asymptomatic mild limb length discrepancy (LLD) in children is generally treated non-operatively, there is limited high quality follow up data to support this recommendation. We hypothesized that there would be no association between LLD and arthritic changes with mild limb length discrepancy. We studied 576 well-preserved cadaveric skeletons ranging from 40 to 79 years of age. Limb length discrepancy was based on combined femoral and tibial lengths measured using digital calipers. Degenerative disease was hand graded in the spine, hips and knees using a previously described classification system. Power was set at 90%. Average age was 56±10 years and average LLD was 4.8±4.0mm. Multiple regression analysis did not demonstrate any correlation between LLD and degenerative disease. After screening to find 26 additional specimens with LLD 10mm or greater, and assessing a potentially quadratic relationship, we still did not find any detrimental effects of LLD. Our data support the general clinical recommendation of observation for mild asymptomatic LLD. These results do not apply to larger LLD nor LLD associated with other deformities or clinical symptoms. Not applicable, anatomic basic science study.