Introduction: Leg Length Inequality (LLI) has been identified as a mechanism that can lead to scoliosis. LLI is a relatively common outcome of total hip replacement (THR) surgery; however, few studies illustrate the potential for THR to result in scoliosis. The current report discusses a scoliosis that may have resulted from LLI following a THR.
Clinical Features: A 65-year-old woman sought care at a hospital based chiropractic clinic for an acquired scoliosis following a THR surgery. This was not present in plain film imaging taken prior to her THR surgery. Post-surgical leg length analysis revealed a significant LLI and subsequently, the rapid progression of a scoliosis.
Interventions and Outcomes: Post THR surgery radiographs of the hips illustrated significant asymmetrical leg lengths and progressing scoliosis.
Conclusion: A significant number of patients develop LLI following THR surgery. Non-surgical LLI have been found to cause or contribute to scoliosis; this case identifies a potential link between an iatrogenic LLI and the onset of scoliosis. The presenting case illustrates a patient that may present with back pain to the general chiropractic office.
Author affiliations: NAH: Staff Chiropractor, VA Central Iowa Healthcare System, Des Moines, IA; Adjunct Faculty, Palmer College of Chiropractic; WEM: President, Parker University
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