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An Anatomic Technique for Establishing Leg Length During the Anterior Approach to Total Hip Arthroplasty

Leg-length discrepancy following total hip arthroplasty is a common challenge to the treating surgeon. A multitude of surgical techniques and measurement strategies have been described to reduce the likelihood of undesirable leg and hip length. We present a simple intraoperative technique using the capsule (Y-ligament) to minimize this problem. After its exposure, the hip capsule is incised in line with the long axis of the femoral neck and dissected from its insertion on the anterior intertrochanteric line. This allows excellent exposure of the hip. At the end of the replacement, the position of the released capsule indicates gain, loss, or unchanged length of the hip. It is an effective intraoperative way to check the desired hip length without fluoroscopy or cumbersome measuring devices. The ease and efficacy of this technique have proven to be another advantage of the anterior approach to hip arthroplasty.