Rodriguez-Merchan EC. When performing a total hip arthroplasty, it is essential to correct any pre-existing leg-length discrepancy during surgery. World J Orthop 2026; 17(1): 113277 [DOI: 10.5312/wjo.v17.i1.113277]
Corresponding Author of This Article
Emerito Carlos Rodriguez-Merchan, MD, PhD, Department of Orthopedic Surgery, Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid 28046, Spain. ecrmerchan@hotmail.com
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Orthopedics
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Letter to the Editor
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 18, 2026 (publication date) through Jan 9, 2026
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World Journal of Orthopedics
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2218-5836
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Rodriguez-Merchan EC. When performing a total hip arthroplasty, it is essential to correct any pre-existing leg-length discrepancy during surgery. World J Orthop 2026; 17(1): 113277 [DOI: 10.5312/wjo.v17.i1.113277]
World J Orthop. Jan 18, 2026; 17(1): 113277 Published online Jan 18, 2026. doi: 10.5312/wjo.v17.i1.113277
When performing a total hip arthroplasty, it is essential to correct any pre-existing leg-length discrepancy during surgery
Emerito Carlos Rodriguez-Merchan
Emerito Carlos Rodriguez-Merchan, Department of Orthopedic Surgery, Hospital Universitario La Paz, Madrid 28046, Spain
Author contributions: Rodriguez-Merchan EC thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Emerito Carlos Rodriguez-Merchan, MD, PhD, Department of Orthopedic Surgery, Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid 28046, Spain. ecrmerchan@hotmail.com
Received: August 20, 2025 Revised: September 11, 2025 Accepted: December 2, 2025 Published online: January 18, 2026 Processing time: 141 Days and 20.8 Hours
Abstract
Leg-length discrepancy (LLD) in individuals experiencing total hip arthroplasty (THA) is related to a substantially higher fall risk, length of post-operative hospital in-patient stay, elevated implant-related adverse events, and earlier revision. Therefore, it is essential to try to avoid LLD when implanting a THA. Several studies focus on this issue, including the following: Accelerometer-based portable navigation system, preoperative digital templating, robot-assisted surgery, the anatomical marker positioning method (shoulder-to-shoulder) and the artificial intelligence-based three-dimensional planning software system. The aforementioned methods should be familiar to surgeons who perform THA procedures, as a fundamental objective of this surgical intervention is to avoid LLD.
Core Tip: Leg-length discrepancies (LLDs), often greater than 5-10 mm, may result in altered gait mechanics, low-back pain, or the perception of limb inequality. These issues can directly affect patient satisfaction and functional recovery. Several advanced methods have been developed to address LLD, including accelerometer-based portable navigation system, preoperative digital templating, robot-assisted surgery, the anatomical marker positioning method (shoulder-to-shoulder) and the artificial intelligence-based three-dimensional planning system. However, it is worth noting that no technique completely eliminates the possibility of post-surgical LLD. Complex deformities, intraoperative instability, and soft-tissue imbalances can still lead to measurable discrepancies, despite the utilization of advanced tools.
