{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:25Z","timestamp":1787755405047,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,3,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Several methods are commonly used to predict lower-limb-length discrepancy (LLD) on pelvic radiographs. It is not clear how the lower-limb length of patients with unilateral developmental dislocation of the hip (DDH) changes and whether a pelvic radiograph is reliable to predict LLD. In this study, we analyzed the characteristics of LLD in patients with unilateral DDH by measuring full-length standing anteroposterior radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The radiographic data of all patients with unilateral DDH who met the inclusion criteria from March 2011 to May 2016 were retrospectively reviewed. These data included femoral length, tibial length, skeletal limb length, and distance from the lesser trochanter to the tibial plafond. We also compared LLD between patients with Hartofilakidis type-II DDH and those with type III.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Sixty-seven patients (12 male and 55 female) were included. The tibial length, skeletal limb length, and lesser trochanter-tibial plafond distance were significantly greater (p &lt; 0.001, p = 0.040, and p &lt; 0.001, respectively) on the ipsilateral (DDH) side, compared with the contralateral side, in 51 patients (76%), 43 patients (64%), and 52 patients (78%), respectively, with the values on the ipsilateral side exceeding those on the contralateral side by an average of 4.6 mm (range, 0.4 to 17.5 mm), 7.0 mm (range, 0.3 to 21.1 mm), and 10.0 mm (range, 1.1 to 28.8 mm), respectively. The femoral length did not differ significantly between the 2 sides (p = 0.562). There was also no significant difference in LLD, femoral length, tibial length, skeletal limb length, or lesser trochanter-tibial plafond distance between patients with Hartofilakidis type II and those with type III (p &gt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with unilateral DDH, regardless of whether the hip dislocation is low or high, may present with LLD derived from both the femur and the tibia. This LLD includes a greater ipsilateral tibial length, skeletal limb length, and lesser trochanter-tibial plafond distance in most patients and an unpredictable femoral length. Using the lesser trochanter on pelvic radiographs to predict LLD is not reliable. The use of full-length standing anteroposterior radiographs for preoperative templating is advisable for this special group of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00187","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T16:48:40Z","timestamp":1520441320000},"page":"388-395","source":"Crossref","is-referenced-by-count":23,"title":["Unexpected Long Lower Limb in Patients with Unilateral Hip Dislocation"],"prefix":"10.2106","volume":"100","author":[{"given":"Zhendong","family":"Zhang","sequence":"first","affiliation":[{"name":"Division of Joint Surgery, Department of Orthopaedic Surgery, First Affiliated Hospital of Chinese People\u2019s Liberation Army General Hospital, Beijing, China"},{"name":"Medical School of Chinese People\u2019s Liberation Army, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianzhong","family":"Luo","sequence":"additional","affiliation":[{"name":"Division of Joint Surgery, Department of Orthopaedic Surgery, First Affiliated Hospital of Chinese People\u2019s Liberation Army General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Joint Surgery, Department of Orthopaedic Surgery, First Affiliated Hospital of Chinese People\u2019s Liberation Army General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Xiao","sequence":"additional","affiliation":[{"name":"Division of Joint Surgery, Department of Orthopaedic Surgery, First Affiliated Hospital of Chinese People\u2019s Liberation Army General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9201-6274","authenticated-orcid":false,"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Joint Surgery, Department of Orthopaedic Surgery, First Affiliated Hospital of Chinese People\u2019s Liberation Army General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"5","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2106\/00004623-199605000-00007","article-title":"Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty","volume":"78","author":"Hartofilakidis","year":"1996","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1302\/0301-620X.95B6.31286","article-title":"Management of developmental dysplasia of the hip in young adults: current concepts","volume":"95-B","author":"Kosuge","year":"2013","journal-title":"Bone Joint J."},{"issue":"11","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"2957","DOI":"10.1007\/s11999-012-2444-y","article-title":"Surgical technique: the capsular arthroplasty: a useful but abandoned procedure for young patients with developmental dysplasia of the hip","volume":"470","author":"Ganz","year":"2012","journal-title":"Clin Orthop Relat Res."},{"issue":"2","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s00264-008-0683-z","article-title":"Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia","volume":"33","author":"Bicanic","year":"2009","journal-title":"Int Orthop."},{"issue":"5","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"334","DOI":"10.5435\/00124635-200209000-00005","article-title":"Surgical treatment of developmental dysplasia of the hip in adults: II. Arthroplasty options","volume":"10","author":"Sanchez-Sotelo","year":"2002","journal-title":"J Am Acad Orthop Surg."},{"issue":"8","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.3928\/01477447-20110627-14","article-title":"Total hip arthroplasty with shortening osteotomy in congenital major hip dislocation sequelae","volume":"34","author":"Dallari","year":"2011","journal-title":"Orthopedics."},{"issue":"1","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.arth.2012.06.014","article-title":"Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type IV congenital hip dislocation","volume":"28","author":"O\u0130","year":"2013","journal-title":"J Arthroplasty."},{"issue":"3","key":"bib8-20230810","first-page":"287","article-title":"Cementless total hip arthroplasty with a double chevron subtrochanteric shortening osteotomy in patients with Crowe type-IV hip dysplasia","volume":"79","author":"Li","year":"2013","journal-title":"Acta Orthop Belg."},{"issue":"3","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.arth.2009.02.023","article-title":"A new technique of subtrochanteric shortening in total hip replacement for Crowe type 3 to 4 dysplasia of the hip","volume":"25","author":"Togrul","year":"2010","journal-title":"J Arthroplasty."},{"issue":"9","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1302\/0301-620X.93B9.25914","article-title":"Total hip replacement for high dislocated hips without femoral shortening osteotomy","volume":"93","author":"Zhao","year":"2011","journal-title":"J Bone Joint Surg Br."},{"issue":"3","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.arth.2011.06.008","article-title":"Magnitude of limb lengthening after primary total knee arthroplasty","volume":"27","author":"Lang","year":"2012","journal-title":"J Arthroplasty."},{"key":"bib12-20230810","first-page":"135","article-title":"Limb length discrepancy and related problems following total hip joint replacement","volume":"134","author":"Williamson","year":"1978","journal-title":"Clin Orthop Relat Res."},{"issue":"10","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1016\/j.arth.2013.03.024","article-title":"The patterns of limb length, height, weight and body mass index changes after total knee arthroplasty","volume":"28","author":"Chang","year":"2013","journal-title":"J Arthroplasty."},{"issue":"2","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00256-011-1166-7","article-title":"Measurement of leg length discrepancy after total hip arthroplasty. The reliability of a plain radiographic method compared to CT-scanogram","volume":"41","author":"Kjellberg","year":"2012","journal-title":"Skeletal Radiol."},{"issue":"3","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.arth.2005.10.021","article-title":"Common misconceptions of normal hip joint relations on pelvic radiographs","volume":"21","author":"Krishnan","year":"2006","journal-title":"J Arthroplasty."},{"issue":"6","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1007\/s11999-010-1588-x","article-title":"Preoperative radiographic assessment of limb-length discrepancy in total hip arthroplasty","volume":"469","author":"Meermans","year":"2011","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib17-20230810","first-page":"424","article-title":"Unexpected long femur in adults with acetabular dysplasia","volume":"71","author":"Metcalfe","year":"2005","journal-title":"Acta Orthop Belg."},{"issue":"5","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1302\/0301-620X.73B5.1894656","article-title":"A quantitative approach to radiography of the lower limb. Principles and applications","volume":"73","author":"Cooke","year":"1991","journal-title":"J Bone Joint Surg Br."},{"issue":"1","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2106\/JBJS.F.01514","article-title":"Assessment of lower limb alignment: supine fluoroscopy compared with a standing full-length radiograph","volume":"90","author":"Sabharwal","year":"2008","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1007\/s00776-013-0457-3","article-title":"Leg length discrepancy and lower limb alignment after total hip arthroplasty in unilateral hip osteoarthritis patients","volume":"18","author":"Fujimaki","year":"2013","journal-title":"J Orthop Sci."},{"issue":"9","key":"bib21-20230810","doi-asserted-by":"crossref","first-page":"943","DOI":"10.3928\/0147-7447-20000901-20","article-title":"Leg-length inequality and nerve palsy in total hip arthroplasty: a lawyer awaits!","volume":"23","author":"Hofmann","year":"2000","journal-title":"Orthopedics."},{"issue":"6","key":"bib22-20230810","first-page":"513","article-title":"[Radiological characteristics of leg length discrepancy and knee varus\/valgus deformity among unilateral developmental hip dislocation patients]","volume":"51","author":"Luo","year":"2013","journal-title":"Zhonghua Wai Ke Za Zhi."},{"issue":"4","key":"bib23-20230810","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1302\/0301-620X.80B4.0800711","article-title":"The morphology of the femur in developmental dysplasia of the hip","volume":"80","author":"Sugano","year":"1998","journal-title":"J Bone Joint Surg Br."},{"issue":"4","key":"bib24-20230810","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/00007632-199104000-00007","article-title":"Leg-length inequality in people of working age. The association between mild inequality and low-back pain is questionable","volume":"16","author":"Soukka","year":"1991","journal-title":"Spine (Phila Pa 1976)."},{"key":"bib25-20230810","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/BLO.0b013e3181576052","article-title":"Anatomy of the dysplastic hip and consequences for total hip arthroplasty","volume":"465","author":"Argenson","year":"2007","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib26-20230810","doi-asserted-by":"crossref","first-page":"457","DOI":"10.5301\/hipint.5000235","article-title":"Pelvic reference selection in patients with unilateral Crowe type IV DDH for measuring leg length inequality","volume":"25","author":"Zhang","year":"2015","journal-title":"Hip Int."},{"issue":"6","key":"bib27-20230810","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.knee.2014.08.012","article-title":"Knee joint changes in patients with neglected developmental hip dysplasia: a prospective case-control study","volume":"21","author":"Li","year":"2014","journal-title":"Knee."},{"key":"bib28-20230810","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1097\/00003086-200111000-00046","article-title":"Bilateral developmental dysplasia of the hip: asymmetric outcome in the older child","volume":"392","author":"Moussa","year":"2001","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib29-20230810","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1007\/s00247-013-2838-3","article-title":"Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. A prospective survey during 1991-2006","volume":"44","author":"Laborie","year":"2014","journal-title":"Pediatr Radiol."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201803070-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:42:27Z","timestamp":1787751747000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201803070-00006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,7]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.00187","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,7]]}}}