Total hip arthroplasty (THA) has long been heralded as one of the most successful surgical innovations in modern medical history, consistently delivering high long-term implant survival and patient satisfaction rates exceeding 90%. Historically, when surgeons evaluate post-operative structural parameters, their primary focus centers heavily on preventing dislocations and achieving perfect leg-length equality. Postoperative leg-length discrepancy (LLD) is notoriously feared in the orthopedic community; it is blamed for causing limps, back pain, and sciatica, making it a leading driver of patient-reported dissatisfaction and a primary cause of medical malpractice litigation following primary surgery.
However, as enabling technologies like computer navigation and advanced robotics scale up in modern operating theaters, they grant us the precision to execute highly personalized multi-planar alignment strategies. With this technological leap comes a critical requirement to evolve past historical dogmas, such as the widely refuted Lewinnek “safe zone”. To establish true biomechanical clarity, we must understand how specific reconstructed dimensions directly impact contemporary patient-reported outcome measures (PROMs).
