Leg Length InequalityHip and Knee arthritisThe relationship between Leg Length Inequality and radiographic knee and hip osteoarthritis was reported in Osteoarthritis and Cartilage, Volume 15, Issue 7, July 2007, Pages 824-829
CausesIt is well known that Osteoarthritis (OA) is one of the most common, chronic conditions and a leading cause of disability among older adults. This is particularly true in the USA where obesity compounds other known causes, knee arthritis affecting six percent of the adult population and hip arthritis three percent.This study examined the relationship of limb length inequality (LLI) with radiographic hip and knee osteoarthritis (OA) in a large, community-based sample. Hypothesised is that Limb Length Inequality alters gait symmetry and joint mechanics during weight bearing, potentially contributing to the development of arthritis in the knee and hip. ResultsThey found that those with LLI were 80% more likely than those without LLI to have radiographic knee OA, and 20% more likely than those without LLI to have radiographic hip OA.In the presence of Leg Length Inequality, hip OA was found to be 30% more common on the short leg side versus 18% on the longer limb side. HypothesisThey speculated, with support from other studies, that mechanical factors, including joint instability and malalignment, contribute to the progressive degeneration that characterizes radiographic OA. Said the authors:
“Individuals with LLI often modify their movement patterns to functionally minimize the inequality, i.e., increasing knee flexion or hip adduction of the longer limb. These compensatory mechanisms may amplify forces across a smaller joint contact area, thus acting as a biomechanical precursor to lower extremity OA.”
“LLI may lead to altered or amplified joint forces, resulting in accelerated degeneration of joint structures and increased OA severity.”
The authors's definition of LLI was a difference of more than 2cm, as they felt that a lesser inequality would not be "clinically meaningful", an opinion that chiropractors, with the spine rather than the hip and knee in mind, would take issue with.
“These results may have important clinical implications for patients seeking treatment for knee or hip OA. Evaluation of LLI should be incorporated into physical examinations for these patients.”
Conclusion“Treatment of LLI in patients with knee or hip OA, with heel or shoe lifts, may aid in reducing joint stresses, pain, and disability.”
How common is LLI in persons suffering from LBP?In a remarkable study done on servicement suffering from LBP, researchers discovered that ...For the Chiropractor
Sacro-iliac JointDue to altered biomechanics leg length inequality also contributes to osteo-arthritis in the sacro-iliac joint. For more about the chiropractic management of the Sacro-iliac Joint, click here …Neck PainA Journal of Rheumatology report confirms the connection between LLI and LBP, and invites questions about the use of heel lifts in the treatment of recalcitrant neck pain. Read more …Knee Joint DistractionResearch confirms that unloading of joints and increasing cartilage perfusion can dramatically reverse osteoarthritic changes. Read more …Contribute to Research topics you would like to see evauated ... Newsletter
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