Leg-length discrepancy after revision hip arthroplasty: are modular stems superior?

We retrospectively reviewed data for 79 consecutive patients who underwent revision hip arthroplasty using cementless femoral stems at our center between September 2008 and November 2010. Two cohorts were included, one using MP (modular) femoral stems and the other using Wagner (monoblock) femoral stems. We assessed leg-length discrepancy (LLD) before and after revision and compared the occurrence of leg-length inequality between the 2 cohorts. We found that the incidence of LLD was high in revision hip arthroplasty and that leg shortening was more common than lengthening. Both acetabular and femoral sides contributed to postoperative LLD. Appropriate placement of the femoral components was most critical in adjusting LLD. We also found that compared with monoblock stems, modular stems made adjustment of postoperative leg length easier.