Overcoming Leg Length Discrepancy After 50 Years

“It felt like a dream!”, is the emotional statement of Ms. Lan after treatment at Sante Hospital. Ms. Lan, 73 years old, had an accident in 1975 but did not have the means for treatment, living with pain and uneven mobility for nearly 50 years.

According to Ms. Lan's family, following the end of the war in 1975, the family experienced substantial financial constraints alongside limited access to modern healthcare. Consequently, after a traumatic accident resulting in pelvic, acetabular, and pubic fractures, she was compelled to endure persistent pain and manage her condition using non-standardized regimens—ranging from over-the-counter pharmaceuticals to traditional herbal therapies based on informal recommendations—without receiving definitive orthopaedic care.

For nearly fifty years, she endured impaired mobility marked by a pronounced antalgic gait. As age progressed and physiological tolerance declined, her clinical status deteriorated considerably. Over the past five years, worsening chronic pain has profoundly compromised her quality of life.

On 20/6/2024, she was brought to Sante Hospital by her family in a state of severe pain radiating from her knees and ankles to her spine,… Choking back tears, she shared, “A good night's sleep is like a miracle to me right now; I am completely exhausted from the pain, and I don't know how much longer I can endure it…”

Following a thorough clinical evaluation and multidisciplinary consultation led by Dr. Tang Ha Nam Anh, MD, PhD, the surgical team determined that Ms. Lan presented with a highly intricate pathology. Chronic post-traumatic ankylosis, severe joint stiffness, and secondary osteoarthritis of the hip—compounded by long-standing displaced pelvic malunion left untreated—had resulted in marked compensatory scoliosis, upward pelvic obliquity, contractures of the iliopsoas and abductor muscle groups, bilateral muscle tone asymmetry, and a limb length discrepancy of approximately 4 cm. Surgical intervention was deemed urgently necessary to restore functional mobility and achieve definitive pain relief.

With the 24-hour hip replacement technique at Sante Hospital, the surgery is minimally invasive, preserving soft tissues such as tissue, muscle, joint capsule... Thanks to this, about 6 – 12 hours after surgery, patients can already begin rehabilitation exercises, which is much faster than traditional surgical methods.

Preoperative and postoperative pelvic radiographs (X-rays) of the patient

For patients undergoing total hip arthroplasty—particularly those presenting with complex gait deformities such as Ms. Lan—structured rehabilitation is critical. Physical therapy progressively restores biomechanical gait, enhances hip abductor strength, mitigates the risk of postoperative dislocation, and expands functional range of motion. Furthermore, early therapeutic mobilization significantly reduces the risk of deep vein thrombosis, pulmonary embolism, and systemic complications associated with prolonged immobility.

By the third postoperative day, the patient experienced complete pain resolution, ambulated comfortably with restored limb symmetry, and was prepared for discharge. In high spirits, Ms. Lan shared: “I am immensely grateful. Upon admission, I felt profound anxiety and apprehension; however, the encouragement and dedicated care from the nursing staff and surgical team gave me the reassurance I needed to proceed. Now that the pain has subsided and my legs are equal in length, walking feels delightfully unfamiliar yet truly wonderful—it feels just like a dream.”

It is known that Ms. Lan's case was one of the highly complex hip replacement surgeries, carrying multiple risks such as paralysis or even death due to blood loss, where surgical precision and the profound experience of the medical team were crucial to achieving the best outcome. As a result, the Orthopedics and Traumatology Center – Sante Hospital once again demonstrated its dedication and high expertise, successfully managing difficult and complex medical cases.

Smiles intertwined with tears of joy from patients and their families are always a tremendous source of motivation for the medical team at Sante Hospital to continually strive and advance in delivering the best solutions for patients.

Dr. Tang Ha Nam Anh emphasized that with the modern and advanced hip replacement techniques currently available at Sante Hospital, patients should not hesitate to undergo joint replacement as soon as indicated by their doctor to prevent complications and negative impacts on daily life. However, for mild cases, doctors always prioritize conservative treatment methods.

(The patient's name has been altered to maintain confidentiality)