Leg length differences and osteoarthritis

Please note that there are a number of simple ways to adjust for leg length differences.

By Jennifer Gibson, PharmD | Share

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At least 20 million people in the United States have osteoarthritis. This prevalent type of arthritis is most simply age-related wear-and-tear of joints. As people age, cartilage that protects the body’s joints breaks down, leading to joint pain and stiffness. Osteoarthritis normally appears after middle age and can cause significant disability if not treated. However, most osteoarthritis is manageable with over-the-counter pain relief, physical therapy and exercise. Physical activity is also the most effective prevention for osteoarthritis; maintaining a healthy body weight and avoiding injury can reduce the risk of developing osteoarthritis. Now, a new study reported in the Annals of Internal Medicine claims that leg length discrepancy is a modifiable risk factor that mitigates the risk of osteoarthritis.

It is estimated that 85% of the world’s population has some sort of leg length discrepancy. This inequality in leg length can range from barely noticeable and less than 1 cm to 6 cm or more. The discrepancy may be functional or congenital, in which a person is born with an anatomical discrepancy in the length of their limbs. An acquired discrepancy, on the other hand, is related to injuries, conditions or diseases that alter the body’s posture and gait. Most often, acquired leg length discrepancy is related to pronation — a slight inward roll of the foot during a normal walking or running gait. Anatomical discrepancies can be corrected through surgical procedures, if the discrepancy is great and likely to cause considerable disability. Acquired discrepancies can often be corrected with athletic conditioning and stretching programs, or by wearing arch supports, heel lifts or similar orthotic devices. Whatever the cause of leg length inequality, it usually results on back and joint pain, depending on the severity of the discrepancy.

The authors of the Annals study examined more than 3000 individuals aged 50 to 79 years who had or were at risk for osteoarthritis. Leg length was measured using full-limb radiography. The results indicate that a greater leg length discrepancy is associated with more prevalent osteoarthritis of the knee. Participants with a leg length inequality of more than 1 cm showed signs of osteoarthritis on the radiographs more often than participants with a leg length discrepancy of less than 1 cm (53% vs. 36%); symptomatic radiographic osteoarthritis also occurred more frequently in the first group (30% vs. 17%). The participants with greater leg length discrepancies also experienced symptomatic (15% vs. 9%) and progressive osteoarthritis (29% vs. 24%) of the knee more often than the comparison group, with or without radiographic confirmation of osteoarthritis…

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