• Hinkeldey NA
• Morgan WE

• Affiliation / Palmer College of Chiropractic
• Affiliation / Parker University
• Affiliation / VA Central Iowa Healthcare System
• Affiliation(G) / United States / Iowa / Davenport
• Affiliation(G) / United States / Iowa / Des Moines
• Affiliation(G) / United States / Texas / Dallas
• Aged
• Arthroplasty, Replacement, Hip / adverse effects
• Female
• Leg Length Inequality / complications
• Open Access Document
• Scoliosis / etiology

Introduction: Leg Length Inequality (LLI) has been identified as a mechanism that can lead to scoliosis. LLI is a relatively common outcome of total hip replacement (THR) surgery; however, few studies illustrate the potential for THR to result in scoliosis. The current report discusses a scoliosis that may have resulted from LLI following a THR. 

Clinical Features: A 65-year-old woman sought care at a hospital based chiropractic clinic for an acquired scoliosis following a THR surgery. This was not present in plain film imaging taken prior to her THR surgery. Post-surgical leg length analysis revealed a significant LLI and subsequently, the rapid progression of a scoliosis.

Interventions and Outcomes: Post THR surgery radiographs of the hips illustrated significant asymmetrical leg lengths and progressing scoliosis. 

Conclusion: A significant number of patients develop LLI following THR surgery. Non-surgical LLI have been found to cause or contribute to scoliosis; this case identifies a potential link between an iatrogenic LLI and the onset of scoliosis. The presenting case illustrates a patient that may present with back pain to the general chiropractic office.

Author affiliations: NAH: Staff Chiropractor, VA Central Iowa Healthcare System, Des Moines, IA; Adjunct Faculty, Palmer College of Chiropractic; WEM: President, Parker University 

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