Advanced Hip Arthrosis, Massive Perceived LLD and Pelvic Obliquity due to Adduction Contracture Treated with THR

These two cases represent patients with advanced hip arthrosis and massive perceived limb length discrepancies (LLD) due to concomitant ipsilateral adduction and flexion contractures of the involved hip. Despite having moderate true LLD, the perceived LLD by both patients was massive. Alleviation of end-stage arthritis symptoms was achieved by performing a total hip replacement (THR). Correction of the flexion and adduction hip deformities by soft-tissue releases around the hip resulted in almost complete and complete resolution of the perceived LLD in the first and second cases, respectively. The joint replacement and soft-tissue releases unlocked the adduction deformity of the hip and the Pelvic obliquity due to adduction contracture of the hip (POACH), leading to correction of the apparent LLD, which was the main contributing factor to the massive perceived LLD.