Symptoms of the knee and hip in individuals with and without limb length inequality

Osteoarthritis Cartilage. 2009 May;17(5):596-600. doi: 10.1016/j.joca.2008.11.005. Epub 2008 Nov 19.


Objective: This cross-sectional study examined the association of limb length inequality (LLI) with chronic joint symptoms at the hip and knee in a large, community-based sample, adjusting for the presence of radiographic osteoarthritis (OA) and other confounders.

Methods: The total study group comprised 3012 participants with complete knee symptoms data, 3007 participants with complete hip symptoms data, and 206 with LLI>or=2 cm. Presence of chronic knee symptoms was defined as report of pain, aching, or stiffness (symptoms) of the knee on most days. Presence of chronic hip symptoms was defined as hip pain, aching, or stiffness on most days or groin pain. Multiple logistic regression models were used to examine the relationship of LLI with knee and hip symptoms, while adjusting for demographic and clinical factors, radiographic knee or hip OA and history of knee or hip problems (joint injury, fracture, surgery, or congenital anomalies).

Results: Participants with LLI were more likely than those without LLI to have knee symptoms (56.8% vs 43.0%, P<0.001), and hip symptoms (49.5% vs 40.0%, P=0.09). In adjusted models, knee symptoms were significantly associated with presence of LLI (adjusted odds ratio [aOR]=1.41, 95% confidence interval, [95% CI] 1.02-1.97), but the relationship between hip symptoms and LLI (aOR=1.20, 95% CI 0.87-1.67) was not statistically significant.

Conclusion: LLI was moderately associated with chronic knee symptoms and less strongly associated with hip symptoms. LLI may be a new modifiable risk factor for therapy of people with knee or hip symptoms.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Humans
  • Leg Length Inequality / complications*
  • Leg Length Inequality / diagnostic imaging
  • Male
  • Middle Aged
  • Osteoarthritis / etiology
  • Osteoarthritis / physiopathology*
  • Pain / diagnostic imaging
  • Pain / etiology*
  • Postural Balance / physiology*
  • Radiography
  • Risk Factors
  • Shoes
  • Weight-Bearing / physiology*