Which intraoperative strategies are used to restore leg length and offset in total hip arthroplasty?

• A. Preoperative templating only
• B. Intraoperative measurement with trial components
• C. A combination of the included strategies
• D. Postoperative radiographs determine leg length

Answer: (C)

Achieving accurate leg length and femoral offset in total hip arthroplasty comes from combining planning with real-time verification. Preoperative templating guides what size components and how they should be positioned to reach the desired leg length and offset. But the true intraoperative result depends on how the components actually seat, the soft-tissue tension, and the precise fit after preparation. That’s where trial components and intraoperative measurements come in: they let the surgeon compare the current setup with the planned targets, assess gaps or tightness, and make adjustments before finalizing the implants.

Relying only on preoperative plans misses intraoperative realities, while depending solely on intraoperative measurements neglects the established preoperative targets. Postoperative radiographs would tell you how it turned out after the fact, not help during the operation. Therefore, using a combination of both planning and intraoperative verification provides the most reliable restoration of leg length and offset.