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Why a Total Knee Replacement May Cause a Leg Length Discrepancy


Are you considering or have recently undergone total knee replacement surgery? If so, it’s important to be aware of the possibility of experiencing a leg length deficiency following the procedure.

Total knee replacement surgery, also called knee arthroplasty, is a surgical procedure to resurface worn bone and cartilage and replace all three areas of the knee joint: the outside (lateral), inside (medial), and under the kneecap (patellofemoral) with metal or plastic.


According to the American College of Rheumatology, this procedure is performed approximately 790,000 times annually in the United States, and this number continues to rise every year. While relatively uncommon, knee replacement procedures can sometimes lead to leg length disparities, causing one leg to become slightly longer than the other.

What is a Leg Length Deficiency?

A leg length deficiency, also sometimes called a leg length discrepancy, simply refers to a difference in the lengths of a person’s legs. Although it may not be visibly apparent, healthcare professionals and physical therapists can assess limb lengths through measurements, gait analysis, or medical imaging techniques like X-rays or CT scans if they suspect a deficiency. Even a small difference in the length of the legs can cause a noticeable effect.

Recognizing Signs of Leg Length Deficiency After Knee Replacement

The manifestations of a leg length deficiency can vary from person to person. If you’ve undergone a total knee replacement and experience any of the following symptoms once you’ve healed, you may be dealing with uneven leg lengths:

  • Difficulty walking or running
  • Pain in the lower back
  • Becoming fatigued from walking
  • Walking with a limp
  • Becoming fatigued and/or sore on one side while standing or walking
  • Loss of muscle strength, resulting in a leg-swing walk instead of lifting the leg
  • A feeling that your ribs, pelvis, or hips are not aligned
  • Observable misalignment of your belt line or shoulders when viewed from behind
  • More severe pain on one side

Treatment Options for a Difference in Leg Lengths

If you suspect a leg length deficiency following knee replacement surgery, one of the least invasive ways to address it is by using a heel lift. This simply means placing a heel pad-type insert in the shoe of your shorter leg. It works by raising the shorter leg to be even with the longer leg, resulting in a more even pelvis and hip, and reducing strain on the shorter leg and hip.  This treatment can be combined with physical therapy to help address discomfort, increase mobility, and strengthen affected muscles. There are also exercises you can do at home to encourage flexibility and strength.

Our Adjust-A-Lift® Heel Lift is a high-quality, versatile product designed to alleviate various symptoms associated with leg length inequalities. Available in three sizes to ensure a snug fit in the shoe, it’s constructed with three layers of extra firm, open-cell foam rubber secured with double-sided adhesive. That allows you to remove layers to achieve the desired height and balance leg lengths effectively.

Best of all, you can rest assured all Warwick Enterprise products are made of the highest quality materials to ensure long-lasting durability and comfort. If you have any questions before purchasing, contact us via phone, email, or form using our Contact Us page.