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3% of patients. There was no difference in the preoperative and postoperative LLD (MD -1.23; 95%CI -3.72, 1.27; = 0.34). Pooled data of two studies ( = 219) revealed significant limb lengthening in valgus deformity than varus (MD -2.69; 95%CI -5.11, 0.27; = 0.03). The pooled data of three studies ( = 611) showed significantly worse functional outcome in patients with LLD of ≥ 10 mm compared to 10 mm (standard MD 0.58; 95%CI 0.06, 1.10; = 0.03). Limb lengthening after TKA is common, and it is significantly more in valgus than varus de