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. 2016:19:31-4.
doi: 10.1016/j.ijscr.2015.12.008. Epub 2015 Dec 14.

Stable fixation of a madreporic Lord femoral prosthesis at 31-year follow-up in a total hip arthroplasty: A case report

Fernando M Judas  1 , Joana Fonseca Ferreira  2 , Rui Freitas Dias  3 , Francisco M Lucas  4
Affiliations

Stable fixation of a madreporic Lord femoral prosthesis at 31-year follow-up in a total hip arthroplasty: A case report

Fernando M Judas et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: Lord total hip prosthesis was discontinued due to high revision rates of the smooth threaded acetabular component and negative effects of stress shielding in the proximal femur.

Presentation of case: We report the outcome of a Lord cementless femoral stem, in a 55-year-old woman. In 1984, the patient underwent a Lord total hip arthroplasty for the treatment of advanced dysplastic osteoarthritis of the left hip. After 12 years, the cementless acetabular component of the prosthesis had been revised due to aseptic loosening. An acetabular metallic support ring and a cemented polyethylene cup were implanted, the femoral stem was not changed. The acetabular bone loss was reconstructed with morsellised cancellous bone allografts by the impacting technique. No complications were reported during the period of 19 years of the postoperative course. At the last clinical and radiological evaluations, the patient presented an asymptomatic hip and expressed high degree of satisfaction with the surgery result. The femoral stem was stable, with no measurable subsidence or radiolucent lines around the stem.

Discussion: Several reports have presented a high clinical success rate with the fully-porous-coated Lord femoral stem in both primary and revision cases. However, the long-term results showed a substantial rate of proximal femoral bone loss and thigh pain.

Conclusion: In our case, the Lord stem showed an excellent long-term result at the 31-year follow-up. To our knowledge, there is no published report with results of the Lord stem longer than 26-year's follow-up.

Keywords: Long-term result; Lord femoral stem; Lord total hip prosthesis.

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Figures

Fig. 1
Fig. 1
The Lord stem and the smooth threaded cup. The chrome–cobalt stem had a porous surface made up of 1 mm spheres, to provide osseous ingrowth/ongrowth and a solid fixation to the femoral bone.
Fig. 2
Fig. 2
Hip radiograph made 21 years after the Lord primary THA, showing a well-fixed Lord primary stem with signs of stress shielding of the proximal femur, and osteolysis of the great trochanter. At 9 years after the revision of the Lord primary acetabular cup, it was seen a stable fixation of the acetabular revision prosthesis.
Fig. 3
Fig. 3
Hip radiograph made 31 years after the Lord primary THA. The femoral stem presented a solid fixation, with proximal osteolysis and no pain. Stable acetabular revision prosthesis with signs of wear of the polyethylene cup, 19 years after de acetabular revision surgery.
See this image and copyright information in PMC

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