The uncemented fully textured Lord hip prosthesis - A 10-to 15-year followup study

One hundred fourteen total hip arthroplasties in 110 patients performed bet ween 1979 and 1983 using the Lord femoral component were analyzed. Nine fem oral revisions were performed within 13 years after surgery (two because of infection). Excluding infections there was a 94% 13-year survival accordin g to a Kaplan-Meier analysis. Subsidence was seen in five hips (five patien ts), but only one needed revision surgery. Seventy-six hips (73 patients) h ad a radiographic followup of 10 years or more and were analyzed in detail. Changes in cortical thickness, density, and formation of spotwelds continu ed beyond 5 years after surgery, meaning the remodeling of periprosthetic b one continued beyond that time. Osteolysis on the femoral side was seen in seven hips, always in the proximal part of the femur, apparently as a conti nuation of the joint space. No remote focal osteolysis was seen. Elderly pa tients, women, and patients with a pedestal were overrepresented among indi viduals with many spotwelds. For the clinical outcome the Merle d'Aubigne a nd Postel score as modified by Charnley was used. hmong 69 hips (66 patient s) with a mean followup of 153 months 96% (66 hips) had a pain score equal to or greater than 4 and 74% (51 hips) had a score of 5 or 6. The Lord femo ral component gave surprisingly good clinical long term results despite the bone remodeling (stress shielding), which in some cases was pronounced. Th e most obvious disadvantage with this design appears to be the difficulties associated with its removal when indicated.