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

• Lord THA was discontinued due to high revision rates of the smooth threaded acetabular component and negative effects of stress shielding in the proximal femur.
• Nevertheless, the madreporic femoral stem continues to demonstrate favorable long-term results, showing a stable fixation to the femoral bone.

IntroductionLord 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 caseWe 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.DiscussionSeveral 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.ConclusionIn 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.