Abstract
I met Professor Lordi n 1978 in Paris, France, and learnedabout Lord-type cementless total hip arthroplasty from him. With this experience as the starting point, I became more interestedin hip surgery and continuedto perform cementless total hip surgery throughout my life.
Lord-type cementless total hip prosthesis consists of a screw-in type acetabular component, high-density polyethylene inner socket, cobalt chrome head and a fully porous coated long straight stem. When I returned to Japan in 1979, I startedusing this system in Juntendo University Hospital. From 1979 to 1998, I operated with this system in 228 cases (277 hips). The Kaplan-Meier survival rate (with revision surgery as the endpoint) of the ring acetabular component was 55.1% in 20 years. These revised cases were mostly caused by loosening for mechanical reasons or osteolysis due to polyethylene wear debris. The survival rate of the full porous coatedstem was 92.2% in 20 years. The clinical results of the stem are satisfactory, but those of the screw-in-type acetabular component are poor and it necessitates revision surgery within a short period.
Production of the Lord-type total hip system ceasedin 1998, so I subsequently attempted to use many other kinds of prosthesis, such as Omnifit (Stryker), PCA (Howmedica), RMHS, Optiplus (Richards), Profile and S-Rom (DePuy), and now, finally, I use ANCA-FIT (Wright Medical) and CentPillar (Stryker). The number of total hip operations up to March 2013 was 964 hips.
Total hip arthroplasty has improvedeach year since the 1960s, in terms of technique, design, andmaterials like cross-linked polyethylene. I hope that the goal of revisionless total hip arthroplasty will be realizedin the future.
