MID-TERM SURVIVORSHIP AND ALL-CAUSE REVISION FOLLOWING TOTAL HIP ARTHROPLASTY FOR INTRACAPSULAR NECK OF FEMUR FRACTURES USING THE LUBINUS SP II COMPOSITE BEAM STEM

Abstract

All-cause failure following total hip arthroplasty (THA) for intracapsular neck of femur (NOF) fracture remains a concern, with revision potentially required for infection, dislocations or peri-prosthetic fracture (POPFF). Mid-term survivorship of the Lubinus SP-II composite beam anatomical femoral stem in trauma THA remains incompletely characterised. This study aimed to determine implant survivorship and incidence of all-cause revision. Over a 9-year period, between January-2017 and December-2025, 165 patients with intracapsular neck-of-femur fractures presenting to NHS-Fife underwent THA in accordance with National Institute for Health and Care Excellence (NICE) guidelines. All procedures utilised the Lubinus SP-II composite beam anatomical femoral stem. Patient demographics including age, sex, address were collected prospectively in a hip fracture database. Medical records and radiographs were reviewed at a mean follow-up of 3.87 years to identify periprosthetic fracture, dislocation, infection, and revision surgery. A total of 165 patients underwent THA for intracapsular NOF fracture during the study period. The mean age was 67.2 years (range 50–84), with 123 females (74.7%) and 42 males (25.3%). Median time from admission to surgery was 2 days (IQR 1–3), and median length of stay was 7 days (IQR 6–9). Femoral component revision-free survival was 98.8% (95% CI 95.7–99.7%) at a mean follow-up of 3.87 years; two patients required revision of the femoral component, both for prosthetic joint infection. Overall, five patients underwent revision surgery (3.0%, 95% CI 1.3–6.9), comprising two revisions for infection and three revision procedures for recurrent dislocation without revision of the femoral stem. No POPFF were recorded (0/165). The Lubinus SP II composite beam femoral stem demonstrated excellent mid-term survivorship with low all-cause revision rates in patients undergoing THA for intracapsular neck of femur fractures. No postoperative periprosthetic femoral fractures were observed in this cohort.