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Revision rates of one new and two established hemiarthroplasty heads : a comparative cohort study from the Swedish Arthroplasty Register

Rogmark, Cecilia LU ; Nåtman, Jonatan ; Overgaard, Sören and Mohaddes, Maziar LU (2025) In HIP International 35(5). p.430-436
Abstract

Introduction: The anatomical Lubinus SPII-stem is commonly used in hemi-arthroplasty for femoral neck fractures (FNF), combined with either the bipolar Variocup, the Unipolar Head (UH) and a newly introduced unipolar Modular Trauma Head (MTH). Similar constructs like the MTH are reported to have risk of corrosion and wear. This is the first publication evaluating the MTH. Aim: To describe the revision rate of the SPII-stems/heads which were divided into 3 groups (Variocup, UH, MTH). The head types are compared by their rate of revision at 2 years, due to any cause and to dislocation. Revision and mortality rates up to 10 years are reported. Methods: This observational cohort study based on prospectively registered data from the Swedish... (More)

Introduction: The anatomical Lubinus SPII-stem is commonly used in hemi-arthroplasty for femoral neck fractures (FNF), combined with either the bipolar Variocup, the Unipolar Head (UH) and a newly introduced unipolar Modular Trauma Head (MTH). Similar constructs like the MTH are reported to have risk of corrosion and wear. This is the first publication evaluating the MTH. Aim: To describe the revision rate of the SPII-stems/heads which were divided into 3 groups (Variocup, UH, MTH). The head types are compared by their rate of revision at 2 years, due to any cause and to dislocation. Revision and mortality rates up to 10 years are reported. Methods: This observational cohort study based on prospectively registered data from the Swedish Arthroplasty Register included 33,059 patients with hemiarthroplasty 2005–2021 due to FNF. SPII-stems combined with Variocup (n = 7,281), UH (n = 23,980), MTH (n = 1,798) were included. The follow-up ended at 10 years for Variocup and UH, for MTH at 2 years. Kaplan-Meier survival analyses was used, with a 95% confidence interval (CI). Patients were censored at death or at the end of the study (31 December 2021). Results: The 2-year revision rate regardless of cause was similar between the groups: after Variocup 3.5% (CI, 3.1–4.0), UH 3.1% (CI, 2.9–3.4), MTH 3.5% (CI, 2.6–4.5). At 10 years, the Variocup and UH had similar revision rates; 4.6% (CI, 4.0–5.2) and 5.0% (CI, 4.4–5.6). For revision due to dislocation at 2 years Variocup 2.3% (CI, 1.9–2.7) had an inferior outcome compared to UH 1.5% (CI, 1.3–1.7). The MTH had an intermediate outcome, 1.7% (CI, 1.0–2.3). Variocup had a higher dislocation related revision rate, until the 10th year. The 2-year-mortality was 36% (CI, 35–37) after Variocup, 43% (CI, 42–43) after UH and 44% (CI, 41–47) after MTH. Conclusions: The hemi-heads have comparable revision rates within 2 and 10 years. The new MTH performs similar to the standard UH. The bipolar Variocup is associated with more revisions due to dislocation.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dislocation, femoral neck fracture, hemiarthroplasty, mortality, revision surgery, stepwise introduction
in
HIP International
volume
35
issue
5
pages
430 - 436
publisher
SAGE Publications
external identifiers
  • scopus:85208044791
  • pmid:39297353
ISSN
1120-7000
DOI
10.1177/11207000241282081
language
English
LU publication?
yes
id
6c7c4ede-10cc-44e1-8ba2-1ec90fa00840
date added to LUP
2024-12-10 15:34:29
date last changed
2026-06-25 21:35:24
@article{6c7c4ede-10cc-44e1-8ba2-1ec90fa00840,
  abstract     = {{<p>Introduction: The anatomical Lubinus SPII-stem is commonly used in hemi-arthroplasty for femoral neck fractures (FNF), combined with either the bipolar Variocup, the Unipolar Head (UH) and a newly introduced unipolar Modular Trauma Head (MTH). Similar constructs like the MTH are reported to have risk of corrosion and wear. This is the first publication evaluating the MTH. Aim: To describe the revision rate of the SPII-stems/heads which were divided into 3 groups (Variocup, UH, MTH). The head types are compared by their rate of revision at 2 years, due to any cause and to dislocation. Revision and mortality rates up to 10 years are reported. Methods: This observational cohort study based on prospectively registered data from the Swedish Arthroplasty Register included 33,059 patients with hemiarthroplasty 2005–2021 due to FNF. SPII-stems combined with Variocup (n = 7,281), UH (n = 23,980), MTH (n = 1,798) were included. The follow-up ended at 10 years for Variocup and UH, for MTH at 2 years. Kaplan-Meier survival analyses was used, with a 95% confidence interval (CI). Patients were censored at death or at the end of the study (31 December 2021). Results: The 2-year revision rate regardless of cause was similar between the groups: after Variocup 3.5% (CI, 3.1–4.0), UH 3.1% (CI, 2.9–3.4), MTH 3.5% (CI, 2.6–4.5). At 10 years, the Variocup and UH had similar revision rates; 4.6% (CI, 4.0–5.2) and 5.0% (CI, 4.4–5.6). For revision due to dislocation at 2 years Variocup 2.3% (CI, 1.9–2.7) had an inferior outcome compared to UH 1.5% (CI, 1.3–1.7). The MTH had an intermediate outcome, 1.7% (CI, 1.0–2.3). Variocup had a higher dislocation related revision rate, until the 10th year. The 2-year-mortality was 36% (CI, 35–37) after Variocup, 43% (CI, 42–43) after UH and 44% (CI, 41–47) after MTH. Conclusions: The hemi-heads have comparable revision rates within 2 and 10 years. The new MTH performs similar to the standard UH. The bipolar Variocup is associated with more revisions due to dislocation.</p>}},
  author       = {{Rogmark, Cecilia and Nåtman, Jonatan and Overgaard, Sören and Mohaddes, Maziar}},
  issn         = {{1120-7000}},
  keywords     = {{Dislocation; femoral neck fracture; hemiarthroplasty; mortality; revision surgery; stepwise introduction}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{430--436}},
  publisher    = {{SAGE Publications}},
  series       = {{HIP International}},
  title        = {{Revision rates of one new and two established hemiarthroplasty heads : a comparative cohort study from the Swedish Arthroplasty Register}},
  url          = {{http://dx.doi.org/10.1177/11207000241282081}},
  doi          = {{10.1177/11207000241282081}},
  volume       = {{35}},
  year         = {{2025}},
}