{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T19:40:11Z","timestamp":1756582811886,"version":"3.44.0"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medical Case Reports"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>\n            The reported rate of femoral stem fracture after total hip arthroplasty (THA) varies between less than 0.1 and 3.4%. The study aimed to evaluate the incidence of Lubinus SP II femoral stem fracture in our population and associated risk factors, and to examine clinical outcomes following revision THA for SP II stem fracture. 4244 primary THAs incorporating the anatomic femoral stem were identified within our institution from a prospectively compiled arthroplasty patient database. 5 patients presented with a broken Lubinus SP II anatomical hip stem. Immediately postoperatively, the operating consultant submitted intraoperative data detailing surgical approach, head size, and components used. Patients were reviewed 6\u2009weeks postoperatively in an orthopedic clinic, then followed up at a dedicated orthopedic audit clinic at 6\u2009months, 1, 3, and 5\u2009years postoperatively, and data were collected prospectively. Postoperative complications were recorded at each follow-up visit. The incidence of stem fracture was 0.1% (5\/4240) at a mean follow-up of 7.5\u2009years. 3 were male, and 2 were female. The mean age was 63.8\u2009years (range, 53\u201372, SD\u2009=\u20097.4). The mean weight was 109\u2009kg (range, 88\u2013128; SD\u2009=\u200914.2). The mean BMI was 36.5\u2009kg\u2009m\n            <jats:sup>\u22121<\/jats:sup>\n            (range, 32.5\u201341.0, SD\u2009=\u20093.08). The mean time from primary THA to fracture was 6.4\u2009years. The mean size of the cement restrictor (indirectly suggesting the femoral canal diameter) was 13.6\u2009mm (range, 12\u201315, SD\u2009=\u20091.1). The implant neck angle used was 117 in 4 patients and 126 in 1 patient. The mean stem position in varus was \u22122.2 (range, \u22126\u20130, SD\u2009=\u20093.0). 4 fractures (80%) occurred at mid-stem and 1 (20%) distally with \u22126 degrees varus and a 15\u2009mm cement restrictor. To minimize stem fracture risk, we recommend using as large a size stem as possible after sequential reaming in tight femoral canals and avoiding stem downsizing along with holistic postoperative management.\n          <\/jats:p>","DOI":"10.1177\/2050313x251366366","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:12:46Z","timestamp":1756365166000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the risk factors for Lubinus SP II femoral stem fractures: A case series of 5 primary total hip arthroplasty patients with a mean follow-up of 7.5 years"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2364-4391","authenticated-orcid":false,"given":"Alexis","family":"Panzures","sequence":"first","affiliation":[{"name":"University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saim","family":"Faisel","sequence":"additional","affiliation":[{"name":"Akhtar Saeed Medical and Dental College, Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9897-7445","authenticated-orcid":false,"given":"Akkhash","family":"Sivakumar","sequence":"additional","affiliation":[{"name":"University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Ashoor Hasan","family":"Kazmi","sequence":"additional","affiliation":[{"name":"Victoria Hospital, Kirkcaldy\u2014NHS Fife, Scotland, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth","family":"Turnbull","sequence":"additional","affiliation":[{"name":"Victoria Hospital, Kirkcaldy\u2014NHS Fife, Scotland, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Victoria Hospital, Kirkcaldy\u2014NHS Fife, Scotland, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Adeel","family":"Akhtar","sequence":"additional","affiliation":[{"name":"University of Edinburgh, Edinburgh, UK"},{"name":"Victoria Hospital, Kirkcaldy\u2014NHS Fife, Scotland, UK"},{"name":"University of St Andrews, St Andrews, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/112070001002000202"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B10.16528"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0883-5403(05)80199-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200200002-00002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679508995581"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200704000-00012"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1235-5"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/00016470410004175"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2014.04.003"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.00259"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874325000903010008"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B1.36442"},{"key":"e_1_3_2_14_2","first-page":"221","article-title":"Cemented total hip arthroplasty: the SP-II femoral component","volume":"28","author":"Lubinus P","year":"2002","unstructured":"Lubinus P, Klauser W, Schwantes B, et al. Cemented total hip arthroplasty: the SP-II femoral component. Giornale Italiano di Ortopedia e Traumatologia 2002; 28: 221\u2013226.","journal-title":"Giornale Italiano di Ortopedia e Traumatologia"},{"key":"e_1_3_2_15_2","first-page":"1279","article-title":"Experience of an anatomic femoral stem in a united kingdom center\u2014excellent survivorship and negligible periprosthetic fracture rates at mean 12 years following primary total hip arthroplasty","author":"Turnbull GS","year":"2023","unstructured":"Turnbull GS, Akhtar MA, Dunstan ERR, et al. Experience of an anatomic femoral stem in a united kingdom center\u2014excellent survivorship and negligible periprosthetic fracture rates at mean 12 years following primary total hip arthroplasty. J Arthrop 2023: 1279\u20131281.","journal-title":"J Arthrop"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-024-03901-1"},{"key":"e_1_3_2_17_2","first-page":"37","article-title":"Influence of implant variations on survival of the Lubinus SP II stem: evaluation of 76,530 hips in the Swedish Arthroplasty Register, 2000\u20132018","volume":"93","author":"Itayem R","year":"2022","unstructured":"Itayem R, Rolfson O, Mohaddes M, et al. Influence of implant variations on survival of the Lubinus SP II stem: evaluation of 76,530 hips in the Swedish Arthroplasty Register, 2000\u20132018. Acta Orthop 2022; 93: 37\u201342.","journal-title":"Acta Orthop"},{"key":"e_1_3_2_18_2","volume-title":"Cobalt alloys: alloying and thermomechanical processing","author":"Klarstrom D","year":"2017","unstructured":"Klarstrom D, Crook P, Sharif A. Cobalt alloys: alloying and thermomechanical processing. 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