ABSTRACT
BACKGROUND: Hemiarthroplasty is widely recommended for the treatment of femoral neck fractures in elderly patients, but it is controversial in choosing cemented or cementless fixation types. OBJECTIVE: To compare the clinical effects of cemented hemiarthroplasty with cementless hemiarthroplasty for the treatment of femoral neck fractures in elderly and to provide a scientific basis for the selection of clinical prosthesis. METHODS: 167 elderly patients with femoral neck fractures undergoing hemiarthroplasty in the Foshan Hospital of Traditional Chinese Medicine from March 2013 to March 2015 were enrolled in this study. According to the type of prosthesis, patients were divided into cementless group (n=81) and cemented group (n=86). The operation time, intraoperative blood loss, hemoglobin levels 1 day after surgery, reoperation rate, mortality and complications at 1 year after surgery were compared. After surgery, clinical function of hip joint was assessed by Harris scoring system. The pain was evaluated by Visual Analogue Scale. RESULTS AND CONCLUSION: (1) All patients were followed up for ≥ 12 months. (2) The operation time in the cementless group was significantly shorter than that in the cemented group (P < 0.01). (3) There was no significant difference in the intraoperative blood loss and hemoglobin levels at postoperative 1 day (P > 0.05). (4) There were no significant differences in Harris hip scores and Visual Analogue Scale score at various time points between both groups (P > 0.05). (5) The incidence of thigh pain in cementless group was slightly higher than that in cemented group at 1 week, 1 and 6 months after operation, but the differences were not statistically significant (P > 0.05). Two patients died from myocardial infarct in the cementless group, and one patient died from pulmonary infection in the cemented group. The mortality was not significantly different at postoperative 1 year between the two groups (P > 0.05). No complications, such as prosthesis loosening and sinking, periprosthetic fracture, and periprosthetic infection, which needed to be refurbished, occurred in both groups. (6) Our findings suggest that both cemented and cementless hemiarthroplasties can obtain satisfactory effect in the treatment of femoral neck fractures in the elderly patients. Cementless hemiarthroplasty can significantly shorten operation time.
ABSTRACT
<p><b>OBJECTIVE</b>To compare two different methods, namely orthotopic implantation and armpit implantation, for establishing nude mouse model bearing osteosarcoma in light of the tumor formation rate and time, tumor growth changes and lung metastasis.</p><p><b>METHODS</b>Osteosarcoma cells were inoculated in the left armpit or the femoral medullary canal of nude mice, and the tumor growth was observed 6 weeks later. The differences in the pulmonary metastasis were examined macroscopically and microscopically.</p><p><b>RESULTS</b>Armpit implantation allowed easy operation and fast tumor growth, but tumors often sustained damages by frictions on the surface (P<0.05), and avascular necrosis occurred earlier in the tumors (P<0.05). With this approach, the pulmonary metastasis rate was only 40% (P<0.05), and the metastases in the lungs were sparser (P<0.05) and small. Orthotopic transplantation could well simulate the original growth environment of osteosarcoma, and resulted in milder avascular necrosis and greater pulmonary metastasis rate (100%) with larger and denser metastatic foci. But orthotopic transplantation required more complicated operation for establishing osteosarcoma-bearing models.</p><p><b>CONCLUSION</b>The two methods both result in high tumor growth rate, but orthotopic transplantation is superior in inducing pulmonary metastasis of osteosarcoma and reducing friction injury of the tumor and avascular necrosis in the tumor.</p>