[Objective]To compare the short-term clinical effect of Corail entirely hydroxyapatite (HA)-coated versus cemen-ted femoral stem prosthesis in total hip arthroplasty(THA) for elderly femoral neck fracture. [Method]Fifty-four cases of unilat-eral femoral neck fracture in patient over 75 were retrospectively analyzed from January 2007 to June 2008. In them,21cases un-derwent THA using Corail femoral prosthesis(HA group) ,and the other 33 were treated with cemented THA(cement group). The difference was compared in time of hospitalization, time of operation, blood loss, hemodynamic parameters, adverse effect, Harris scoring and radiological results. [Result](1) The average operation time were (52.6～7.2) minutes in HA group and (62.5 ±8.5) minutes in cement group, with significant difference (P < 0.05). The blood loss were (217.9± 37.7) ml in HA group and (250.2 ±57.3)ml in cement group, with significant differernce(P < 0.05). (2)At the moment when infusing the cement, the systolic blood pressure(SBP) and diastolic blood pressure(DBP) decreased significantly for 5～10 minutes,and recovered after 10 minutes. At 3 minutes after infusing the cement,the heart rate(HR) changed rapidly,and recovered after 5～20 minutes. But the hemodynamie parameters showed no significant change in HA group. (3)There were no significant statistical differences be-tween two groups in time of hospitalization, complications and radiographic evaluations(including radiolucent line, osteolysis, pros-thetie loosening and subsidence). [Conclusion]THA using Corail entirely HA-coated femoral stem prosthesis for treatment of elder patients with femoral neck fracture can be effectively performed without increased risk of complications. It has advantages of less operative time, blood loss and inhibition effect onmyocardial contraction and peripheral vascular function duringthe operation. Its short term result is satisfactory, but the me-dium and long term effection still need further research.

)获得随访,平均随访时间14.1月.两组Harris评分、简易12项表(short form-12,SF-12)评分及并发症无显著性差异(P>0.05);影像学上股骨头相对髋臼中心的矢量位移L-MoM组较MoPE组显著降低(P<0.01),透亮线、股骨柄中置、异位骨化、骨溶解、假体松动、股骨距吸收、假体断裂两组无显著差异(P>0.05).结论:经后外侧小切口行L-MoM THA可取得与常规MoPE THA相似的早期临床疗效.并不会增加手术并发症,且髋臼磨损率更低,其中长期临床结果仍有待进一步研究.

A total of 13 cases with metastatic tumor of bone involving the proximal femur, including 8 male and 5 female with an average age of 46 years (range 28-65 years) were selected from Department of Orthopaedics, the First affiliated Hospital of Chongqing Medical University from March 2003 to March 2008. Diagnoses included metastatic breast carcinoma in 4 patients, lung carcinoma in 3, prostate carcinoma in 2, renal carcinoma in 1, thyroid carcinoma in 1, and poorly differentiated carcinoma in 2. Three of 13 patients had complete pathologic fracture before the operation. All patients were treated with curettage of lesion and artificial prosthesis replacement, including 9 patients received artificial total hip replacement and 4 underwent bipolar artificial femoral head replacement. The patients were followed up since the third month postoperatively and evaluated clinically and radiographically respectively for pain relief, limb function by Enneking score and quality of life by Kanofsky. All patients were in good condition during the operation with no deep infection or deep venous thrombosis. One died about two months after operation due to tumor metastasis and diffusion, and the remaining 12 patients survived. The radiolucent line happened in 2 of 12 cases, but there was no osteolysis, prosthesis loosening, dislocation or femoral stem subsidence. According to WHO standard for therapeutic effect of cancer, complete pain relief was achieved in 2 cases, significant relief in 6, partial relief in 3 and no relief in 1; the total remission rate was 91.7%. According to the Enneking functional scoring system, the patients were rated as excellent in 3, good in 5, fair in 3 and poor in 1, and the excellent and good rate was 66.7%. Postoperative quality life was excellent in 6 cases and good in 3 cases according to Kanofsky score, and the total effective rate was 75%. The results indicate that artificial prosthesis replacement for metastatic tumors involving the proximal femur could lead to remarked improvement in pain relief, joint functional recovery and quality of life.

Objective:To compare the clinical effect of large-diameter metal-on-metal(L-MoM)total hip arthroplasty(THA)versus conventional metal on poly ethylene(MoPE)THA following posterolateral minimal incision.Methods:22 L-MoM THA in 20 patients were performed with posterolateral minimal incision.A matched group of 22 hips in 20 patients who had undergone a MoPE THA with posterolateral minimal incision were also performed by the same surgeon.The two groups of patients were evaluated clinically and radiographically respectively,including the length of the incision,surgical time,intra-operative blood loss,postoperative drainage volume,postoperative amount of decreasing hemoglobin(Hb),postoperative pain score,C-reactive rotein(CRP),erythrocyte sedimentation rate(ESR),the circumference difference of the operated thighs,length of stay,major complications and component positions.Results:There were no differences between the two groups with regard to the length of the skin incision,operating time,blood loss,postoperative amount of decreasing Hb,the visual analog scale(VAS)pain score at 24 hours after surgery,CRP,ESR,the circumference difference of the operated thighs,length of stay,major complications and component positions.Conclusion:L-MoM THA with posterolateral minimal incision can be effectively performed without increased risk of complications.The key is to master the surgical skills.

Cardiac troponin Ⅰ(cTnI)is a sensitive,specific marker of myocardial damage,which is extensively used in the diagnosis and assessment of acute myocardial infarction.Its usefulness can be limited by false positive or negative results caused by potential interferences in the patient's blood,specimen type,identification of antibody/epitope recognition sites,or other factors.