INTRODUCTIONHip hemiarthoplasties are commonly performed for displaced femoral neck fractures. Considerable differences of opinion exists regarding the choice between unipolar and bipolar designs. The main theoretical advantage of a bipolar over a unipolar prosthesis is the reduction of acetabular erosion due to movement taking place within the implant rather than at the acetabular implant interface. It is thus hypothesised that bipolar prostheses lead to better long-term functional outcomes with less complications. In this study, we aimed to compare unipolar (Moore's) and bipolar hemiarthroplasty looking specifically for differences in 1) pain and functional hip scores; 2) rates of acetabular erosion, component migration and revision surgery; and 3) rates of postoperative morbidity.

MATERIALS AND METHODSInclusion criteria were 1) age more than or equal to 65 years; 2) displaced femoral neck fracture of non-pathologic origin; 3) normal cognitive function; 4) ambulatory with or without assistive devices prior to the fracture; and 5) treated with a primary prosthetic replacement. Of the 193 patients that were available for review, 118 were in the Moore's group and 75 in the bipolar group. Postoperatively, patients were assessed with regards to pain, satisfaction, Modified Harris hip score and Oxford hip score. Standard anteroposterior pelvis and lateral hip radiographs were obtained at regular intervals. These were analysed specifically with regards to acetabular erosion and component migration.

RESULTSThere was no significant difference between a Moore's and a bipolar prosthesis regarding hip pain, functional hip scores, rates of acetabular erosion, component migration, revision surgery and complications rates.

CONCLUSIONUse of the more expensive bipolar prosthesis in elderly and premorbidly ambulant patient is not justified.

Age Factors ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; instrumentation ; Female ; Femoral Neck Fractures ; surgery ; Hemiarthroplasty ; instrumentation ; Hip Prosthesis ; Humans ; Male ; Postoperative Complications ; epidemiology ; Prosthesis Design ; Prosthesis Failure ; Reoperation ; Treatment Outcome

Aberrant chromosomal fusion of the Ewing's sarcoma oncogene (EWS) to several different cellular partners produces the Ewing's family of oncoproteins (EWS-fusion-proteins, EFPs) and associated tumors (EFTs). EFPs are potent transcriptional activators, dependent on the N-terminal region of EWS (the EWS-activation-domain, EAD) and this function is thought to be central to EFT oncogenesis and maintenance. Thus EFPs are promising therapeutic targets, but detailed molecular studies will be pivotal for exploring this potential. Such studies have so far largely been restricted to intact mammalian cells while recent evidence has indicated that a mammalian cell-free transcription system may not support bona fide EAD function. Therefore, the lack of manipulatable assays for the EAD presents a significant barrier to progress. Using Xenopus laevis oocytes we describe a plasmid-based micro-injection assay that supports efficient, bona fide EAD transcriptional activity and hence provides a new vehicle for molecular dissection of the EAD.
Animals ; Biological Assay ; Female ; Oncogene Proteins ; genetics ; Oncogenes ; genetics ; Oocytes ; metabolism ; pathology ; RNA-Binding Protein EWS ; genetics ; metabolism ; Sarcoma, Ewing ; genetics ; pathology ; Xenopus

The evolutionarily conserved RNA Polymerase II Rpb4/7 sub-complex has been thoroughly studied in yeast and impacts gene expression at multiple levels including transcription, mRNA processing and decay. In addition Rpb4/7 exerts differential effects on gene expression in yeast and Rpb4 is not obligatory for yeast (S. cerevisiae) survival. Specialised roles for human (hs) Rpb4/7 have not been extensively described and we have probed this question by depleting hsRpb4/7 in established human cell lines using RNA interference. We find that Rpb4/7 protein levels are inter-dependent and accordingly, the functional effects of depleting either protein are co-incident. hsRpb4/7 exhibits gene-specific effects and cells initially remain viable upon hsRpb4/7 depletion. However prolonged hsRpb4/7 depletion is cytotoxic in the range of cell lines tested. Protracted cell death occurs by an unknown mechanism and in some cases is accompanied by a pronounced elongated cell morphology. In conclusion we provide evidence for a gene-specific role of hsRpb4/7 in human cell viability.
Cell Line ; Cell Nucleus ; metabolism ; Cell Survival ; drug effects ; Gene Expression Profiling ; HeLa Cells ; Humans ; RNA Interference ; RNA Polymerase II ; antagonists & inhibitors ; genetics ; metabolism ; RNA, Small Interfering ; pharmacology