BackgroundThis retrospective analysis compared the long-term outcomes for patients with a femoral neck fracture (AO/OTA type 31B) treated with a primary unilateral total hip arthroplasty with uncemented or cemented femoral components (UTHA or CTHA, respectively).MethodsWe conducted a retrospective cohort study using the South China Hip Arthroplasty Database. We identified 422 patients with femoral neck fracture (AO/OTA type 31B) who were previously treated with primary unilateral UTHA or CTHA between 2007 and 2015, with follow-up until 2019. Follow-up occurred 1, 3, 6 and 12 months postoperatively and yearly thereafter. The primary outcome was the Harris hip score (HHS). The secondary outcome was the orthopaedic complication rate.ResultsIn total, 324 patients (UTHA n = 160, mean age 68.61 ± 7.49 years; CTHA n = 164, mean age 68.75 ± 7.04 years) were evaluated for study eligibility. The median follow-up was 73.3 months (range, 11.6–89.2 months). At the final follow-up, HHS was 74.09 ± 6.23 vs 79.01 ± 10.21 (UTHA vs CTHA, p = 0.012). Significant differences were detected in the incidence of prosthetic revision, loosening, and periprosthetic fracture between the UTHA and CTHA groups (7.5% for UTHA vs 1.8% for CTHA, p = 0.015; 17.5% for UTHA vs 8.5% for CTHA, p = 0.016; 11.9% for UTHA vs 4.9% for CTHA, p = 0.021, respectively).ConclusionIn this setting, CTHA demonstrated superiority to UTHA by improving functional outcomes and decreasing complication rates.

Background The purpose of this study was to compare the efficacy of osimertinib (OSI) versus afatinib (AFA) in patients with T790M-positive, non-small-cell lung cancer (NSCLC) and multiple central nervous system (CNS) metastases after failure of initial epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment. Methods The cohort consisting of 124 patients (OSI: n=60, median age=64.24 years [range, 51.91 to 76.57]; AFA: n=64, median age=64.13 years [range, 50.41 to 77.85]) with T790M-positive NSCLC and multiple CNS metastases after failure of initial EGFR-TKI treatment were consecutively identified at the Cancer Medical Center, Sun Yat-Sen University between March 2017 and July 2017; patients underwent either oral OSI (80 mg/day) or oral AFA (40 mg/day) until the occurrence of disease progression, intolerable adverse events (AEs), or death. The co-primary endpoints were overall survival (OS) and progression-free survival (PFS). Results After a median follow-up of 24 months (range, 6 to 26), a significant improvement in OS was observed in the OSI group compared with the AFA group (hazard ratio [HR] 0.30, 95% confidence interval [CI] 0.23 - 0.41; p = 0.009; median, 13.0 versus 9.2 months). The median duration of PFS was significantly longer with OSI than with AFA (HR 0.25, 95% CI 0.11 - 0.34; p = 0.001; median, 5.4 versus 4.3 months). The proportion of grade 3 or higher AEs was lower with OSI (22.4%) than with AFA (39.4%). Conclusion In patients with T790M-positive NSCLC and multiple CNS metastases after failure of initial EGFR-TKI treatment, OSI was associated with significantly improved survival benefit compared with AFA, and OSI exhibited a controllable tolerability profile.