We believe a PMGR is a simple way of treating a patient with PF who has failed to respond to conservative management. In our series, the results were favorable, the recovery fast and the morbidity low.

There has been a trend toward higher levels of evidence in foot and ankle surgery literature over a decade, but the differences did not reach significance.

A minimally invasive circumferential paratenon release and peritendinous steroid infusion was a simple method to treat non-insertional Achilles tendinopathy and had low morbidity in our series. This technique has become our preferred primary surgical intervention for this condition.

INTRODUCTION We performed a questionnaire study to establish the frequency and consequences of the detection of orthopaedic implants by airport security and to help us advise patients correctly. All published literature on this subject is based on experimental studies and no 'real-life' data are available.PATIENTS AND METHODS A total of 200 patients with a variety of implants were identified. All patients were sent a postal questionnaire enquiring about their experience with airport security since their surgery.RESULTS Of the cohort, 154 (77%) patients responded. About half of the implants (47%) were detected, but the majority of patients (72%) were not significantly inconvenienced. When detected, only 9% of patients were asked for documentary evidence of their implant. We also found that patients with a total knee replacement (TKR) had a greater chance of detection as compared to those with a total hip replacement (THR; 71% versus 31%; P = 0.03).CONCLUSIONS All patients, and in particular those with a TKR, can be re-assured that, although they have a fair chance of detection by airport security, a major disruption to their journey is unlikely. We advise that documentation to prove the presence of an orthopaedic implant should be offered to those who are concerned about the potential for inconvenience, but such documentation is not required routinely.

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A new operation for implantation of the artificial urinary sphincter for total urinary incontinence in women is described. The procedure is done through the vestibule of the vagina with clear exposure of the vesical neck and urethra anteriorly, and easier accessibility for dissection of the vagina from the posterior wall of the vesical neck and upper urethra. This approach reduces the incidence of occlusive cuff erosion and eliminates the chance of shifting of the device. The model AS 800 artificial sphincter was implanted for the first time in 4 patients with total urinary incontinence. Primary deactivation was used and the patients practiced nocturnal deactivation. Complete post-activation continence was achieved in all 4 patients. Mean followup has been 14 months. This approach is easier and less traumatic to the patient. Hospitalization and postoperative recovery times are markedly reduced. Technically, the method is much simpler to perform, particularly dissection between the vagina and the posterior aspect of the urethra, thereby reducing the operative time and complication rate.

Introduction: Synovial metaplasia around a prosthesis and in particular around silicone breast implants has been noted by various investigators, but has unknown clinical significance. We report on a patient where a large amount of synovial fluid mimicked rupture of an implant. We believe this to be an unusual clinical presentation of this phenomenon. Review of the English language literature failed to identify a comparable case.

Acute limp in childhood is associated with considerable anxiety for parents and clinicians alike. It can be a diagnostic challenge in the uncooperative child and any delay in diagnosis can result in significant morbidity and even mortality. A thorough clinical evaluation is of utmost importance. This review revisits the clinical assessment of a limping child and explores the relevant literature.