Twenty-year survival of a cementless revision hip arthroplasty using a press-fit bulk acetabular allograft for pelvic discontinuity: a case report.

Acetabular revision in a total hip arthroplasty (THA) with pelvic discontinuity is uncommon and challenging. Optimal management remains controversial, particularly with graft and implant selection. Interpretation of outcomes is confounded by the heterogeneity of patterns of bone loss and the lack of long-term results in great numbers for any given choice of treatment. We report a revision THA using a press-fit bulk acetabular allograft and an uncemented porous-coated anatomic prosthesis for the management of pelvic discontinuity. After 20 years, the patient still had an excellent functional outcome with radiographic evidence of graft incorporation and no signs of loosening.

Using 'cling film' to protect lower limb plaster casts in babies with club foot.

Clubfoot or congenital talipes equinovarus is a common condition affecting babies and non-surgical treatment involves serial manipulation and plaster casting for many weeks. The casts are susceptible to soiling during this time, which makes management and child care even more challenging. The authors report initial experience in a typical district general hospital clubfoot clinic where the parents of a baby used conventional cling film to cover the casts and provide a low-cost, effective and well-tolerated method of protection. Informal reports received from these parents were very positive and encouraging throughout the duration of treatment. The authors believe parents with babies undergoing such treatment for clubfoot could be advised of the benefits of using cling film to protect plaster casts. More formal analysis of feedback from parents and collaborative experience with other hospitals is required before widespread use is recommended. There may also be scope for using cling film to protect lower limb casts used in managing developmental dysplasia of the hip or fractures in children and potentially adults.