Patellofemoral joint arthroplasty: patient selection,surgical technique and outcomes

Isolated patellofemoral arthritis is an increasingly recognized entity, and is usually associated with previous patellofemoral dysplasia or instability. Patellofemoral arthroplasty (PFA) has evolved significantly in recent years, both in terms of implant design and importantly in the understanding of appropriate patient selection. This review outlines the indications and investigations for PFA, provides a brief history of the development of contemporary implants, and presents the clinical outcomes for the prostheses most commonly used in the UK. In addition, it provides a detailed surgical technique for implantation of an onlay implant, with tips on how to optimize patellofemoral biomechanics and thus achieve a consistently good outcome.     

Laterality of cross-modal spatial processing

This study examined the laterality of spatial-form perception in normal adults using a cross-modal matching paradigm involving visual and tactile processing. Randomly generated eight-point and 12-point Vanderplas and Garvin (1959) patterns were used as the stimuli. In a visual-to-tactile task, a lateralized visual pattern was followed immediately by a haptic task requiring subjects to discriminate which of two simultaneously felt shapes matched the visual pattern. In a tactile-to-visual task, subjects decided which of two simultaneously felt shapes matched a lateralized visual pattern presented after haptic manipulation. There were no main effects for laterality or for sex differences. Matching accuracy was better in the visual-to-tactile task and for less complex stimuli. A visual field by feeling hand interaction showed best recognition accuracy when visual-feeling hand combinations on the same side of the body were used in the two matching tasks. These data reflect a stimulus-response compatibility explanation of spatial-form perception that is consistent with a behavioral and not a cerebral asymmetry model.     

Youth Tobacco Access and Possession Policy Interventions: Effects on Observed and Perceived Tobacco Use

This study evaluated the effects of tobacco Purchase, Use and Possession (PUP) laws on student perceptions of adolescent tobacco use within towns and schools. Twenty‐four towns were randomly assigned into two conditions, the experimental condition (E PUP) involved efforts to increase both PUP law enforcement and reduce minors' access to commercial sources of tobacco, whereas the control condition (C) focused only on efforts to reduce minors' access to commercial sources of tobacco. A hierarchical linear modeling analytical approach was selected due to the multilevel data and nested design. The present study found that over time, youth in the experimental PUP condition observed less youth tobacco usage at school and in their town, and perceived lower rates of tobacco among their peers at school and among friends than youth in the control condition. The findings suggest that PUP law enforcement might be used to strengthen community norms against youth tobacco use.     

Preconception Care for Improving Perinatal Outcomes: The Time to Act

Maternal and Child Health Journal -