Revision of reversed shoulder arthroplasty : is a reoperation possible?

Introduction. As the number of reversed shoulder arthroplasty (RSA) procedures increases, the revision rate will also increase. In case of severe bone insufficiency, instability or infection of the primary RSA, revision to another RSA is preferable but not always possible. Hemiarthroplasty (HA), spacers and resection arthroplasty (RA) have been described in this indication. Materials and methods. Between 2004 and 2016, 20 shoulders in 19 patientswere treated at Ghent University Hospital for failed revision of RSA. Nine received a megahead prosthesis, a spacerwas implanted in 6, and 5 underwent RA. Results. Indications for implantation of a megahead prosthesis were loosening RSA (n = 5), infection (n = 4), dislocation (n = 1) and nerve irritation (n = 1). Improvement of range ofmotionwas observed. Anterosuperior migration of the prosthesis was noted in 2 patients. Another 2 patients were ultimately revised to RSA. Seven permanent spacerswere implanted for infection, of which 2 remain in place till today. The other 5 were revised to RSA. Of the 5 patients treated with RA, 3 were revised further on to RSA, resulting in pain relief and regain of function. Discussion. Our study shows that amegahead prosthesis has better functional results than RA, but is inferior to RSA. Due to increasing surgical experience and improving technique, 9 patients could ultimately be reconverted to another RSA. A review of current literature is presented. In HA and RA, the functional results are poor, and pain relief is uncertain. Results of spacers are variable and can be satisfactory. Arthrodesis is a last resort. Conclusion. In our case series study, a hemiarthroplasty can be performed in case of failure of RSA. However, the results are inferior to another RSA

Prosthetic overhang is the most effective way to prevent scapular conflict in a reverse total shoulder prosthesis

Methods An average and a "worst case scenario" shape in A-P view in a 2-D computer model of a scapula was created, using data from 200 "normal" scapulae, so that the position of the glenoid and humeral component could be changed as well as design features such as depth of the polyethylene insert, the size of glenosphere, the position of the center of rotation, and downward glenoid inclination. The model calculated the maximum adduction (notch angle) in the scapular plane when the cup of the humeral component was in conflict with the scapula. Results A change in humeral neck shaft inclination from 155 degrees to 145 degrees gave a 10 degrees gain in notch angle. A change in cup depth from 8 mm to 5 mm gave a gain of 12 degrees. With no inferior prosthetic overhang, a lateralization of the center of rotation from 0 mm to 5 mm gained 16 degrees. With an inferior overhang of only 1 mm, no effect of lateralizing the center of rotation was noted. Downward glenoid inclination of 0 boolean OR to 10 boolean OR gained 10 degrees. A change in glenosphere radius from 18 mm to 21 mm gained 31 degrees due to the inferior overhang created by the increase in glenosphere. A prosthetic overhang to the bone from 0 mm to 5 mm gained 39 degrees. Interpretation Of all 6 solutions tested, the prosthetic overhang created the biggest gain in notch angle and this should be considered when designing the reverse arthroplasty and defining optimal surgical technique

From collective curating to sharing curatorial authority: Collaborative practices as strategies of democratisation in exhibition making in Lubumbashi, Democratic Republic of Congo.

Research Report Masters in Heritage StudiesMany museums in Africa, such as the National Museum of Lubumbashi, are complex spaces with layers of burdened histories of colonisation and post-independence nation building, of contested objects and displays. This research traces two community-based art and heritage projects conducted in Lubumbashi, Democratic Republic of Congo, and explores how a sharing of curatorial authority can function as a strategy that democratises museum practice. The study will explore how mediation between public, researchers, curators and community participants engage a strategy of ‘collective curating’, which forms part of collective practices. At the intersection of art history and heritage studies, this study extends considerations of the notion of collective curating into issues of authority, using Michael Frisch’s concept of ‘shared authority’ and the practical application on exhibition making, exploring what can be called ‘shared curatorial authority’. Collective curating and the sharing of curatorial authority will operate as a concept that explores the way in which diverse collaborative approaches worked for the two case studies in Lubumbashi, D.R.C, and explores how those projects start to speak about the role of museums in Africa as social agents, and as places of active participation of the ommunities they serve.E.R. 201

Activités physiques et santé psychologiques des sujets blessés médullaires

La lésion médullaire traumatique se présente comme un événement dévastateur qui vient affecter tant le plan physique que le plan psychologique de l’individu. Au-delà de la perte de la fonction motrice et des modifications physiologiques suscitées, la lésion médullaire peut s’accompagner de troubles émotionnels considérables (e.g. colère, déni, dépression, détresse, anxiété,...) et de déficits cognitifs diffus en nature (i.e. difficultés en termes d’attention, de concentration, de mémoire, de résolution de problème, et de flexibilité mentale). Ces différentes conséquences sont susceptibles de limiter le degré d’indépendance des sujets et refréner leur motivation à participer à la vie au sein de la communauté. Leur niveau de qualité de vie peut alors s’en trouver altéré. Dans ce cadre, la pratique régulière d’une activité physique adaptée peut se révéler comme une modalité thérapeutique d’intervention efficace dans une perspective de maintien d’un niveau de qualité de vie acceptable et probablement dans le maintien ou le développement de la fonction cognitive. Cet article se propose de faire le point sur les connaissances actuelles dans ce domaine de recherche. À travers une analyse de la littérature, nous reviendrons sur les facteurs susceptibles de moduler les effets de la lésion médullaire en matière de qualité de vie et discuterons des déficits cognitifs rencontrés. Nous montrerons par la suite les effets avérés et probables de l’activité physique. Les mécanismes sous-tendant la relation entre activité physique et qualité de vie y seront présentés

What happens to whiteness upon migration? An examination of the dual transnationalism of White Zimnabwean emigrants

This thesis examines the development of dual transnationalism and diasporism among white Zimbabweans, arguing that they are dual transnationals following their – or their families’ - migration to Zimbabwe and their own subsequent emigration elsewhere. Whiteness both complicates and facilitates their movement, and their whiteness, in turn, is affected by their dual transnationalism. This thesis examines these interactions, ultimately examining what happens to whiteness upon migration. ‘Whiteness’ in this thesis is conceptualised as the interplay between power, privilege and identity, whose production and reproduction is historical, contextual, multi-layered and perpetually shifting. The thesis challenges the notion of whiteness as invisible, showing how migration experiences redefine power, privilege and identity to create relativity within whiteness. For white Zimbabwean emigrants, this leads to a subjective visibility of whiteness. The analysis demonstrates how colonial and post-colonial power structures shape individuals’ conceptualisations of their white identity as Euro-centric. Upon emigration from Zimbabwe, those same power structures provoke experiences that position individuals on the periphery of whiteness. This leads to a reconceptualisation of individual identities and the notion of ‘home’ so that white Zimbabweans re-conceptualise themselves as Afro-centric and embrace their hybridity. Thus, the thesis contributes to an understanding of positions of duality, specifically, white Zimbabwean experiences of dual diasporism and dual transnationalism. It draws on a translocational lens on intersectionality; transnationalism, intersectionality and whiteness literature. The research draws on 23 narrative and in-depth interviews with white Zimbabwean emigrants

Radiological AP-view analysis of the shoulder with cuff tear arthropathy

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Effets de l'activité physique sur les aspects physiques, psychologiques et cognitifs des personnes paraplégiques de nature traumatique

ORSAY-PARIS11-Bib. STAPS (914712103) / SudocSudocFranceF