Prospective cohort of 45 patients treated with the Grammont Delta III reverse shoulder prosthesis across three indications: cuff tear arthropathy, fracture sequelae, and failed prior arthroplasty. Mean follow-up was 40 months. The study asks whether functional outcomes and complication profiles differ by diagnosis.
When a patient over 70 presents with pseudoparalysis and cuff-deficient glenohumeral arthritis, this paper is the foundation for why RSA is your operation. Before midterm data like this existed, constrained prostheses had failed repeatedly due to loosening, and hemiarthroplasty offered only Neer's "limited goals" — pain relief without meaningful function.
Two decision rules follow directly from this data. First, counsel every RSA patient preoperatively that elevation will improve but rotation will not. This is a design consequence, not a surgical failure. Second, before any revision RSA, order inflammatory markers, a three-phase bone scan, and send intraoperative cultures and frozen sections. The 47% complication rate in revision cases. Driven largely by occult infection. Means your threshold for a staged procedure should be low.
Always evaluate teres minor on preoperative advanced imaging. Severe fatty infiltration (Goutallier grade 3-4) predicts 0° external rotation regardless of how well the implant functions. Set that expectation before the patient goes to the OR.
Prospective cohort of 45 patients treated with the Grammont Delta III reverse shoulder prosthesis across three indications: cuff tear arthropathy, fracture sequelae, and failed prior arthroplasty. Mean follow-up was 40 months. The study asks whether functional outcomes and complication profiles differ by diagnosis.
When a patient over 70 presents with pseudoparalysis and cuff-deficient glenohumeral arthritis, this paper is the foundation for why RSA is your operation. Before midterm data like this existed, constrained prostheses had failed repeatedly due to loosening, and hemiarthroplasty offered only Neer's "limited goals" — pain relief without meaningful function.
Two decision rules follow directly from this data. First, counsel every RSA patient preoperatively that elevation will improve but rotation will not. This is a design consequence, not a surgical failure. Second, before any revision RSA, order inflammatory markers, a three-phase bone scan, and send intraoperative cultures and frozen sections. The 47% complication rate in revision cases. Driven largely by occult infection. Means your threshold for a staged procedure should be low.
Always evaluate teres minor on preoperative advanced imaging. Severe fatty infiltration (Goutallier grade 3-4) predicts 0° external rotation regardless of how well the implant functions. Set that expectation before the patient goes to the OR.