This is a multicentre retrospective radiological study of 68 Grammont reverse shoulder arthroplasties at 8 to 12 years. It asks how the glenoid and humeral bone changes evolve at long term, and whether cemented and uncemented humeral stems differ.
The core teaching point flips a resident's intuition about shoulder arthroplasty failure. In anatomical total shoulder replacement the glenoid is the weak link. In the Grammont reverse prosthesis, medialising the center of rotation to the glenoid interface offloads the glenoid, so failure shifts to the humeral side.
That is why this series showed 8 humeral loosenings and zero glenoid loosenings, plus heavy stress shielding and tuberosity resorption around uncemented stems. Practically, know the Sirveaux-Nerot four-grade notching classification and the approach effect: the superolateral approach and a high, superiorly tilted baseplate drive notching, while placing the baseplate low protects against it.
The reassuring counterpoint is that these radiological changes were not clinically meaningful at 10 years. None led to revision, and satisfaction stayed high, so alarming films do not mandate intervention in an otherwise functioning shoulder.
This is a multicentre retrospective radiological study of 68 Grammont reverse shoulder arthroplasties at 8 to 12 years. It asks how the glenoid and humeral bone changes evolve at long term, and whether cemented and uncemented humeral stems differ.
The core teaching point flips a resident's intuition about shoulder arthroplasty failure. In anatomical total shoulder replacement the glenoid is the weak link. In the Grammont reverse prosthesis, medialising the center of rotation to the glenoid interface offloads the glenoid, so failure shifts to the humeral side.
That is why this series showed 8 humeral loosenings and zero glenoid loosenings, plus heavy stress shielding and tuberosity resorption around uncemented stems. Practically, know the Sirveaux-Nerot four-grade notching classification and the approach effect: the superolateral approach and a high, superiorly tilted baseplate drive notching, while placing the baseplate low protects against it.
The reassuring counterpoint is that these radiological changes were not clinically meaningful at 10 years. None led to revision, and satisfaction stayed high, so alarming films do not mandate intervention in an otherwise functioning shoulder.