Multicenter retrospective study of 80 shoulders treated with the Grammont reverse shoulder prosthesis for glenohumeral osteoarthritis with massive, irreparable rotator cuff tears. Mean follow-up was 44.5 months. The study evaluates whether this medialized, inverted design can restore function when the rotator cuff is absent — and identifies what predicts a good result.
When the rotator cuff is irreparably torn and the glenohumeral joint is arthritic, hemiarthroplasty provides pain relief but leaves most patients below functional elevation thresholds — only 18% exceed 120° of active elevation. This paper established that the Grammont reverse design changes that calculus: 70% of patients exceed 120° elevation, and the mean Constant score nearly triples.
Assess teres minor function before every reverse arthroplasty. A torn teres minor costs roughly 9 Constant points and reliably produces the hornblower sign. Counsel patients preoperatively about expected external rotation deficits.
Position the glenoid baseplate on the inferior portion of the glenoid with a slight inferior tilt, especially in E2/E3 erosion patterns, to reduce scapular notch risk. Grade 3–4 notching correlates with worse outcomes and is more common when superior bone loss forces a high baseplate position.
The survivorship data are the reason early guidelines restricted reverse arthroplasty to patients over 70: probability of mechanical failure rises steeply after year seven, making this a procedure with a defined lifespan that must match patient life expectancy.
Multicenter retrospective study of 80 shoulders treated with the Grammont reverse shoulder prosthesis for glenohumeral osteoarthritis with massive, irreparable rotator cuff tears. Mean follow-up was 44.5 months. The study evaluates whether this medialized, inverted design can restore function when the rotator cuff is absent — and identifies what predicts a good result.
When the rotator cuff is irreparably torn and the glenohumeral joint is arthritic, hemiarthroplasty provides pain relief but leaves most patients below functional elevation thresholds — only 18% exceed 120° of active elevation. This paper established that the Grammont reverse design changes that calculus: 70% of patients exceed 120° elevation, and the mean Constant score nearly triples.
Assess teres minor function before every reverse arthroplasty. A torn teres minor costs roughly 9 Constant points and reliably produces the hornblower sign. Counsel patients preoperatively about expected external rotation deficits.
Position the glenoid baseplate on the inferior portion of the glenoid with a slight inferior tilt, especially in E2/E3 erosion patterns, to reduce scapular notch risk. Grade 3–4 notching correlates with worse outcomes and is more common when superior bone loss forces a high baseplate position.
The survivorship data are the reason early guidelines restricted reverse arthroplasty to patients over 70: probability of mechanical failure rises steeply after year seven, making this a procedure with a defined lifespan that must match patient life expectancy.