Grammont reverse prosthesis: design, rationale, and biomechanics
Journal of Shoulder and Elbow Surgery (2005)
Pascal Boileau, Duncan J Watkinson, Armodios M Hatzidakis, Frederic Balg
Why this paper?
Pascal Boileau won the Neer award for this study on the Grammont style reverse shoulder prosthesis. At the time the Grammont design reverse shoulder replacement was becoming increasingly popular. This study demonstrated the high degree of scapular notching and the limitation of rotational movement that occurs with this design and it influenced him to develop his Bio-RSA design prosthesis to lateralize the glenoid side of the reverse arthroplasty.
This paper influenced my current understanding of reverse arthroplasty design. I now favour a more modern prosthesis designed by Mark Frankle. The lateralisation on the glenoid side, and more anatomical (135 degree) cut on the humeral side increases the amount of active rotational movement in the shoulder which I believe is pivotal to optimal function in the shoulder. The idea of an anatomic reverse arthroplasty that is focused more on re tensioning the soft tissue to improve passive and active range of motion in the shoulder.
Even though that paper was published before these modern designs were developed, it has had an impact in terms of my understanding of the limitations of the previous designs in reverse arthroplasty and how we should be looking towards the future.