Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff

TLDR

The integrity of the teres minor muscle is critical for external rotation recovery and strongly influences the Constant score. The study evaluated 80 shoulders in 77 patients with a mean 44‑month follow‑up after Grammont inverted total shoulder arthroplasty. At 44 months, the Grammont inverted prosthesis yielded significant functional gains—Constant score rose from 22.6 to 65.6, forward elevation from 73° to 138°, and 96 % of shoulders were pain‑free—though 3 revisions, 5 glenoid loosening, and 7 dissociations occurred, confirming early promise but suggesting use in elderly patients.

Abstract

We reviewed 80 shoulders (77 patients) at a mean follow-up of 44 months after insertion of a Grammont inverted shoulder prosthesis. Three implants had failed and had been revised. The mean Constant score had increased from 22.6 points pre-operatively to 65.6 points at review. In 96% of these shoulders there was no or only minimal pain. The mean active forward elevation increased from 73° to 138°. The integrity of teres minor is essential for the recovery of external rotation and significantly influenced the Constant score. Five cases of aseptic loosening of the glenoid and seven of dissociation of the glenoid component were noted. This study confirms the promising early results obtained with the inverted prosthesis in the treatment of a cuff-tear arthropathy. It should be considered in the treatment of osteoarthritis with a massive tear of the cuff but should be reserved for elderly patients.