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CC BY-NC-ND 4.0 · Joints 2019; 07(04): 141-147
DOI: 10.1055/s-0041-1731010
Original Article

Short-Term Outcomes of the Grammont Reverse Shoulder Arthroplasty: Comparison between First and Second Generation Delta Prosthesis

Riccardo Luigi Alberio 
1   Department of Orthopaedics and Traumatology, University of East Piedmont, Hospital “Maggiore della Carità,” Novara, Italy
,
Marco Landrino 
1   Department of Orthopaedics and Traumatology, University of East Piedmont, Hospital “Maggiore della Carità,” Novara, Italy
,
Paolo Fornara
1   Department of Orthopaedics and Traumatology, University of East Piedmont, Hospital “Maggiore della Carità,” Novara, Italy
,
Federico Alberto Grassi 
1   Department of Orthopaedics and Traumatology, University of East Piedmont, Hospital “Maggiore della Carità,” Novara, Italy
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Abstract

Purpose This article compares short-term outcomes of two series of patients, who underwent reverse total shoulder arthroplasty (RTSA) with two different implants, both based on Grammont's principles: the Delta III (D-3) and the Delta Xtend (D-XT) prostheses.

Methods The D-3 group included a consecutive series of 26 patients (mean age 75 years), that were treated between 2000 and 2006; the D-XT group included a consecutive series of 31 patients (mean age 72.5 years), for a total of 33 implants performed between 2011 and 2015. In both groups the most common diagnoses were cuff tear arthropathy (18 and 22 shoulders, respectively) and malunion of proximal humerus fractures (3 and 5). All procedures were performed by the same surgeon. Constant–Murley score (CMS) was used to assess clinical and functional outcomes. Radiographic evaluation included the true anteroposterior and axillary views.

Results Twenty-three patients of the D-3 group and 22 patients (24 shoulders) of the D-XT group were evaluated at a mean follow-up of 42 months (range 26–84) and 44 months (range 26–66), respectively. Four complications occurred in the D-3 group (1 partial deltoid detachment, 1 dislocation, and 2 glenoid component loosening), while one early postoperative infection occurred in the D-XT group. Increases in elevation and CMS between preoperative and postoperative period were observed in both groups; only the D-XT group showed a slight improvement in rotations. The incidence of scapular notching was significantly different between the two groups: 100% for D-3 and 22.2% for D-XT in patients with a minimum follow-up of 5 years.

Conclusion Prosthetic design evolution and greater acquaintance with this surgery have undoubtedly led to an improvement in short-term outcomes with second generation implants of RTSA. Future studies will have to ascertain whether newer implants, relying on biomechanical solutions alternative to Grammont's original concept, might provide additional advantages and minimize drawbacks.

Keywords

reverse shoulder arthroplasty - grammont prosthesis - deltopectoral - transdeltoid - rotator cuff arthropathy


Publication History

Received: 27 February 2019

Accepted: 18 April 2021

Article published online:
20 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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