Grammont Versus Lateralizing Reverse Shoulder Arthroplasty for Proximal Humerus Fracture: Functional and Radiographic Outcomes

Overview

Journal Musculoskelet Surg

Date 2018 Oct 22

PMID 30343472

Citations 9

Authors

M A Verdano

D Aliani

C Galavotti

C Maroun

E Vaienti

F Ceccarelli

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study is to retrospectively compare clinical and radiographic outcomes of patients treated with non-lateralizing reverse shoulder arthroplasty (RSA) and with humeral lateralizing RSA after proximal humerus fracture (PHF).

Methods: In total, 32 patients (8 men and 24 women), with a mean age of 77.4 (67-92), have been reevaluated (follow-up of 14.3 months) and divided into Grammont group (G-group-16 patients, 2 men and 14 women, mean age 82.3) and lateralizing group (L-group-16 patients, 4 men and 12 women, mean age 72.5). The dominant side was affected in 21 patients. Pain, Constant-Murley score (CMS), range of motion accurately measured with inertial sensors (SHoWlder, NCSLab) and complications. Anatomic tuberosity healing, signs of loosening or mobilization of the implants and scapular notching (according to Sirveaux classification) have been measured on standard X-ray series (antero-posterior view in neutral, external and internal rotation; axillary view; outlet view).

Results: Similar CMS was recorded between the two groups (G-group: 61/100; L-group: 64/100). G-group had higher forward flexion (128° vs. 112°) and abduction (126° vs. 114°), L-group had higher external rotation in abduction (35° vs. 41°); similar internal rotation (sacrum) and rotation with elbow in adduction were measured (12° vs. 19°). No statistically significant differences emerged. Anatomic healing of the tuberosity was higher in G-group (87.5% vs. 50%); low-grade scapular notching was higher in L-group (18.25% grade 1-2 vs. 0). Anatomic healed tuberosity guaranteed highly statistically significant improved functional outcomes. No revisions of the implant were performed.

Conclusions: RSA can be considered a valid solution for the treatment of PHF in elderly low-demanding population. Cuff conditions should be investigated before surgery for the indication of the adequate model.

Citing Articles

Complications following reverse total shoulder arthroplasty for proximal humeral fractures: a systematic review.

Bents E, Ardebol J, Noble M, Galasso L, Denard P, Menendez M JSES Rev Rep Tech. 2025; 5(1):60-69.

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Demographic-, Radiographic-, and Surgery-Related Factors Do Not Affect Functional Internal Rotation Following Reverse Total Shoulder Arthroplasty: A Retrospective Comparative Study.

Hochberger F, Siebler J, Rupp M, Scheiderer B, Siebenlist S, Geyer S Healthcare (Basel). 2024; 12(17).

PMID: 39273720 PMC: 11395514. DOI: 10.3390/healthcare12171695.

Associations between radiographic parameters in the reverse shoulder arthroplasty and patient outcomes.

Maksoud A, Steinlechner C, Baldwick C, Tabi W Shoulder Elbow. 2023; 15(3 Suppl):19-34.

PMID: 37974644 PMC: 10649507. DOI: 10.1177/17585732211057887.

Improved outcomes of older patients with acute and displaced proximal humerus fractures treated with window bone ingrowth fracture-specific stem reverse shoulder arthroplasty.

Claro R, Ribau A, Fonte H, Amorim-Barbosa T, Barros L, Sevivas N BMC Geriatr. 2023; 23(1):553.

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Factors affecting internal rotation following total shoulder arthroplasty.

Lauria M, Hastings M, DiPaola M, Duquin T, Ablove R JSES Rev Rep Tech. 2023; 2(4):431-436.

PMID: 37588455 PMC: 10426481. DOI: 10.1016/j.xrrt.2022.08.003.

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