Skip to main content
SpringerLink
Log in

Grammont’s Idea: The Story of Paul Grammont’s Functional Surgery Concept and the Development of the Reverse Principle

  • Symposium: Reverse Total Shoulder Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The increased use of the reverse prosthesis over the last 10 years is due to a large series of publications using the reverse prosthesis developed by Paul Grammont. However, there is no article reporting the story of the concepts developed by Grammont.

Questions/purposes

The purposes of this review are to describe the principles developed by Grammont, the chronology of development, and the biomechanical concepts and studies that led to the current design of the reverse prosthesis.

Methods

We selectively reviewed literature and provide personal observations.

Results

From phylogenetic observations, Grammont developed the principle of functional surgery applied to the rotator cuff tears. To increase the deltoid lever arm, he imagined two possibilities: the lateralization of the acromion, which facilitates the action of the rotator cuff, and the medialization of the center of rotation, which has been developed to respond to situations of rotator cuff deficiency. Grammont proposed the use of an acromiohumeral prosthesis, which was quickly abandoned due to problems of acromial loosening. Finally, Grammont used the principle of reverse prosthesis developed in the 1970s, but made a major change by medializing the center of rotation in a nonanatomic location. In 1985, Grammont validated the concept by an experimental study and the first model using a cemented sphere was implanted.

Conclusions

The development of the modern reverse prosthesis is the result of the intellectual and experimental work conducted by Grammont and his team for 20 years. Knowledge of this history is essential to envision future developments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ahir SP, Walker PS, Squire-Taylor CJ, Blunn GW, Bayley JI. Analysis of glenoid fixation for a reversed anatomy fixed-fulcrum shoulder replacement. J Biomech. 2004;37:1699–1708.

    Article  PubMed  CAS  Google Scholar 

  2. Arntz CT, Jackins S, Matsen FA 3rd. Prosthetic replacement of the shoulder for the treatment of defects in the rotator cuff and the surface of the glenohumeral joint. J Bone Joint Surg Am. 1993;75:485–491.

    PubMed  CAS  Google Scholar 

  3. Barrett WP, Franklin JL, Jackins SE, Wyss CR, Matsen FA 3rd. Total shoulder arthroplasty. J Bone Joint Surg Am.1987;69:865–872.

    PubMed  CAS  Google Scholar 

  4. Basamania C. Hemiarthroplasty for cuff tear arthropathy. In: Zuckermann JD, ed. Advanced Reconstruction—Shoulder. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2007:567–578.

  5. Baulot E, Cavaillé A, Grammont PM. Translation-rotation osteotomy of the spine of the scapula for treatment of impingement syndrome and incomplete cuff tears. Eur J Orthop Surg Trauma. 1993;3:221–226.

    Google Scholar 

  6. Baulot E, Chabernaud D, Grammont PM. Results of Grammont’s inverted prosthesis in omarthritis associated with major cuff destruction: report of 16 cases [in French]. Acta Orthop Belg. 1995;61:112–119.

    PubMed  Google Scholar 

  7. Baulot E, Grammont PM. The Delta prosthesis [in French]. Cahiers d’Enseignement SOFCOT. 1999;68:405–415.

    Google Scholar 

  8. Bergmann JH, De Leeuw M, Jansen TW, Veeger DH, Willems WJ. Contribution of the reverse endoprosthesis to glenohumeral kinematics. Clin Orthop Relat Res. 2008;466:594–598.

    Article  PubMed  Google Scholar 

  9. Billuart F, Devun L, Skalli W, Mitton D, Gagey O. Role of deltoid and passives elements in stabilization during abduction motion (0 degrees-40 degrees): an ex vivo study. Surg Radiol Anat. 2008;30:563–568.

    Article  PubMed  CAS  Google Scholar 

  10. Blaimont P, Tahéri A. Vanderhostadt A. Displacement of the instantaneous center of rotation of the humeral head during abduction: implication for scapulohumeral muscular function [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2005;91:399–406.

    PubMed  CAS  Google Scholar 

  11. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 Suppl S):147S–161S.

    Article  PubMed  Google Scholar 

  12. Deries X. A Biomechanical Approach to Study the Effects of a Modification of the Rotation Center of a Shoulder Prosthesis on the Deltoid Strengths During the Abduction Movement [in French] [thesis]. Orsay, France: Université Paris XI; 1986.

  13. De Wilde LF, Audenaert EA, Berghs BM. Shoulder prostheses treating cuff tear arthropathy: a comparative biomechanical study. J Orthop Res. 2004;22:1222–1230.

    Article  PubMed  Google Scholar 

  14. Fick R. Anatomie und Mechunik der Gelenke. Teil III. Spezielle Gelenk- und Muskelmechanik. Jena, Germany: Gustav Fischer; 1911.

    Google Scholar 

  15. Fischer LP, Carret JP, Gonon GP, Dimnet J. Cinematic study of the movements of the scapulohumeral joint [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1977;63(Suppl 2):108–115.

    PubMed  Google Scholar 

  16. Franklin JL, Barrett WP, Jackins SE, Matsen FA 3rd. Glenoid loosening in total shoulder arthroplasty: association with rotator cuff deficiency. J Arthroplasty 1988;3:39–46.

    Article  PubMed  CAS  Google Scholar 

  17. Gagey O, Hue E. Mechanics of the deltoid muscle. Clin Orthop Relat Res 2000;375:250–257.

    Article  PubMed  Google Scholar 

  18. Gérard Y, Leblanc JP, Rousseau B. A complete shoulder prosthesis [in French]. Chirurgie, 1973;99:655–663.

    PubMed  Google Scholar 

  19. Grammont PM. Place de l’ostéotomie de l’épine de l’omoplate avec translation, rotation, élévation de l’acromion dans les ruptures chroniques de la coiffe des rotateurs. Lyon Chir. 1979;55:327–329.

    Google Scholar 

  20. Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16:65–68.

    PubMed  CAS  Google Scholar 

  21. Grammont PM, Bourgon J, Pelzer P. Study of a Mechanical Model for a Shoulder Total Prosthesis: Realization of a Prototype [in French]. Thèse de Sciences de l’Ingénieur. Dijon, France: Université Dijon; Lyon, France: ECAM de Lyon; 1981.

  22. Grammont PM, Lelaurain G. Osteotomy of the scapula and the Acropole prosthesis (author’s transl) [in German]. Orthopäde. 1981;10:219–229.

    PubMed  CAS  Google Scholar 

  23. Grammont PM, Trouilloud P, Laffay JP, Deries X. Study and development of a new shoulder prosthesis [in French]. Rhumatologie. 1987;39:407–418.

    Google Scholar 

  24. Grammont PM, Trouilloud P, Sakka M. Translation-rotation osteotomy, 1975–1985: experiences with anterior impingement and incomplete lesions of the rotator cuff [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1988;74:337–340

    PubMed  CAS  Google Scholar 

  25. Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G. Reverse total shoulder arthroplasty: survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am. 2006;88:1742–1747.

    Article  PubMed  Google Scholar 

  26. Gutierrez S, Levy JC, Lee WE 3rd, Keller TS, Maitland ME. Center of rotation affects abduction range of motion of reverse shoulder arthroplasty. Clin Orthop Relat Res. 2007;458:78–82.

    PubMed  Google Scholar 

  27. Hawkins RJ, Bell RH, Jallay B. Total shoulder arthroplasty. Clin Orthop Relat Res. 1989;242:188–194.

    PubMed  Google Scholar 

  28. Kolbel R, Friedebold G. Shoulder joint replacement [in German]. Arch Orthop Unfallchir. 1973;76:31–39.

    Article  PubMed  CAS  Google Scholar 

  29. Neer C, Craig E, Fukuda H. Cuff tear arthropathy. J Bone Joint Surg Am. 1983;65:1232–1244.

    PubMed  Google Scholar 

  30. Nyffeler RW, Werner CM, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg. 2005;14:524–528.

    Article  PubMed  Google Scholar 

  31. Nyffeler RW, Werner CM, Simmen BR, Gerber C. Analysis of a retrieved Delta III total shoulder prosthesis. J Bone Joint Surg Br. 2004;86:1187–1191.

    Article  PubMed  CAS  Google Scholar 

  32. Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am. 2006;88:800–805.

    Article  PubMed  Google Scholar 

  33. Pearl R, Schultz F. Human Biology: A Record of Research. Baltimore, MD: Warwick and York Inc Publishers; 1930.

    Google Scholar 

  34. Pollock RG, Deliz ED, Mcllveen SJ, Flatow EL, Bigliani LU. Prosthetic replacement in rotator cuff-deficient shoulders. J Shoulder Elbow Surg 1992;1:173–186.

    Article  Google Scholar 

  35. Roche C, Flurin PH, Wright T, Crosby LA, Mauldin M, Zuckerman JD. An evaluation of the relationships between reverse shoulder design parameters and range of motion, impingement, and stability. J Shoulder Elbow Surg 2009;18:734–741.

    Article  PubMed  Google Scholar 

  36. Sanchez-Sotelo J, Cofield R, Rowland C. Shoulder hemiarthroplasty for glenohumeral arthritis associated with severe rotator cuff deficiency. J Bone Joint Surg Am. 2001;83:1814–1822.

    PubMed  Google Scholar 

  37. Torrens C, Lopez JM, Puente I, Caceres E. The influence of the acromial coverage index in rotator cuff tears. J Shoulder Elbow Surg. 2007;16:347–351.

    Article  PubMed  Google Scholar 

  38. Williams GR Jr, Rockwood CA Jr. Hemiarthroplasty in rotator cuff-deficient shoulders. J Shoulder Elbow Surg 1996;5:362–367.

    Article  PubMed  Google Scholar 

  39. Zuckerman JD, Scott AJ, Gallagher MA. Hemiarthroplasty for cuff tear arthropathy. J Shoulder Elbow Surg. 2000;9:169–172.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de chirurgie orthopédique et traumatologique, Hôpital d’enfants, Dijon, France

    Emmanuel Baulot MD

  2. Clinique de traumatologie et d’orthopédie, 49 rue Hermite, 54000, Nancy, France

    François Sirveaux MD

  3. Service de chirurgie orthopédique, Hôpital Archet 2, Nice, France

    Pascal Boileau MD

Authors
  1. Emmanuel Baulot MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. François Sirveaux MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pascal Boileau MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to François Sirveaux MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

This work was performed at Clinique de traumatologie et d’orthopédie.

About this article

Cite this article

Baulot, E., Sirveaux, F. & Boileau, P. Grammont’s Idea: The Story of Paul Grammont’s Functional Surgery Concept and the Development of the Reverse Principle. Clin Orthop Relat Res 469, 2425–2431 (2011). https://doi.org/10.1007/s11999-010-1757-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-010-1757-y

Keywords

Search

Navigation