Comparison of short-term clinical outcomes and radiographic changes in Grammont reverse shoulder arthroplasty between the French and Japanese populations: A propensity score-matched analysis

Published:November 24, 2022DOI:



      Although Grammont-style reverse total shoulder arthroplasty (RSA) showed excellent clinical results in Europe, its utility for Asian populations remains unclear. This study aimed to compare the French and Japanese populations in terms of range of motion (ROM), functional outcomes, and scapular notching rates in patients who underwent standard Grammont-style RSA. We hypothesized that RSA for the Japanese population may not provide as good ROM and functional results at the final follow-up as that for the French population.


      A total of 25 Japanese patients undergoing RSA were propensity score matched to 25 French patients undergoing RSA. The patients were matched for four different covariates using a propensity score analysis. The minimum follow-up period was 2 years. We investigated differences between the populations with respect to body size and shoulder joint ROM and Constant score (CS) measured preoperatively and at the final follow-up. Scapular notching was examined using radiographs at the final follow-up.


      The average height and weight of the French and Japanese patients were 164 cm and 70 kg and 152 cm and 56 kg, respectively. Anterior elevation (AE), external rotation (ER) at the side, internal rotation (IR), and CS total changed from 101° to 145°, 17° to 15°, 4.5 points to 5.5 points, and 36 points to 72 points, respectively, in the French population and from 63° to 119°, 8.5° to 13°, 4.6 points to 4 points, and 28 points to 58 points, respectively, in the Japanese population. AE improved in both the groups; ER and IR remained unchanged before and after surgery. The frequency of scapular notching (>grade 1) was higher in the Japanese population (56%) than in the French population (20%) (p = 0.019).


      Grammont-style RSA improved AE and CS in both the populations, but AE and CS were significantly higher in the French population than in the Japanese population at the final follow-up. Scapular notching frequently occurs in the Japanese population.


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        • Grammont P.M.
        • Baulot E.
        Delta shoulder prosthesis for rotator cuff rupture.
        Orthopedics. 1993 Jan; 16: 65-68
        • Ernstbrunner L.
        • Andronic O.
        • Grubhofer F.
        • Camenzind R.S.
        • Wieser K.
        • Gerber C.
        Long-term results of reverse total shoulder arthroplasty for rotator cuff dysfunction: a systematic review of longitudinal outcomes.
        J Shoulder Elbow Surg. 2019 Apr; 28: 774-781
        • Lindbloom B.J.
        • Christmas K.N.
        • Downes K.
        • Simon P.
        • McLendon P.B.
        • Hess A.V.
        • et al.
        Is there a relationship between preoperative diagnosis and clinical outcomes in reverse shoulder arthroplasty? An experience in 699 shoulders.
        J Shoulder Elbow Surg. 2019 Jun; 28: S110-S117
        • Sevivas N.
        • Ferreira N.
        • Andrade R.
        • Moreira P.
        • Portugal R.
        • Alves D.
        • et al.
        Reverse shoulder arthroplasty for irreparable massive rotator cuff tears: a systematic review with meta-analysis and meta-regression.
        J Shoulder Elbow Surg. 2017 Sep; 26: e265-e277
        • Jiang J.J.
        • Toor A.S.
        • Shi L.L.
        • Koh J.L.
        Analysis of perioperative complications in patients after total shoulder arthroplasty and reverse total shoulder arthroplasty.
        J Shoulder Elbow Surg. 2014 Dec; 23: 1852-1859
        • Villacis D.
        • Sivasundaram L.
        • Pannell W.C.
        • Heckmann N.
        • Omid R.
        • Hatch G.F.R.
        Complication rate and implant survival for reverse shoulder arthroplasty versus total shoulder arthroplasty: results during the initial 2 years.
        J Shoulder Elbow Surg. 2016 Jun; 25: 927-935
        • Chalmers P.N.
        • Rahman Z.
        • Romeo A.A.
        • Nicholson G.P.
        Early dislocation after reverse total shoulder arthroplasty.
        J Shoulder Elbow Surg. 2014 May; 23: 737-744
        • Lévigne C.
        • Boileau P.
        • Favard L.
        • Garaud P.
        • Molé D.
        • Sirveaux F.
        • et al.
        Scapular notching in reverse shoulder arthroplasty.
        J Shoulder Elbow Surg. 2008 Nov-Dec; 17: 925-935
        • Melis B.
        • DeFranco M.
        • Lädermann A.
        • Molé D.
        • Favard L.
        • Nérot C.
        • et al.
        An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years. J Bone Joint Surg Br Surg.
        Br. 2011 Sep; 93: 1240-1246
        • Wierks C.
        • Skolasky R.L.
        • Ji J.H.
        • McFarland E.G.
        Reverse total shoulder replacement: intraoperative and early postoperative complications.
        Clin Orthop Relat Res. 2009 Jan; 467: 225-234
        • Mizuno N.
        • Nonaka S.
        • Ozaki R.
        • Yoshida M.
        • Yoneda M.
        • Walch G.
        Three-dimensional assessment of the normal Japanese glenoid and comparison with the normal French glenoid.
        Orthop Traumatol Surg Res. 2017 Dec; 103: 1271-1275
        • Matsumura N.
        • Oki S.
        • Ogawa K.
        • Iwamoto T.
        • Ochi K.
        • Sato K.
        • et al.
        Three-dimensional anthropometric analysis of the glenohumeral joint in a normal Japanese population.
        J Shoulder Elbow Surg. 2016 Mar; 25: 493-501
        • Ji J.H.
        • Jeong J.Y.
        • Song H.S.
        • Ok J.H.
        • Yang S.J.
        • Jeon B.K.
        • et al.
        Early clinical results of reverse total shoulder arthroplasty in the Korean population.
        J Shoulder Elbow Surg. 2013 Aug; 22: 1102-1107
        • Kelly J.D.
        • Humphrey C.S.
        • Norris T.R.
        Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part One: the twelve-mm rule.
        J Shoulder Elbow Surg. 2008 Jul-Aug; 17: 589-594
        • Constant C.R.
        • Gerber C.
        • Emery R.J.H.
        • Søjbjerg J.O.
        • Gohlke F.
        • Boileau P.
        A review of the Constant score: modifications and guidelines for its use.
        J Shoulder Elbow Surg. 2008 Mar-Apr; 17: 355-361
        • Sirveaux F.
        • Favard L.
        • Oudet D.
        • Huquet D.
        • Walch G.
        • Molé D.
        Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders.
        J Bone Joint Surg Br. 2004 Apr; 86: 388-395
        • Wall B.
        • Nové-Josserand L.
        • O'Connor D.P.
        • Edwards T.B.
        • Walch G.
        Reverse total shoulder arthroplasty; a review of results according to etiology.
        J Bone Joint Surg Am. 2007 Jul; 89: 1476-1485
        • Boileau P.
        • Seeto B.L.
        • Clowez G.
        • Gauci M.O.
        • Trojani C.
        • Walch G.
        • et al.
        SECEC Grammont Award 2017: the prejudicial effect of greater tuberosity osteotomy or excision in reverse shoulder arthroplasty for fracture sequelae.
        J Shoulder Elbow Surg. 2020 Dec; 29: 2446-2458
        • Kurowicki J.
        • Triplet J.J.
        • Momoh E.
        • Moor M.A.
        • Levy J.C.
        Reverse shoulder prosthesis in the treatment of locked anterior shoulders: a comparison with classic reverse shoulder indications.
        J Shoulder Elbow Surg. 2016 Dec; 25: 1954-1960
        • Raiss P.
        • Edwards T.B.
        • Bruckner T.
        • Loew M.
        • Zeifang F.
        • Walch G.
        Reverse arthroplasty for patients with chronic locked dislocation of the shoulder (type 2 fracture sequela).
        J Shoulder Elbow Surg. 2017 Feb; 26: 279-287
        • Boileau P.
        • Moineau G.
        • Roussanne Y.
        • O'Shea K.
        Bony increased-offset reversed shoulder arthroplasty: minimizing scapular impingement while maximizing glenoid fixation.
        Clin Orthop Relat Res. 2011 Sep; 469: 2558-2567
        • Boileau P.
        • Morin-Salvo N.
        • Gauci M.O.
        • Seeto B.L.
        • Chalmers P.N.
        • Holzer N.
        • et al.
        Angled BIO-RSA (bony-increased offset-reverse shoulder arthroplasty): a solution for the management glenoid bone loss and erosion.
        J Shoulder Elbow Surg. 2017 Dec; 26: 2133-2142
        • Athwal G.S.
        • MacDermid J.C.
        • Reddy K.M.
        • Marsh J.P.
        • Faber K.J.
        • Drosdowech D.
        Does bony increased-offset reverse shoulder arthroplasty decrease scapular notching?.
        J Shoulder Elbow Surg. 2015 Mar; 24: 468-473
        • Dimock R.
        • Fathi Elabd M.
        • Imam M.
        • Middleton M.
        • Godenèche A.
        • Narvani A.A.
        Bony increased-offset reverse shoulder arthroplasty: a meta-analysis of the available evidence.
        Shoulder Elbow. 2021 Feb; 13: 18-27
        • Favard L.
        • Levigne C.
        • Nerot C.
        • Gerber C.
        • Wilde De L.
        • Mole D.
        Reverse prostheses in arthropathies with cuff tear are survivorship and function maintained over time?.
        Clin Orthop Relat Res. 2011 Sep; 469: 2469-2475
        • Matsuki K.
        • King J.J.
        • Wright T.W.
        • Schoch B.S.
        Outcomes of reverse shoulder arthroplasty in small- and large-stature patients.
        J Shoulder Elbow Surg. 2018 May; 27: 808-815
        • Mollon B.
        • Mahure S.A.
        • Roche C.P.
        • Zuckerman J.D.
        Impact of scapular notching on clinical outcomes after reverse total shoulder arthroplasty: an analysis of 476 shoulders.
        J Shoulder Elbow Surg. 2017 Jul; 26: 1253-1261