The Classic: Delta Shoulder Prosthesis for Rotator Cuff Rupture

摘要

We provide a link to the original description of the “delta” reverseshoulder arthroplasty published in 1993 by Paul Grammont and Emmanuel Baulot. Whilemany surgeons view “anatomic reconstruction” as essential forvirtually all operations, Grammont recognized that not all reconstructions needed tobe anatomic and in fact some problems with so-called anatomic reconstructions couldbe solved by developing nonanatomic approaches. Through careful reasoning andintuition, Grammont and Baulot suggested placing the ball of the shoulder on theglenoid and the concave matching surface on the humerus in patients with an absentrotator cuff (essentially rendering any anatomic reconstruction“nonanatomic” when the cuff function could not be normally restored).They argued the deltoid muscle could compensate for an absent rotator cuff if fourconditions were present: (1) a lever arm effective from the start of movement; (2) afixed center of rotation; (3) inherent stability; (4) maintenance of adequateexternal rotation. The result of their reasoning was the Delta Shoulder Prosthesis,the prototype of all other modern reverse shoulder arthroplasty designs. Theybriefly reported 14 patients with 2-year followup, finding acceptably restoredfunction in 13. (Editor’s Note: The original article had no Abstract; thisAbstract was therefore written to provide readers a summary.) The Classic article is© 1993 and is reprinted from Grammont PM, Baulot E. Delta Shoulder Prosthesisfor Rotator Cuff Rupture. Orthopedics. 1993;16:65-68 available athttp://www.orthosupersite.com/view.aspx?rid=84164. An accompanyingbiographical sketch of Paul Grammont is available at DOI10.1007/s11999-011-1959-y.