Paul Marie Grammont

Paul-Marie Grammont: 1940-2012

Paul-Marie Grammont was born on 12 April 1940 in Salins les Bains. After school in Besançon he moved to Lyon after his father was appointed as headmaster of the Parc Lycée.

He passed his mathematics baccalaureate with flying colours in 1957. The boys in the "Grammont household" were for the Polytéchnique. Whilst his two brothers rose to this challenge, Paul-Marie stood out already and said he wanted to do "his medicine".

After an internship in general and osteo-articular surgery he worked in succession as lecturer at the Michel Latarjet anatomy laboratory from October 1968 to 1971, and then acting Clinical Registrar in Albert Trillat's renowned Department until March 1972 when he was appointed as permanent Clinical Registrar until April 1974. Following the competitive Agrégation examination (high level competititive examination for teachers) he was included in the specialist registrar, becoming the third graduate from Albert Trillat's great school after Henri Dejour and Gilles Bousquet and before Jean-Luc Lerat in July 1974. He then went back to Dijon as a clinical reader in September 1974 when his career was suddenly cut short by a serious cerebrovascular accident in June 1997.

It was in Dijon when this passionate patron of the "knee and shoulder" with his profusion of new ideas began to innovate, thanks to his dreadful immobility. We need at this point to go back to read Léopold Ollier (Traité des résections) which Paul Grammont quoted in the introductory words to his thesis entitled "The rotatory prosthesis in total knee replacement", words which he made his own throughout his career:
"Here, as in everywhere, we need to give up what was good and adopt what is better, and not become set in methods which were undoubtedly excellent at the time but are only of modest value. The prudence of yesterday can no more be the wisdom of today. Conditions have changed and we need to change with them." Innovation was P-M Grammont's key word. He undoubtedly had the essential intuition for an inventor but this shouldn't mask the main work of examining a question from a new angle, but always grounded in the solid bases of mechanics and then experimental validation.
In carrying out his work he followed what he taught us as a lesson:
- always examine everything without exception and without ceremony
- follow your thoughts and think for yourself
- you have to be able to undo learning land forget in order to learn
- and finally and above all, do not retreat in the face of difficulties and comments

PG's career was all the more remarkable as he achieved it with limited resources. Research however is not only a question of resources. In the laboratory he always could count on the unfailing collaboration and energy of Pierre Trouilloud of whom he was so fond, and of all of the groups which succeeded him. When some people criticised him for not publishing enough, he answered, not without some mischief: "usually people who invent do not publish much and those who publish don't invent much", as he believed resolutely that nothing could stop a good idea. His achievements are impressive: the automatic extension nail in osteogenesis. The "morpho-adapted" customised hip replacement. The patello-tibial nail, rechristened patellar olecranisation and the femoro-patella prosthesis in knee disease. He was, however, at his most inventive and creative in his "favourite" of shoulder disease and surgery, where his greatest achievements were made. Because of this, he was very closely linked to the European Society and to all of his colleagues and friends. He was a member of this society from its formation and was always very proud of wearing the first (and now rare) tie commemorating its first meeting! In anterior instability surgery with the procedure which he called "Bristow – Trillat" and his biomechanical explanation with the scapular spine osteotomy (1975) in antero-superior impingement, which we now understand to play a key role, as it is based on the fundamental mechanical principles of his future reversed prosthesis. First in line therefore is his reverse shoulder prosthesis, the fruits born of his principle of functional surgery applied to the joint. Rather than its shape, it was ultimately its universally recognised novel biomechanical concept which is permanently linked to its name and is now universally used. The bugle prosthesis firstly emerged 10 years later in 1985, followed by the first generation Delta prosthesis, both developed in collaboration with the French Medinov Company.

This was a true odyssey as it had a long and difficult development, although that never detracted him. P-M Grammont fully understood that there would always be difficulties, concerns, apprehensions and questions in any change process. This actually provided him with an additional source of motivation. Finally, to paraphrase a famous quotation, I think that we can say that Paul Grammont did not ask what Orthopaedics could do for him, but rather what he could do for Orthopaedics, particularly French Orthopaedics, the image and quality of which he was profoundly connected with.
In this sense he was completely successful. His contribution is already and will remain exceptional. It is therefore my dear and wise patron, a wonderful team animator and above all a very decent inventor who has just left us from this world.

Professor Emmanuel Baulot
Department of Orthopaedics and Traumatology
Le Bocage Hospital - Dijon Cedex.

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