Boileau P, Morin-Salvo N, Bessière C, et al. - This study was undertaken to investigate mid- to long-term functional and radiologic outcomes after bony increased-offset–reverse shoulder arthroplasty (BIO-RSA) using a Grammont-style (medialized) humeral implant. Researchers included 143 consecutive shoulders (140 patients; mean age, 72 years) treating with a BIO-RSA for rotator cuff deficiency. The data indicated that BIO-RSA was found to be a safe and effective method to lateralize the glenoid, serving consistent bone graft healing, excellent functional outcomes, a low revision rate, and a high rate of patient satisfaction. Associations were found between thin patients (with a low body mass index), glenosphere malposition (with persistent superior inclination and/or insufficient lowering of the baseplate and sphere) and higher risk of scapular notching. The outcomes verified the importance of implanting the baseplate with a neutral inclination (reverse shoulder arthroplasty angle < 5°) and with sufficient glenosphere inferior overhang (>5 mm) in preventing scapular notching. It was found that the usage of a less medialized humeral implant (135° or 145° inclined) and smaller (25-mm) baseplate (when using a small, 36-mm sphere) should allow reduction in the incidence of scapular notching.