Shoulder and Elbow最新文献

{"title":"Low-tension rotator cuff repair for retracted tears: Balancing mechanical relaxation and footprint coverage.","authors":"Dung Anh Vu, Thanh Tien Nguyen, Thang Ngoc Pham, Dinh Nhat Vu","doi":"10.1177/17585732261485551","DOIUrl":"10.1177/17585732261485551","url":null,"abstract":"<p><p>Retear after arthroscopic rotator cuff repair remains a major concern, especially in large, chronic, retracted tears. Although anatomic footprint restoration is preferred, forced lateralization may increase repair tension, compromising fixation mechanics and tendon perfusion. This systematized narrative review synthesizes clinical, biomechanical, cadaveric, and technical evidence on repair tension, footprint coverage, medialization, margin convergence, interval slide procedures, and partial functional repair. A structured PubMed/MEDLINE search was supplemented by targeted publisher searches and citation chaining through April 2026. Evidence suggests that repair tension is measurable, reflects tear severity and imaging risk factors, and may be associated with poorer cuff integrity and reduced tendon microvascular flow. Recent Level III comparative evidence favors tension-reducing repair at 24 months, but measurement methods and thresholds do not support a universal strategy. Complete anatomic repair remains the goal when achievable under acceptable tension. In retracted tears, a tension-aware approach may support selective mobilization, margin convergence, limited medialization, or functional partial repair rather than forced high-tension repair. Medialization refers to bone-bed location, whereas functional partial repair is defined by a planned residual tendon defect. This review proposes a decision framework and provisional tension-aware categories, emphasizing individualized surgical judgment and prospective comparative studies.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261485551"},"PeriodicalIF":1.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative proton pump inhibitors use and postoperative surgical complications following primary total shoulder arthroplasty.","authors":"Hailey Ninness, Jarrod Woodland, Brandon L Rogalski, Josef K Eichinger, Brent A Ponce, Richard J Friedman","doi":"10.1177/17585732261483539","DOIUrl":"10.1177/17585732261483539","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are commonly used perioperatively, but their effect on postoperative total shoulder arthroplasty (TSA) outcomes is unclear. The purpose of this study is to determine the effects of perioperative PPIs on surgical complications following primary TSA.</p><p><strong>Methods: </strong>A retrospective cohort study using TriNetX identified patients undergoing TSA using CPT code 23472. The exposure cohort included patients prescribed a perioperative PPI from seven days preoperatively to two days postoperatively and underwent propensity score matching 1:1 to its nearest neighbor. Surgical outcomes were studied at 3 years. Risk ratios (RRs), 95% confidence intervals (CIs), and <i>p</i>-values were reported. Statistical significance was set at <i>p</i> <i><</i> 0.05.</p><p><strong>Results: </strong>At 3 years postoperatively, PPI cohort had increased rates of aseptic loosening (1.3% vs. 0.7%; RR 1.9; 95% CI 1.0, 3.6; <i>p</i> = 0.034), dislocation (2.3% vs. 1.3%; RR 1.7; 95% CI 1.1, 2.7; <i>p</i> = 0.017), and revision TSA (3.0% vs. 2.0%; RR 1.5; 95% CI 1.0, 2.2; <i>p</i> = 0.031), and overall complications (5.7% vs. 4.3%; RR 1.3; 95% CI 1.0, 1.7; <i>p</i> = 0.043) compared to matched controls.</p><p><strong>Conclusion: </strong>Perioperative PPI use was associated with increased rates of aseptic loosening, dislocation, and revision TSA through 3 years following primary TSA, suggesting PPI exposure may be an important preoperative risk factor.</p><p><strong>Level of evidence: </strong>Level III-Retrospective cohort study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261483539"},"PeriodicalIF":1.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, risk factors, and outcomes of patients with coracoid-based pain after reverse total shoulder arthroplasty.","authors":"Favian Su, Miguel Fiandeiro, Jacob LaMonaca, Alex Charlton, Nicholas J DeMario, Matthew L Ramsey, Surena Namdari","doi":"10.1177/17585732261484885","DOIUrl":"10.1177/17585732261484885","url":null,"abstract":"<p><strong>Background: </strong>Coracoid-based pain is an underrecognized complication after reverse total shoulder arthroplasty (RTSA). The purpose of this study was to determine the prevalence, risk factors, and outcomes of patients with coracoid pain after RTSA.</p><p><strong>Methods: </strong>A case-control study was performed. Patients with coracoid or conjoint tendon tenderness at least 3 months after RTSA were included as cases. Controls without surgical complications and with a minimum 1-year follow-up were matched 3:1 to cases. Patient-reported outcomes were collected retrospectively. Multivariable logistic regression was used to identify risk factors for the development of coracoid pain.</p><p><strong>Results: </strong>67 patients developed coracoid-based pain at a mean time of 10.0 months (range, 3-72 months) after RTSA. The overall prevalence over a 10-year period was 1.0%. Symptoms completely resolved in 33 (49%) patients at a mean time of 4.9 months (range, 1-15 months) with non-operative treatment. On multivariate analysis, osteoporosis, a decreased subcoracoid distance, more anterior glenosphere overhang, and less calcar distalization were significant predictors of coracoid pain.</p><p><strong>Discussion: </strong>Coracoid pain is uncommon and tends to completely resolve in 49% of patients with non-operative measures. It is associated with surgeon factors that decrease the subcoracoid space and humeral arc to impingement.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261484885"},"PeriodicalIF":1.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Length of stay, discharge disposition, and 90-day emergency department visits and readmissions following primary shoulder arthroplasty in octogenarians vs septuagenarians.","authors":"Samuel Lorentz, Eoghan T Hurley, Jay M Levin, Mark Cullen, Bryan S Crook, Mark P Karavan, Christopher S Klifto, Oke Anakwenze","doi":"10.1177/17585732261483462","DOIUrl":"10.1177/17585732261483462","url":null,"abstract":"<p><strong>Background: </strong>The purpose of the current of study was to compare short-term outcomes in primary total shoulder arthroplasty (TSA) patients stratified by age groups of 70-79 years old (septuagenarians) and 80-89 years old (octogenarians).</p><p><strong>Methods: </strong>This was a retrospective cohort study at a single academic medical center which included consecutive patients undergoing primary anatomic or reverse TSA (rTSA) over a 5-year period (2014-2019). Peri-operative patient outcomes were collected including length of stay (LOS), discharge location, and 90-day emergency department (ED) visits or readmissions. Multivariable logistic and linear regression analyses were performed to determine whether age group remained independently associated with these outcomes after adjusting for sex, American Society of Anesthesiologists (ASA) score, and procedure type (anatomic versus rTSA).</p><p><strong>Results: </strong>Overall, 798 patients were included in this study (630 septuagenarians and 168 octogenarians). There was no statistically significant difference in patient race (p = 0.88) or ASA score (p = 0.44) between groups. Octogenarians were more often female (70.8% vs 56.8%; p = 0.001), more often underwent rTSA (61.3% vs 45.2%; p < 0.001), and more often underwent TSA for fracture (13.1% vs 7.1%; p = 0.01). Octogenarians had longer hospital stays (2.8 vs 2.2 days; p < 0.001), less frequently underwent outpatient surgery (1.2% vs 7.1%; p = 0.004), and were more likely to discharge to a skilled nursing facility (SNF)/rehabilitation facility (32.7% vs 12.7%; p < 0.001). On multivariable analysis adjusting for sex, ASA score, and procedure type, octogenarian age group remained independently associated with longer LOS (+0.61 days; p < 0.001) and non-home discharge (adjusted odds ratio [OR] 2.91; 95% confidence interval 1.92-4.41; p < 0.001). There was no statistically significant difference in 90-day ED visit (10.1% vs 7.1%; p = 0.20) or readmission rates (3.6% vs 3.3%; p = 0.88) between groups on either univariable or multivariable analysis.</p><p><strong>Conclusion: </strong>Octogenarians undergoing primary shoulder arthroplasty have similar 90-day post-operative ED visit and readmission rates when compared to their septuagenarian counterparts. However, octogenarians have longer hospital lengths of stay and are more likely to require SNF/rehabilitation at discharge independent of sex, ASA score, and procedure type.</p><p><strong>Level of evidence: </strong>III retrospective comparative study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261483462"},"PeriodicalIF":1.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the editor: \"A supplement, not a substitute: Accuracy and completeness of ChatGPT responses for common elbow pathology\".","authors":"Benjamin Fiedler, Phillip Goldman, Umar Ghilzai, Abdullah Ghali, Michael B Gottschalk, Eric R Wagner, Adil Shahzad Ahmed","doi":"10.1177/17585732261470041","DOIUrl":"10.1177/17585732261470041","url":null,"abstract":"","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261470041"},"PeriodicalIF":1.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and management of atraumatic distal clavicular osteolysis: A scoping review.","authors":"Michael Wilkinson, Nathan Groch, Carrie-Anne Freestone, Archie Clements, Steven Obst","doi":"10.1177/17585732261479715","DOIUrl":"10.1177/17585732261479715","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of this review were to map the literature for risk factors, clinical and radiographic features of atraumatic distal clavicular osteolysis (ADCO) and indications for surgery.</p><p><strong>Methods: </strong>A scoping review using PRISMA-ScR guidelines. Four electronic databases [CINAHL, Emcare (Ovid), PubMed, and Scopus] were searched for cohort studies involving ADCO.</p><p><strong>Results: </strong>Eight studies were included with data on 483 patients. Bench pressing was the most common activity-based risk factor (49.1%) following by general/unspecified weight training (24.4%). Frequency and intensity of loading were noted as potential risk factors for onset of ADCO. The most common reported symptoms were distal clavicle/acromioclavicular joint (ACJ) pain (69.9%). Imaging features included marrow oedema and subchondral fracture of the distal clavicle on MRI. Most patients recovered with conservative care, but 16% required surgery due to failure of conservative care.</p><p><strong>Conclusions: </strong>Clinical signs and symptoms for ADCO were not distinguishable from other shoulder pathologies. Primary contact clinicians may benefit from consideration of sporting and loading patterns when assessing patients with ACJ pain. MRI was the most frequently utilised imaging modality but should be taken in context with clinical examination. Surgical referral resulted in largely favourable outcomes following resection.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261479715"},"PeriodicalIF":1.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of health disparities are associated with lower total shoulder arthroplasty utilization and increased medical complications: A propensity-matched analysis.","authors":"Arsen M Omurzakov, Argen Omurzakov, Yousi Oquendo, Alex E White, Joshua S Dines, Michael C Fu, Gabriella E Ode, David M Dines, Lawrence V Gulotta, Christopher M Brusalis, Michelle E Kew, Samuel A Taylor","doi":"10.1177/17585732261476678","DOIUrl":"https://doi.org/10.1177/17585732261476678","url":null,"abstract":"<p><strong>Background: </strong>Total shoulder arthroplasty (TSA) is an effective treatment for glenohumeral osteoarthritis (GHOA), with utilization increasing over time. While prior studies have examined racial and ethnic disparities, the impact of broader social determinants of health (SDOH) on TSA utilization and outcomes remains unclear.</p><p><strong>Methods: </strong>The TriNetX database was used to identify patients with GHOA and stratify them by SDOH disparities. Patients were matched 1:1 using propensity scores. The primary outcome was TSA utilization within 5 years. Secondary outcomes included 90-day and 1-year postoperative complications. Bonferroni correction was applied.</p><p><strong>Results: </strong>After matching, 84,767 patients were included per utilization cohort. TSA utilization was higher in patients without SDOH disparities (5.78% vs. 3.14%, <i>p</i> < 0.001). The complications cohorts included 2071 patients each. The SDOH cohort had higher rates of emergency department visits and cardiac events at 90 days and 1 year (<i>p</i> < 0.001). At 1 year, acute kidney injury, urinary tract infection, pneumonia (<i>p</i> < 0.001), and pulmonary embolism (<i>p</i> = 0.002) were also higher. Mechanical complications were higher at 1 year on unadjusted analysis only. Revision, periprosthetic joint infection, and fracture rates were similar.</p><p><strong>Conclusions: </strong>SDOH disparities are associated with lower TSA utilization and increased postoperative medical complications, suggesting disparities in access to care and healthcare utilization rather than surgical durability.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261476678"},"PeriodicalIF":1.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of primary reverse total shoulder arthroplasty in patients younger than 65 years: A systematic review.","authors":"Mohini Johri, Nour-Maria Bouzid, Josh W Thibeault, Shahabeddin Yazdanpanah, Charles R Reiter, Joshua C Setliff, John W Cyrus, Jennifer L Vanderbeck, James R Satalich","doi":"10.1177/17585732261476954","DOIUrl":"10.1177/17585732261476954","url":null,"abstract":"<p><strong>Background: </strong>Reverse total shoulder arthroplasty (RTSA) is increasingly performed in younger patients, yet prior studies frequently include heterogeneous cohorts and revision cases. This systematic review evaluated outcomes of primary RTSA in patients <65 years.</p><p><strong>Methods: </strong>Embase, PubMed, and CENTRAL were queried through October 2025. Methodological quality was assessed using the Newcastle-Ottawa Scale (level III) and NIH Quality Assessment Tool for Case Series (level IV). Random-effects meta-analysis generated pooled estimates for range-of-motion (ROM), patient-reported outcome measures (PROMs), and complication/revision rates.</p><p><strong>Results: </strong>Thirteen studies (nine level III, four level IV; fair-to-good quality) were included. Weighted mean age was 55.4 years (60.9% female; follow-up 2-7.8 years). Forward flexion = 133.2° (95% CI 126-140.4); external rotation = 38.1° (95% CI 32-44.2); abduction = 118.2° (95% CI 111.2-125.2); internal rotation = 3.7 (95% CI 2.7-4.7, 0-7 scale). ASES = 69.5 (95% CI 64.7-74.4); VAS = 2.6 (95% CI 1.3-3.9); Constant-Murley = 62.9 (95% CI 60.3-65.5); SST = 7.5 (95% CI 5.9-9.1); SPADI = 38 (95% CI 33.3-42.7); UCLA = 27.9 (95% CI 26.9-28.8). Complication rate was 13% (95% CI 6%-23%) and revision rate 8% (95% CI 5%-14%), most commonly for instability. Sensitivity analyses demonstrated significant pre-to-postoperative improvements in forward flexion (+46.6°; 95% CI 34.9-58.3) and external rotation (+16.6°; 95% CI 13.6-19.5).</p><p><strong>Discussion: </strong>Primary RTSA in patients <65 years improves ROM and PROMs. Although complication/revision risk increases over time, these findings support RTSA in appropriately selected younger patients and provide benchmarks for outcome counseling.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261476954"},"PeriodicalIF":1.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between shoulder pain, muscle strength, and closed kinetic chain performance tests in swimming athletes: Cross-sectional study.","authors":"Gabriel Alves Dos Santos, Matheus Lêmos Dos Santos, Luiz José Frota Solon-Júnior, Germanna Medeiros Barbosa, Danyelle Leite Furtado de Araújo, Sávio Douglas Ferreira Santana, Valeria Mayaly Alves de Oliveira, Danilo Harudy Kamonseki","doi":"10.1177/17585732261473900","DOIUrl":"10.1177/17585732261473900","url":null,"abstract":"<p><strong>Context: </strong>This cross-sectional study examined whether shoulder pain and muscle strength of kinetic chain components are associated with performance on the modified Closed Kinetic Chain Upper Extremity Stability Test (mCKCUEST), Upper Quarter Y Balance Test (UQYBT), and Upper Limb Rotation Test (ULRT) in swimmers.</p><p><strong>Methods: </strong>Sixty-two competitive swimmers (aged 12-60 years; 30 with shoulder pain, 32 asymptomatic) across all competition levels were included. Isometric strength of the scapular protractors, lower trapezius, trunk flexors, Hip Stability Isometric Test (HIPSIT), and knee extensor was assessed. Participants also completed the mCKCUEST, UQYBT, and ULRT. Hierarchical multiple linear regression analyses were conducted to examine the associations between shoulder pain, kinetic chain muscle strength, and upper limb performance tests.</p><p><strong>Results: </strong>The model explained 28% of the variance in mCKCUEST performance, with shoulder pain and HIPSIT reaching statistical significance. Knee extensors and scapular protractors strength were significantly associated with the medial direction of the UQYBT, explaining 35% of the variance. Lower trapezius strength was associated with the superolateral direction (11% of variance), while knee extensor strength was associated with the inferolateral direction (37% of variance). Knee extensors and scapular protractors strength were associated with the composite score (38% of variance). For the ULRT, pain, scapular protractors, knee extensors, and trunk flexors strength showed significant associations, explaining 38% of the variance.</p><p><strong>Discussion: </strong>Shoulder pain and isometric strength of kinetic chain muscles may be associated with performance on the mCKCUEST, UQYBT, and ULRT, highlighting the relevance of kinetic chain assessment in swimmers.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261473900"},"PeriodicalIF":1.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of the dislocated reverse total shoulder arthroplasty: A tertiary centre experience.","authors":"Oubida Asaad, Parag Raval, Hassan Raja, Mark Falworth, Will Rudge, Addie Majed, David Butt, Deborah Higgs","doi":"10.1177/17585732261472448","DOIUrl":"10.1177/17585732261472448","url":null,"abstract":"<p><strong>Background: </strong>Instability is a major complication after reverse total shoulder arthroplasty (rTSA). This study reports a tertiary centre experience of managing this challenging complication.</p><p><strong>Methods: </strong>We retrospectively reviewed a prospectively maintained database of patients treated surgically for a dislocated rTSA between 2013 and 2023, with a minimum follow-up of 12 months. Demographics, indication for the index procedure, timing and cause of dislocation, revision procedures, and persistence of instability were recorded.</p><p><strong>Results: </strong>Forty-two dislocated rTSAs were identified. The mean age was 68 years. 30 cases were primary rTSAs and 12 cases were revision rTSAs. Most dislocations occurred early, with 34 of 42 (81%) within 6 weeks. Loss of compression was the commonest mechanism of instability, present in 33 of 42 cases (78.5%). Loss of containment occurred in 12% and impingement in 9.5%. Stability was achieved in 36 of 42 shoulders (86%). Modular component exchange was the most frequent successful revision strategy, used in 20 cases (47.5%).</p><p><strong>Discussion: </strong>Dislocation after rTSA most commonly reflects the loss of compression, particularly in the early postoperative period. Modular component exchange restores stability in many cases, but a substantial proportion requires more extensive revision or salvage procedures. Careful identification of the mechanism of instability is essential for guiding treatment.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261472448"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}