Shoulder and Elbow最新文献

{"title":"Tranexamic acid utilization remains low in anatomical and reverse total shoulder arthroplasty despite decreased postoperative complications: A propensity-matched analysis.","authors":"Jai Sehgal, Natalie R Black, Jeremy S Somerson","doi":"10.1177/17585732261440373","DOIUrl":"10.1177/17585732261440373","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effect of tranexamic acid (TXA) on postoperative outcomes in anatomic total shoulder (aTSA) or reverse total shoulder arthroplasty (rTSA) surgery.</p><p><strong>Methods: </strong>We queried the TriNetX network for patients who underwent TSA from 2000 to 2025. Patients were 1:1 matched into aTSA or rTSA cohorts and subcategorized into TXA or non-TXA groups. Yearly trends in TXA utilization by TSA procedure were reported. Postoperative complications at 90 days and 2 years were assessed.</p><p><strong>Results: </strong>TXA utilization increased 7% in aTSA and 11% in rTSA from 2020 to 2024. Within 90 days, TXA patients in both cohorts had a reduced risk of transfusions, acute post-hemorrhagic anemia, and hospital readmission. TXA patients in the aTSA cohort had a reduced risk of pulmonary embolism within 90 days. At 2 years, TXA patients in both cohorts had a reduced risk of transfusions, surgical site infection, pulmonary embolism, and hospital readmission. TXA patients in the rTSA cohort had a higher risk of periprosthetic loosening at both follow-ups.</p><p><strong>Discussion: </strong>Patients receiving TXA had a significantly reduced risk of postoperative complications. TXA has a similar impact on outcomes in both TSA variations, and utilization should be considered as part of a comprehensive management strategy.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261440373"},"PeriodicalIF":1.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692530","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":"Effect of infraspinatus integrity on external rotation following reverse total shoulder arthroplasty for massive rotator cuff tears.","authors":"Alexander S Guareschi, Robert Achilike, Derek T Dixon, Thomas W Throckmorton, Tyler J Brolin","doi":"10.1177/17585732261441863","DOIUrl":"10.1177/17585732261441863","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare clinical outcomes between patients who underwent primary rTSA for mRCT involving anterosuperior (AS), posterosuperior (PS), and three-tendon (3T) tears.</p><p><strong>Method: </strong>We identified patients who underwent primary rTSA for mRCT between 2011 and 2023 by two high-volume shoulder arthroplasty surgeons with minimum 1-year follow-up. Demographics and clinical outcomes were compared between groups preoperatively and 1-year postoperatively. Type of mRCT was assessed with MRI or CT arthrography and confirmed intraoperatively.</p><p><strong>Results: </strong>Included were 224 shoulders (mean follow-up of 12.4 months). Patients with AS tears demonstrated significantly greater external rotation (ER, mean = 52.8°; <i>P</i> < 0.01) and internal rotation (IR, mean = 58.3°; <i>P</i> = 0.03) 1-year postoperatively than patients with PS and 3T tears. Patients with AS tears demonstrated greater mean improvements in ER than those with PS and 3T tears (21.3° vs. 7.8°, <i>P</i> = 0.04).</p><p><strong>Discussion: </strong>There were no differences in patient-recorded outcome measures 1 year after rTSA for different mRCT subtypes. Patients with AS tears exhibited significantly higher ER and IR 1 year after rTSA than those with tears involving the infraspinatus tendon. These findings suggest patients with an intact infraspinatus tendon can expect greater improvement in and higher overall ER following rTSA.</p><p><strong>Level of evidence: </strong>III, Retrospective Cohort Study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261441863"},"PeriodicalIF":1.2,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677375","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":"British Elbow and Shoulder Society practice guidelines: Rehabilitation following traumatic anterior shoulder dislocation (post-operative and non-operative care).","authors":"Carl Wong, Anju Jaggi, Rebecca Kearney, Steve Gwilym","doi":"10.1177/17585732261439731","DOIUrl":"10.1177/17585732261439731","url":null,"abstract":"<p><strong>Background: </strong>Traumatic anterior shoulder dislocation is common and carries a high risk of recurrence. Rehabilitation is central to management following both surgical and non-surgical treatment. However, consistency in rehabilitation practice and continuity of care are lacking. The British Elbow and Shoulder Society (BESS) therefore commissioned the development of guidelines for post-operative and non-operative rehabilitation.</p><p><strong>Methods: </strong>This guideline was developed through a multi-staged process that combined a UK national survey, Delphi consensus, evidence synthesis, and a final expert workshop. The post-operative guideline was based on a BESS best-practice framework, while the non-operative guideline was informed by the ARTISAN intervention development methodology, with both organised into phase-based protocols.</p><p><strong>Results: </strong>The process produced aligned rehabilitation protocols comprising five sequential phases: (1) Acute protection and education (0-3 weeks), (2) Movement and early strengthening (3-6 weeks), (3) Progressive strengthening (6-12 weeks), and (4) Return to sport (>12 weeks) and (5) high-level function. Key guidance following surgical treatment included sling use after surgery, initiation of through-range resisted exercise, and criteria-based progression to contact sport. The non-operative pathway mirrored these phases, with earlier sling weaning.</p><p><strong>Conclusion: </strong>Through a rigorous process, BESS has established pragmatic, evidence-informed rehabilitation guidelines for traumatic anterior shoulder dislocation, promoting consistent, safe, and adaptable patient-centred care across both operative and non-operative management.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261439731"},"PeriodicalIF":1.1,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646697","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 testosterone therapy linked to higher 5-year risk of periprosthetic joint infection without increased 90-day major complications or revision rates in total shoulder arthroplasty.","authors":"Jad J Lawand, Connor Crutchfield, Alejandro M Holle, Olawale A Sogbein, Sameer R Khawaja, Umar Ghilzai, Brian W Hill, Adam Z Khan, John G Horneff, Joseph A Abboud","doi":"10.1177/17585732261437972","DOIUrl":"10.1177/17585732261437972","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative testosterone exposure has been associated with various health outcomes, but its impact on postoperative complications in patients undergoing total shoulder arthroplasty (TSA) has not been fully explored. This study aims to evaluate the association between preoperative testosterone exposure and postoperative medical and surgical complications in patients undergoing TSA.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the PearlDiver database. Patients who underwent TSA and used preoperative testosterone within 3 months of the index procedure were identified and matched 1:4 to controls without testosterone use using propensity score matching. Matching was performed based on age, gender, comorbidities, Charlson comorbidity index, obesity, tobacco use, and hypogonadism to balance the groups. Postoperative complications were assessed at 90 days and five years. Statistical comparisons were made using odds ratios (ORs) with 95% confidence intervals (CIs), and a <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The matched cohort included 677 testosterone users and 2554 controls. There were no statistically significant differences between the testosterone and control groups in 90-day complications such as myocardial infarction (OR 2.52, <i>P</i> = 0.31), pneumonia (OR 0.86, <i>P</i> = 0.70), and deep vein thrombosis (no cases in the testosterone group). Over five years, the testosterone group had a significantly higher risk of periprosthetic joint infection (4.1% vs. 2.4%, OR 1.76, 95% CI 1.10-2.75, <i>P</i> = 0.015), but no differences in revision rates, dislocation, aseptic loosening, or stiffness were observed.</p><p><strong>Conclusion: </strong>Preoperative testosterone exposure was associated with a higher risk of periprosthetic joint infection following TSA, but no significant differences were found in major medical complications or revision rates.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261437972"},"PeriodicalIF":1.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646819","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":"Does bony morphology of the shoulder affect rotator cuff retear rates? A 24-year retrospective cohort of rotator cuff repairs.","authors":"Florence Ou-Suet Pang, Thomas Chun Hei Lo, Wai-Wang Chau, Rex Wang Fung Mak, Cham-Kit Wong, Jonathan Patrick Ng, Michael Tim Yun Ong, Patrick Shu-Hang Yung","doi":"10.1177/17585732261437760","DOIUrl":"10.1177/17585732261437760","url":null,"abstract":"<p><strong>Background: </strong>Rotator cuff tears can result in pain which can be debilitating. The etiology of failed repair or retears is multifactorial. Multiple risks factors were proposed, with critical shoulder angle (CSA) being one of the factors of emerging interest. Other radiological parameters including glenoid inclination (GI), lateral acromial angle (LAA), and acromial index (AI) were also suggested for a possible correlation.</p><p><strong>Methods: </strong>A retrospective review of 397 rotator cuff repairs on January 1, 2000 to December 31, 2023 recruited from two major hospitals was carried out. Primary outcome measure of radiographic shoulder angles (CSA, GI, LAA, and AI) was measured.</p><p><strong>Results: </strong>There is no statistical difference in radiographic shoulder angles measured in the rotator cuff retear group and the no retear group. Retear patients were more likely to have Goutallier grade 3 and 4 (p = 0.01). Goutallier grade 4 was the potential predictor of retear regardless of sex (Odds ratio=5.25 (1.38, 20.02); p = 0.02).</p><p><strong>Conclusion: </strong>There is no definite association of rotator cuff retear and radiographic parameters including CSA, GI, LAA, and AI in this study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261437760"},"PeriodicalIF":1.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640025","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":"Can Hirsch index predict academic rank among full-time academic orthopaedic shoulder surgeons?","authors":"Sameer R Khawaja, Kevin Heo, Hadley Grundman, Maya Sinha, Victoria Conn, Jaden C Hardrick, Krishna N Chopra, Thomas Bradley Edwards, Michael B Gottschalk, Eric R Wagner","doi":"10.1177/17585732261434964","DOIUrl":"10.1177/17585732261434964","url":null,"abstract":"<p><strong>Background: </strong>Hirsch index (h-index) has emerged as a refined metric for research productivity, offering a better approximation of scholarly influence. The aim of this study was to assess whether h-index can predict academic rank among shoulder surgeons.</p><p><strong>Methods: </strong>A cross-sectional study was performed for full-time academic shoulder surgeons affiliated with American Shoulder and Elbow-recognized shoulder and elbow surgery fellowship programs. Study variables for each surgeon were classified as bibliometric (h-index, m-index, total number of publications, total number of citations, I-10 index, and maximum number of citations from a single work) and demographic (gender, training factors). Outcomes included the academic rank of each surgeon.</p><p><strong>Results: </strong>153 full-time academic shoulder surgeons were included. H-index, I-10 index, and the total number of publications and citations were all strongly correlated with academic rank, while maximum citations for a single work, m-index, and years as an attending were moderately correlated with academic rank. H-index most reliably demonstrated an association with increasing academic rank. The h-index thresholds for assistant professor, associate professor, professor, and endowed professor were found to be 12.5, 12.5, 19, and 32.5, respectively.</p><p><strong>Discussion: </strong>When evaluating candidates for academic promotion in shoulder surgery, h-index is a reliable tool to quantitatively assess research productivity and scholarly impact.</p><p><strong>Level of evidence: </strong>Survey Study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261434964"},"PeriodicalIF":1.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624036","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":"Arthroscopic versus mini-open rotator cuff repair: A meta-analysis.","authors":"Marc Boutros, Guy Awad, Ali Hamyeh, Bassem Elhassan","doi":"10.1177/17585732261437751","DOIUrl":"10.1177/17585732261437751","url":null,"abstract":"<p><strong>Background: </strong>Mini-open and all-arthroscopic rotator cuff repairs are commonly performed, yet it remains uncertain whether one approach consistently outperforms the other.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus, Cochrane, and Google Scholar through November 2025 identified 33 comparative studies (six RCTs and 27 cohort studies) including 1980 patients (mini-open: 980; arthroscopic: 1000). Extracted outcomes included operative time, shoulder ROM, functional scores, pain, satisfaction, re-tear rates, postoperative stiffness, and other complications.</p><p><strong>Results: </strong>Shoulder ROM demonstrated no significant differences between groups in forward flexion (p = 0.51), abduction (p = 0.48), internal rotation (p = 0.68), or external rotation (p = 0.11). Functional outcomes were likewise comparable for ASES (p = 0.16), Constant (p = 0.92), UCLA (p = 0.12), and DASH (p = 0.39). Arthroscopy was associated with slightly lower postoperative VAS pain scores (MD 0.28; p = 0.002). Satisfaction rates (p = 0.50), re-tear rates (p = 0.71), operative time (p = 0.15), and stiffness (p = 0.06) were similar. Complications such as infection, anchor issues, frozen shoulder, or dehiscence (p = 0.69) did not differ.</p><p><strong>Conclusion: </strong>Both techniques provide comparable clinical and structural outcomes, although inference is limited by the predominance of non-randomized evidence. Arthroscopy may be associated with modest pain advantages; however, analgesia regimens were not consistently reported. Overall functional outcomes appear comparable between techniques. Technique selection should reflect the surgeon expertise and patient priorities.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261437751"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623967","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":"Variation in reverse shoulder replacement surgery: A survey of UK shoulder surgeons.","authors":"Faheem Bhatti, Akhilesh Pradhan, Ananth Srinivasan, Puneet Monga, Aravind Desai, Harvinder Pal Singh","doi":"10.1177/17585732261437401","DOIUrl":"10.1177/17585732261437401","url":null,"abstract":"<p><strong>Background: </strong>Despite reverse shoulder replacement (RSR) being the predominant form of shoulder arthroplasty in the United Kingdom, substantial variation exists in implant selection and surgical technique. This study aims to capture current RSR practice among members of the British Elbow and Shoulder Society (BESS).</p><p><strong>Methods: </strong>A 24-question online survey was sent to BESS surgeon members in December 2024, assessing routine practice in both trauma and elective RSR. Descriptive statistical analysis was performed.</p><p><strong>Results: </strong>In total, 127 surgeons responded. Over half performed at least 20 RSRs annually (54.3%). The most common glenosphere sizes were 42 mm and 36 mm for male and female patients, respectively. Glenoid onlay components were used by 87.9% of respondents, and humeral inlay components by 55.6%. Most surgeons used symmetric liners (69.2%), a standard (50.0%) or short (48.4%) humeral stem, 10°-20° of humeral version (56.7%), and 135° (45.4%) or 145° neck-shaft angles (36.1%). Intraoperatively, 79.5% of surgeons routinely repaired the subscapularis, and metallic augments (70.9%) were the most used method of building offset. Preoperative planning was used by 67.7% of surgeons, while 7.9% used computer navigation.</p><p><strong>Discussion: </strong>This survey highlights variation in implant selection, operative technique, and technology use among UK surgeons, underscoring the need for evidence-based standardisation.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261437401"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610214","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":"Development and validation of a novel risk stratification tool for patients 65 years and older undergoing total shoulder arthroplasty for primary osteoarthritis.","authors":"Cameron J Sabet, Bhav Jain, Pari Patel, Bara M Hammadeh, Jiaqi Liu","doi":"10.1177/17585732261437671","DOIUrl":"10.1177/17585732261437671","url":null,"abstract":"<p><strong>Purpose: </strong>Current preoperative risk tools assess frailty, nutrition, and acute illness separately, limiting accuracy. This study aimed to create and validate a composite risk score for adults ≥65 undergoing total shoulder arthroplasty for primary osteoarthritis.</p><p><strong>Methods: </strong>A retrospective study of 10,061 patients from the ACS NSQIP (2015-2021) was conducted. A composite score combining ASA class, Risk Analysis Index, and acute conditions was developed via multivariable logistic regression. Outcomes included 30-day mortality, complications, readmission, reoperation, extended stay, and non-home discharge. Model performance was assessed using ROC curves and internal bootstrap validation.</p><p><strong>Results: </strong>The composite score demonstrated higher discrimination for major complications (area under the curve 0.747), readmission (0.669), extended length of stay (0.660), and non-home discharge (0.700) compared to individual indices. In multivariable analysis, the composite score outperformed the modified frailty index, Risk Analysis Index, and nutritional risk index. Internal validation confirmed robust predictive accuracy with minimal optimism bias across all outcomes.</p><p><strong>Conclusions: </strong>This composite risk score provides a validated framework for perioperative risk stratification among older adults undergoing total shoulder arthroplasty. Its integration of chronic frailty, physiologic reserve, and acute severity may aid clinical decision-making and resource allocation in short-term perioperative care. However, the score is limited by the absence of psychosocial factors and disease-specific characteristics (e.g., preoperative stiffness), which are important determinants of functional outcomes and are not captured in the ACS-NSQIP database.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261437671"},"PeriodicalIF":1.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595119","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":"Stemless reverse total shoulder arthroplasty: A bibliometric analysis from 2011 to 2026.","authors":"Marc Boutros, Shaza Hammad, Guy Awad, Rodrigo Saad Berreta, Uma Srikumaran","doi":"10.1177/17585732261435605","DOIUrl":"10.1177/17585732261435605","url":null,"abstract":"<p><strong>Background: </strong>Reverse total shoulder arthroplasty (RTSA) treats rotator cuff-deficient shoulders. Stemless designs preserve humeral bone stock and reduce operative time. Interest in stemless RTSA has grown recently.</p><p><strong>Methods: </strong>A literature search was performed in Scopus through February 21, 2026. Extracted data included publication metrics. Bibliometric visualization and knowledge mapping (co-authorship, co-citation, topic trends, thematic maps) were completed using the bibliometrix and biblioshiny packages. Outcomes included scientific output, institutional productivity, citation metrics, influential authors and journals, most cited documents, keyword patterns, and author productivity per Lotka's law.</p><p><strong>Results: </strong>A total of 129 articles on stemless RTSA were identified, accumulating 2003 citations. Publications rose steadily, with sustained growth observed after 2021 (<i>P</i> < .05). Citation counts showed a parallel rise (<i>P</i> < .05). The United States was the most productive country (26.86% of total publications), the University of Western Ontario the leading institution, and Abboud J.A. and Athwal G.S. the most prolific authors. The Journal of Shoulder and Elbow Surgery was the most cited journal and demonstrated the highest h-index (h-index = 9).</p><p><strong>Conclusion: </strong>Evidence for stemless RTSA is expanding and demonstrates international engagement but remains limited primarily to short- to mid-term outcomes. Larger, multicenter studies with longer follow-up are needed.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261435605"},"PeriodicalIF":1.2,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595191","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}