Shoulder and Elbow最新文献

{"title":"Salvage reverse shoulder arthroplasty after failed plate fixation of proximal humeral fractures: Clinical outcomes, complications, and prognostic factors.","authors":"Riccardo Ranieri, Andrea Gabriele Calamita, Giacomo Delle Rose, Simone Pavone, Martina Todeschi, Eva Savarè, Mario Borroni, Marco Conti, Alessandro Castagna, Raffaele Garofalo","doi":"10.1177/17585732261488974","DOIUrl":"10.1177/17585732261488974","url":null,"abstract":"<p><strong>Background: </strong>Failed plate fixation (open reduction and internal fixation) for proximal humeral fractures causes bone loss, tuberosity malunion, and soft-tissue imbalance. Reverse shoulder arthroplasty (RSA) is a salvage option with variable outcomes. This study evaluated RSA outcomes for fracture sequelae and previous plate fixation and identified prognostic factors.</p><p><strong>Methods: </strong>This retrospective monocentric study included patients undergoing RSA between 2011 and 2023 for fracture sequelae following plate fixation, with a minimum two-year follow-up. Outcomes included clinical scores, range of motion, patient satisfaction, and radiographic findings. Prognostic factors were analyzed using univariate analysis.</p><p><strong>Results: </strong>Twenty-nine patients were included (mean follow-up 4.6 years; mean age 59 years). Clinical scores and range of motion improved compared with the preoperative evaluation (all <i>p</i> < 0.05), except for external rotation. Final mean adjusted Constant score was 64%, Subjective Shoulder Value 56, and American Shoulder and Elbow Surgeons (ASES) 65. Overall, 34% had complications, 10% required reoperation, and 7% underwent revision.The most common complication was persistent painful shoulder stiffness (21%). Humeral bone resorption in the previous plate area was observed in 50%. Greater tuberosity deficiency and anterior deltoid dysfunction were associated with worse outcomes.</p><p><strong>Conclusion: </strong>RSA improves outcomes after failed plate fixation; however, recovery remains moderate, and complication rates are high. Tuberosity deficiency and anterior deltoid dysfunction are prognostic factors, and humeral bone resorption may affect long-term survival.</p><p><strong>Level of evidence: </strong>Level IV; Case Series; Treatment Study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261488974"},"PeriodicalIF":1.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064922","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":"Clinical and radiographic outcomes of reverse shoulder arthroplasty performed with 40 mm polyethylene glenospheres vs. 36 mm cobalt chrome glenospheres at minimum 2-years follow-up.","authors":"Pamela Boekel, Robert P Piggott, Christopher Conyard, Stephen Bale, Michael Walton, Puneet Monga, Amar Malhas, Ian A Trail","doi":"10.1177/17585732261489263","DOIUrl":"10.1177/17585732261489263","url":null,"abstract":"<p><strong>Introduction: </strong>Most reverse total shoulder arthroplasty utilise a cobalt chrome (CoCr) glenosphere with a polyethylene liner. The Lima Shoulder Modular Replacement (SMR)™ platform has inverted the materials to potentially decrease polyethylene debris when the humeral liner contacts the scapula.</p><p><strong>Methods: </strong>This retrospective, multi-centre study was conducted to examine the equivalence of the Lima SMR™ 40 mm highly cross-linked polyethylene (XLPE) glenospheres to the 36 mm CoCr glenospheres, examining patients from 2013 to 2022 with a minimum of 2-year clinical and radiographic follow-up.</p><p><strong>Results: </strong>199 patients were investigated: 107 with the XLPE glenosphere and 92 with the CoCr glenosphere. At 2-year follow-up, there was no significant difference in Oxford Shoulder scores (<i>p</i> = 0.081). There were more areas of glenoid radiolucency in the CoCr group (<i>n</i> = 18 zones in eight patients) at 2 years (<i>z</i> = -2.04, <i>p</i> = 0.04). There was no significant difference in notching (16% in the XLPE group, 20% in CoCr group (<i>p</i> = 0.190)). Two patients in the XLPE group were revised and five in the CoCr group.</p><p><strong>Discussion: </strong>XLPE glenosphere outcomes were largely equivalent to a CoCr glenosphere at 2 years. While the XLPE glenosphere had fewer major complications, this could be attributed to other factors including the larger diameter, rather than the polyethylene glenosphere.</p><p><strong>Level of evidence: </strong>Level III - retrospective comparative study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261489263"},"PeriodicalIF":1.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008931","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":"Implant selection and fixation in radial head arthroplasty: A qualitative analysis of surgeon decision-making.","authors":"Harry Beale, Alex Abouharb, Peter Reilly, Angela E Kedgley, Sanjeeve Sabharwal","doi":"10.1177/17585732261487599","DOIUrl":"10.1177/17585732261487599","url":null,"abstract":"<p><strong>Background: </strong>Radial head arthroplasty (RHA) requires surgeons to choose an implant and a fixation strategy where comparative trial evidence is sparse. How training, intraoperative judgement and tactile feedback shape these choices remains poorly characterised.</p><p><strong>Methods: </strong>Ten UK consultant orthopaedic surgeons sub-specialised in upper-limb arthroplasty and elbow surgery were recruited through purposive and snowball sampling and interviewed using a semi-structured guide. Transcripts underwent inductive thematic analysis until no new conceptual categories emerged.</p><p><strong>Results: </strong>Five themes and 13 sub-themes were identified: implant selection drivers; fixation philosophy; intraoperative cues; patient profiles and outcomes. Surgeons applied pragmatic, reproducible heuristics where comparative trial evidence is absent. Convergence centred on bone quality as the pivotal determinant of fixation, on modularity for managing anatomical variability and on functional rather than radiographic definitions of success. Surgeons diverged on the threshold for the 'unfixable' fracture, on primary stem fixation philosophy and on whether excision remains an acceptable definitive option in low-demand elderly patients.</p><p><strong>Discussion: </strong>Surgeons apply systematic, shared heuristics under uncertainty. Several prioritised determinants, including tolerance of controlled stem toggle, intraoperative bone quality assessment and avoidance of overstuffing, are not captured by current quantitative frameworks. These findings are hypothesis-generating and identify candidates for future comparative work.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261487599"},"PeriodicalIF":1.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983438","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":"Clinical and radiological outcomes following complete release of the long head of triceps in reverse shoulder arthroplasty.","authors":"Hean Wu Kang, Kristine Italia, Rohit Mahesh Sane, Rachel Sarah Marie Price, Helen Ingoe, Jashint Maharaj, Sarah L Whitehouse, Ashish Gupta","doi":"10.1177/17585732261487441","DOIUrl":"10.1177/17585732261487441","url":null,"abstract":"<p><strong>Background: </strong>Complete long head of the triceps release (LHTR) during reverse shoulder arthroplasty (RSA) aims to eliminate inferior impingement and ensures tether-free range of motion (ROM). However, it remains infrequently performed due to concerns such as triceps strength deficits and instability. This study aimed to present the clinical and radiological outcomes following RSA with LHTR, focusing on the impact on triceps strength.</p><p><strong>Methods: </strong>This was a retrospective review of patients who underwent primary RSA with LHTR. The primary outcome was 2-year triceps strength compared with the preoperative strength. Secondary outcomes were the improvement of shoulder ROM, Constant Score, American Shoulder and Elbow (ASES) Score, and Visual Analog Score (VAS) at 2-year postoperative time point, and radiological outcomes including notching and heterotopic ossification (HO).</p><p><strong>Results: </strong>Eighty patients were included with mean age of 71.1 years. Two-year triceps strength was comparable to the preoperative strength (6.3 kg vs. 6.2 kg, p = .703). Active ROM, VAS, ASES, and Constant scores significantly improved at 2 years postoperatively (p < .001). Notching was present in 15% of patients while HO was present in 18.75%. There were no dislocations or neurovascular injuries.</p><p><strong>Discussion: </strong>Complete LHTR during RSA appears safe with no adverse effect on triceps strength, patient-reported outcomes, or stability.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261487441"},"PeriodicalIF":1.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977371","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":"Osteochondritis dissecans of the glenoid: A case report and review of the literature.","authors":"Sharif Garra, Nikolas Krasovitsky, Michael S Howard","doi":"10.1177/17585732261481796","DOIUrl":"10.1177/17585732261481796","url":null,"abstract":"<p><strong>Background: </strong>Osteochondritis dissecans (OCD) is an articular disorder characterized by focal subchondral bone involvement that may progress to cartilage instability and fragment detachment. Although OCD most commonly affects the knee, ankle, and elbow, shoulder involvement is rare, and glenoid lesions are particularly uncommon. The limited literature consists primarily of isolated case reports, most frequently describing male overhead athletes. Optimal management strategies for glenoid OCD remain poorly defined, particularly in adolescent athletes with big chondral lesions.</p><p><strong>Purpose: </strong>To report a rare case of an International Cartilage Regeneration & Joint Preservation Society (ICRS) grade III OCD-like glenoid subchondral lesion with a large unstable overlying chondral flap in a 16-year-old competitive female softball athlete who failed conservative management and to describe the arthroscopic surgical approach utilized for cartilage preservation.</p><p><strong>Conclusion and clinical relevance: </strong>OCD-spectrum lesions of the glenoid are an uncommon condition that can occur in adolescent female overhead athletes. In cases of unstable lesions that remain viable and fail nonoperative treatment, surgical management aimed at preserving native cartilage and restoring articular congruity may represent a feasible cartilage-preserving treatment strategy. This case contributes to the limited body of literature on glenoid OCD and supports individualized, cartilage-preserving approaches in high-demand adolescent athletes.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261481796"},"PeriodicalIF":1.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977909","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":"Knotless and knotted all-suture anchors have comparable clinical outcomes and return to sport rates following arthroscopic anterior labral (Bankart) repair.","authors":"Clay B Townsend, Tomas F Vega, Matthew P Ithurburn, Alexander E Loeb, Andrew Atkinson, Ryan Froom, Anna E Crawford, Ariel L Kidwell-Chandler, Eric A Mussell, Cindy Nguyen, Erin K Powell, Marcus A Rothermich, Michael K Ryan, Benton A Emblom, E Lyle Cain, Jeffrey R Dugas","doi":"10.1177/17585732261472078","DOIUrl":"10.1177/17585732261472078","url":null,"abstract":"<p><strong>Background: </strong>This retrospective comparative study aimed to characterize the clinical outcomes of patients undergoing arthroscopic labral repair using either knotless or knotted all-suture anchors.</p><p><strong>Methods: </strong>This study identified all patients who underwent arthroscopic Bankart repair with all-suture anchors, both knotless and knotted, with at least 2 years of follow-up. Demographic, athletic, return-to-sport, surgical, and functional outcomes data, including American Shoulder and Elbow Surgery (ASES) and Western Ontario Shoulder Instability Index (WOSI) scores, were collected and compared between anchor groups.</p><p><strong>Results: </strong>Outcomes data were collected for 192 patients, with an average follow-up of 3.1 years and a mean age of 23.8 years. Among anchor types, 72% were knotless-only (138/192), 13% knotted-only (26/192), and 14% combined (28/192). There were no differences in rates of revision shoulder surgery, rates of return to sport, or postoperative ASES or WOSI scores when comparing anchor types (<i>p</i> > .05). Among competitive athletes (66% of cohort) who attempted to return to preinjury level of sport, 95% (88/93) were able to.</p><p><strong>Discussion: </strong>Knotless and knotted all-suture anchors demonstrated comparable revision rates, patient-reported outcomes, and return to preinjury sport rates for patients who underwent arthroscopic Bankart repair.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261472078"},"PeriodicalIF":1.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977930","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":"The impact of glucagon-like peptide-1 (GLP-1) receptor agonists on postoperative outcomes following rotator cuff repair.","authors":"Ankit Choudhury, Sonia Slusarczyk, Lucas Mathson, Matthew Van Boxtel, Anthony LoGiudice, Jessica Hanley","doi":"10.1177/17585732261486333","DOIUrl":"10.1177/17585732261486333","url":null,"abstract":"<p><strong>Background: </strong>Patients with type II diabetes mellitus (T2DM) undergoing rotator cuff repair (RCR) have increased postoperative risk. Glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly used in T2DM, but their perioperative safety remains uncertain. This study evaluated the association between preoperative GLP-1 agonist exposure and postoperative outcomes following RCR.</p><p><strong>Methods: </strong>A retrospective cohort study using the TriNetX Research Network identified adults with T2DM undergoing RCR between 2018 and 2024. Patients were stratified by preoperative GLP-1 agonist exposure. Outcomes included 90-day medical complications, surgical complications, and healthcare utilization. Univariate and inverse propensity score-weighted binary logistic regression were performed to adjust for confounding.</p><p><strong>Results: </strong>Among 5876 patients, 233 used GLP-1 preoperatively. Unadjusted analyses revealed increased odds of postoperative respiratory complications (odds ratio (OR): 1.97, 95% confidence interval (CI): 1.32-2.86, <i>P</i> = 0.0006), urinary tract infection (OR: 3.85, 95% CI: 1.31-9.12, <i>P</i> = 0.0055), and postoperative stiffness (OR: 2.20, 95% Cl: 1.31-3.49, <i>P</i> = 0.0016) among GLP-1 users. After inverse propensity score-weighting, no significant differences in postoperative outcomes were observed.</p><p><strong>Discussion: </strong>Preoperative GLP-1 agonist use was not independently associated with decreased or increased risk of postoperative complications following RCR. These findings suggest perioperative continuation of GLP-1 therapy may be safe, though prospective studies are warranted.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261486333"},"PeriodicalIF":1.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913617","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":"Radial extracorporeal shockwave therapy (rESWT) for patients with chronic lateral elbow tendinopathy (tennis elbow): A double-blinded randomised controlled trial.","authors":"Patrick C Wheeler, Chloe Tattersall, Rachel Calver","doi":"10.1177/17585732261484894","DOIUrl":"10.1177/17585732261484894","url":null,"abstract":"<p><strong>Background: </strong>Investigating outcomes following radial extracorporeal shockwave therapy (rESWT) for patients with chronic lateral elbow tendinopathy (tennis elbow).</p><p><strong>Methods: </strong>43 patients with chronic lateral elbow tendinopathy were recruited from a single NHS Sport Medicine clinic. Participants were randomised equally within this double-blinded randomised controlled trial to receive either three sessions of 'therapeutic-dose' or 'minimal-dose' rESWT, respectively, alongside a structured and progressive home exercise programme. Participants: 63% female, 70% affecting the dominant arm, mean age 47.9 ± 8.0 years, symptom duration: 31.7 ± 25.4 months. Maximum six-month follow-up, with interim data at six weeks and three months.</p><p><strong>Results: </strong>Improvements were seen in both groups, but no between-group differences were seen with any measure at any time point, suggesting no benefit from 'therapeutic' levels of extracorporeal shockwave therapy (ESWT) above minimal dosage. Self-reported 'average' pain improved by 27% at six weeks, rising to 40% at three months, and 52% at six months, irrespective of ESWT 'dose'. Improvements were seen across different validated patient-reported outcome measures.</p><p><strong>Conclusion: </strong>This study has not shown superiority of rESWT compared to 'minimal-dose' rESWT in patients with chronic lateral elbow tendinopathy (tennis elbow), when performed alongside a structured progressive loading home exercise programme. This study does not support the use of rESWT performed at the 'maximally comfortably tolerated dose' as per manufacturer recommendations.</p><p><strong>Level of evidence: </strong>Level I - Randomised controlled trial.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732261484894"},"PeriodicalIF":1.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913672","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":"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}