What's New — Shoulder — August 2026¶
257 new articles published this month.
Themes: Rotator Cuff Repair Outcomes · Shoulder Instability Management · Reverse Shoulder Arthroplasty · Proximal Humerus Fracture Care · Arthroplasty Perioperative Care · Athletic Shoulder and Elbow
Digest generated 2026-09-14 08:10:15+00:00.
Highlights¶
Rotator Cuff Repair Outcomes¶
This month's literature advances rotator cuff repair (RCR) evidence across technique, prediction, and augmentation. Meta-analyses confirm double-row repair benefits large tears but not small-to-medium tears [15], and arthroscopic versus mini-open repair yield comparable results [90]. Tear size stratifies recovery trajectories [219], while MRI predictors such as shift angle [16], subscapularis atrophy classification [48], and the subscapularis muscular border angle [169] inform reparability and diagnosis. Machine learning [192] and deep learning on arthroscopic images [1] predict retear and tendon integrity. Augmentation remains prominent: dermal allograft patches [4], patch materials compared [159], histologic outcomes [69], and industry funding analyses [123] are covered, alongside biceps autograft interposition [10] and the Hybridge technique [31]. Comorbidities including hyperlipidemia [109,181], osteoporosis [46], and bariatric surgery [133] influence secondary procedures, with corticosteroid injections [130,152] and statins [162] also implicated.
Shoulder Instability Management¶
Anterior instability dominates this theme, spanning Bankart repair, Latarjet, and bone block reconstruction. Long-term arthroscopic Latarjet outcomes at 5 years [21], primary versus revision Latarjet in contact athletes [150], and open Latarjet with single-button fixation [202] are reported, alongside comparative outcomes versus open capsuloplasty [216] and free bone blocks [132]. Bankart repair debates include episode-count thresholds [86,87], long-term on-track outcomes [185], declining PROs over time [165], posterior humeral head translation [101], and the BRACE risk score [157]. Hill-Sachs management features remplissage outcomes [70,127] and lesion morphometrics [161]. Glenoid bone loss solutions include iliac crest grafting techniques [2,25,184], cortical button fixation [24], the mooring technique [18], distal tibial allograft [129,174,180], and labral augmentation biomechanics [14]. Posterior instability is addressed via distal tibia allograft [129], natural history studies [188], and the SCOPE osteotomy [232].
Reverse Shoulder Arthroplasty¶
Reverse total shoulder arthroplasty (rTSA) literature spans indications, complications, and implant technology. Indication-specific outcomes include proximal humerus fractures [29,103,205,247], chronic dislocation [198,247], and younger patients [36,51,177]. Complication management covers instability risk factors [98] and dislocation treatment [42,209], scapular spine and acromial fractures [57,66,93,200], baseplate loosening [7], periprosthetic infection [189,235], and failure mechanisms [253]. Implant and technique innovations include lateralized versus inferiorized glenospheres [246], semi-inlay versus onlay stems [41], stemless systems [186,250], augmented reality navigation [128,193], custom glenoid components [75], and polyethylene wear [196,222,243]. Functional recovery studies examine external rotation predictors [248], hand-behind-back function [17,245], scapulohumeral rhythm [191], and deltoid fatty infiltration [223]. Perioperative topics include sling use [176], length of stay [234,255], and frailty [203,228].
Proximal Humerus Fracture Care¶
Proximal humerus fracture (PHF) management evidence spans fixation, arthroplasty selection, and conservative care. Locking plate studies evaluate whether four proximal screws suffice [5], compare first- versus new-generation plates [220], and assess cement-augmented screws versus rTSA in the elderly [103]. Greater tuberosity fixation outcomes are implant-specific [227]. Arthroplasty decision-making includes fracture-specific stems [34], RSA versus hemiarthroplasty in-hospital outcomes [29], and Neer/Mayo classification prognostic value [205]. Conservative management is addressed through immobilisation device randomization [244] and surgical timing consensus via Delphi survey [256]. Complications and revisions feature corrective osteotomy with 3D-printed guides [194], the ORIN nailing technique [78], and frailty-predicted morbidity [203]. Related clavicular and scapular trauma includes malunion correction with 3D printing [54], scapular ORIF techniques [62], and midshaft clavicle fracture management in athletes [183,241].
Arthroplasty Perioperative Care¶
Perioperative and health-services research around shoulder arthroplasty is robust this month. Enhanced recovery protocols improve early outcomes [58], while liposomal bupivacaine interscalene blocks [182,187], tranexamic acid use [136], and preoperative hemoglobin thresholds [107] inform analgesia and complication reduction. Patient factors including octogenarian status [11], GLP-1 receptor agonist use [20,89], social determinants of health [22], metabolic bone disease screening [105], and anemia [107] shape utilisation and outcomes. Infection prevention spans antibiotic prophylaxis choices [189], Cutibacterium acnes metabolic phenotyping [102], pilosebaceous pretreatment [106], and preoperative biopsy utility [40]. Registry and database analyses cover polyethylene revision risk [94,243], all-polyethylene glenoid survival [146], pyrocarbon implants [217], and AC joint excision trends [79]. Technology adoption is examined through robotic-assisted arthroplasty perceptions [251] and telehealth examination validity [156].
Athletic Shoulder and Elbow¶
Sports-related upper extremity research centers on baseball pitching biomechanics and injury epidemiology. Arm slot studies demonstrate sidearm deliveries carry lower injury burden [116] and segmental momentum sequencing varies by slot [113], with fastball velocity and spin rate linked to injuries [141] and lower-extremity injury predicting upper-extremity injury [149]. Return-to-play after labral repair in MLB players [124,147] and youth baseball rule changes reducing osteochondritis dissecans [126] are documented, alongside caregiver education interventions [135]. Female collegiate softball and baseball players show high imaging abnormality rates [95]. Diagnostic studies address first rib stress fractures [154], posterior instability examination maneuvers [153], and carrying angle versus ulnar nerve instability [63]. Broader athletic topics include upper limb bone stress injuries [37], swimmer kinetic chain performance [38], lacrosse injury epidemiology [55], and pectoralis major repair fixation comparison [73].
Articles by Theme¶
Rotator Cuff Repair Outcomes (34)¶
1. Wu K, Mosca A, Jhan S, et al. Arthroscopic Images Predict Tendon Integrity After Arthroscopic Rotator Cuff Repair Using a Deep Learning Model. Arthroscopy 2026. doi:10.1002/arj.70481
A deep learning model (ConvNeXt-Tiny with attention module) was trained on intraoperative arthroscopic images taken after double-row bridging rotator cuff repair to predict postoperative tendon integrity at ≥6 months by ultrasound. The model showed strong discriminative performance for predicting healing versus retear. This suggests intraoperative AI-based assessment could provide real-time feedback on repair quality and guide decisions such as augmentation.
4. Kim D, Jeon SW, Son E, et al. Dermal Allograft Patch Augmentation With Mini‐Open Triple‐Row Repair for Large to Massive Rotator Cuff Tears Results in a Low Retear Rate and Favorable Clinical Outcomes Without Adverse Events. Arthroscopy 2026. doi:10.1002/arj.70482
Thirty-nine patients with large to massive (>3 cm) rotator cuff tears underwent dermal allograft patch augmentation combined with mini-open triple-row suture-bridge repair, with mean follow-up of 32.5 months. The retear rate was low (12.8%), graft incorporation was complete in most MRI-evaluated cases, and clinical outcomes improved without adverse events. Patch augmentation with this construct appears safe and effective for high-risk tear repairs.
10. Gong W, Jiang H, Zhu R. Arthroscopic Rotator Cuff Repair With a Compressed Long Head of the Biceps Tendon Interposition Graft. Arthroscopy Techniques 2026. doi:10.1002/atn2.70236
This technical note presents an arthroscopic double-row rotator cuff repair augmented with a compressed autograft long head of the biceps tendon used as an interposition graft at the tendon-bone interface. The approach targets the persistent problem of incomplete healing and structural failure in large or chronic tears by providing biologic augmentation from a readily accessible, biologically compatible tissue source. It offers surgeons a biologic augmentation strategy to improve structural integrity in challenging rotator cuff repairs.
15. Seok H, Park J, Park S. Double‐Row Repair Improves Outcomes for Large Rotator Cuff Tears but Offers No Advantage for Small‐to‐Medium Tears: A Systematic Review and Meta‐analysis of Randomized Controlled Trials. Arthroscopy 2026. doi:10.1002/arj.70463
This systematic review and meta-analysis of 18 randomised controlled trials (1308 patients) compared single-row versus double-row arthroscopic rotator cuff repair for retear rates, functional scores, range of motion, and operative times, with subgroup analysis by tear size. Double-row repair yielded better UCLA scores, improved forward flexion, and lower overall and partial-thickness retear rates than single-row repair. The advantage appears concentrated in large tears, with no benefit for small-to-medium tears, guiding tear-size-specific technique selection.
16. Yoshimura H, Ueki H, Araya N. Shift Angle and Medial Retraction of the Deep Layer on Magnetic Resonance Imaging Are Associated With Intraoperative Reparability in Arthroscopic Rotator Cuff Repair. Arthroscopy, Sports Medicine, and Rehabilitation 2026. doi:10.1002/ars2.70058
In this retrospective study of 177 shoulders undergoing arthroscopic repair of large-to-massive rotator cuff tears, MRI-based measurements of the deep layer, shift angle (anteroposterior tear extent on sagittal images) and medial retraction (distance from the deep-layer stump to cartilage margins), were assessed for predicting intraoperative reparability. Irreparable tears showed significantly larger shift angles (114.3° vs 82.6°) and greater medial retraction (33.9 vs 25.5 mm), with good diagnostic accuracy on receiver operating characteristic analysis. These preoperative MRI measures can help surgeons anticipate irreparability and plan for augmentation or alternative procedures.
31. Dai F, Xiang M. The Hybridge Technique: A Combined Technique of Suture Bridge and Biceps Tenodesis and Lateral Corner of Rotator Cuff Interval Stabilization for an Arthroscopic Rotator Cuff Repair. Arthroscopy Techniques 2026. doi:10.1002/atn2.70218
This Technical Note describes the 'Hybridge' technique, combining suture-bridge rotator cuff repair with biceps tenodesis and stabilisation of the lateral corner of the rotator cuff interval, addressing commonly associated biceps pulley lesions and interval tears. The hybrid approach uses fewer anchors and simplifies the procedure compared with existing methods. It targets supraspinatus (and infraspinatus) tears with concurrent long head of the biceps pathology in a single arthroscopic intervention.
46. Scott TA, Rabinowitz JM, Barnes CL, et al. Impact of osteoporosis on post-operative outcomes following rotator cuff repair. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100723
Using the PearlDiver Mariner170 database with 1:1 propensity matching, this study compared 2-year outcomes after rotator cuff repair in patients with and without osteoporosis, including revision surgery, conversion to reverse shoulder arthroplasty, and pathological humeral fracture. Osteoporosis was associated with differences in post-operative complications and healthcare utilisation, with analyses stratified by open versus arthroscopic repair. These findings support preoperative bone quality assessment and closer surveillance in osteoporotic patients undergoing rotator cuff repair.
48. Sahara W, Hirose T, Kiyomoto M, et al. A novel magnetic resonance imaging–based classification of subscapularis muscle atrophy: reproducibility and clinical relevance. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100720
This study proposed and validated a novel MRI-based classification of subscapularis muscle atrophy on T1-weighted oblique sagittal Y-view images, grading atrophy as none, mild, moderate, or severe based on cranial-to-caudal progression in 72 shoulders. The classification demonstrated reproducibility and correlated with clinical parameters in patients undergoing rotator cuff repair or reverse shoulder arthroplasty. It provides a practical, standardised tool for preoperative assessment of subscapularis atrophy to guide surgical decision-making.
69. Hitchens H, Fang WH, Mo K, et al. Histologic outcomes of rotator cuff patch augmentation: a literature review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100721
This PRISMA-guided literature review synthesized 42 studies reporting histologic or biochemical outcomes after patch-augmented rotator cuff repair, comparing dermal matrix, extracellular matrix-derived, synthetic polymer, and biologically augmented scaffolds. Dermal matrices accelerated early neovascularization and collagen synthesis but showed incomplete fibrocartilage formation and persistent type III collagen; ECM patches improved collagen alignment but provoked inflammation; synthetic polymers produced dense type I collagen with variable immune reactions; biologically augmented scaffolds achieved high collagen density with minimal macrophage response. The findings guide scaffold selection based on desired biologic healing response at the tendon-bone interface.
90. Yuwarungsikul C, Mathurunyanont K, Sirisoonthron J, et al. Arthroscopic and Mini-open Rotator Cuff Repair Yield Comparable Clinical and Structural Outcomes in Small to Medium full-thickness tears: A Systematic Review and Meta-analysis of Randomized Controlled Trials Importance. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101193
This systematic review and meta-analysis of randomised controlled trials compared arthroscopic versus mini-open rotator cuff repair in small to medium full-thickness tears. The pooled analysis found comparable clinical and structural outcomes between the two techniques. Surgeons can reasonably choose either approach for small to medium tears based on preference and expertise, as neither demonstrates a clear outcome advantage.
109. Prabhavalkar ON, Morriss NJ, Malin M, et al. Hyperlipidemia Is Associated With an Increased Risk of Secondary Procedures in Patients Undergoing Arthroscopic Rotator Cuff Repair. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.018
This TriNetX-based retrospective cohort study of adults undergoing primary arthroscopic rotator cuff repair compared secondary procedure rates (repeat RCR, arthroplasty) among patients without hyperlipidemia, with hyperlipidemia without statins, and with perioperative statin use, using propensity score matching. Hyperlipidemia was associated with increased rates of secondary procedures over follow-up up to 5 years, and the analysis tested whether statin therapy mitigated this risk. The results suggest hyperlipidemia should be considered when counseling patients about rotator cuff healing and revision risk, with potential benefit from perioperative statin use warranting further study.
119. Kim DM, Cho JW, Oh S, et al. The Efficacy of Synovectomy in Rotator Cuff Repair: A Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261474635
In a randomised controlled trial, 60 patients undergoing arthroscopic repair of full-thickness rotator cuff tears were assigned to repair with or without adjunctive synovectomy, with 3-month worst pain (VAS) as the primary outcome and motion, strength, functional scores, and satisfaction as secondary outcomes. Synovectomy did not improve early postoperative pain relief or other clinical outcomes compared with repair alone. Routine synovectomy as an adjunct to rotator cuff repair is not supported by these level 1 evidence findings.
121. Cunningham BP, Agoro KS, Puckett HD, et al. Paper 06. Rotator Cuff Repair RoHI Scoring: Identifying Characteristics to Validate or Modify the Score System. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00267
Investigators retrospectively applied the Rotator Cuff Healing Index (RoHI), a 15-point score integrating six predictors of tendon healing, to 782 patients undergoing primary rotator cuff repair and compared scores with patient-reported outcomes. The analysis sought to validate the score's ability to stratify healing risk in a real-world cohort. Findings will inform whether RoHI requires modification, such as excluding bone mineral density, for routine clinical use in predicting repair success.
122. Wong IH, Akindoju K, Remedios SM, et al. Paper 36. Augmentation with Dermal or BioInductive Patches Improves Rotator Cuff Healing compared to Rotator Cuff Repair Alone. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00294
A single-center retrospective cohort compared arthroscopic rotator cuff repair alone versus augmentation with acellular dermal allografts or bioinductive collagen patches in medium-to-large tears. The study directly compared tendon healing and clinical outcomes across the three approaches, addressing a gap in head-to-head evidence. Results support patch augmentation as a strategy to improve healing rates in this high retear-risk population.
123. Lin EH, Barcenas AB, Feingold CL, et al. Paper 37. Industry Funding in Rotator Cuff Repair with Patch Augmentation Does Not Influence Reported Outcomes. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00295
This PRISMA-compliant systematic review examined whether industry funding influences reported outcomes in studies of patch augmentation for rotator cuff repair. Studies from 2000 to 2024 reporting funding sources and conflicts of interest were independently screened and included. The findings address concerns about publication bias by clarifying whether funded research reports systematically different efficacy results.
130. Jain S, Morriss N, Prabhavalkar O, et al. Poster 224. Corticosteroid Injections as Early as 12 Months Pre-Op Increases Risk of Subsequent Shoulder Surgery after Rotator Cuff Repair: A Database Study of 79,582 patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00520
Using the TriNetX database of 79,582 rotator cuff repair patients, this propensity-matched cohort study compared rates of subsequent shoulder surgery and arthroplasty between patients receiving corticosteroid injections within 6 or 6-12 months preoperatively and matched controls without recent injections. The key finding was that corticosteroid injection even up to 12 months before repair increased the risk of repeat shoulder surgery. Clinically, this suggests surgeons should exercise caution and consider timing when administering steroid injections to patients who may undergo rotator cuff repair.
133. Lau E, Cong T, Steuer F, et al. Poster 229. Bariatric Surgery is Associated with Surgical Failure and Inferior Outcomes after Arthroscopic Rotator Cuff Repair Compared to a Matched Cohort. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00525
This single-institution study compared failure rates and patient-reported outcomes after arthroscopic rotator cuff repair for full-thickness supraspinatus tears between patients with prior bariatric surgery and a matched cohort who qualified for but had not undergone bariatric surgery. The key finding was that prior bariatric surgery was associated with higher surgical failure and inferior outcomes despite similar BMI at the time of repair. Clinically, a history of bariatric surgery should factor into preoperative counseling and expectations for rotator cuff healing.
136. Coombs J, Loyd K, Park A, et al. Poster 234. Perioperative Outcomes Following Tranexamic Acid Use in Arthroscopic Rotator Cuff Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00529
This TriNetX database study with propensity score matching compared one-year perioperative outcomes after arthroscopic rotator cuff repair with versus without perioperative tranexamic acid, including ED visits, hospital admission, infections, pulmonary embolism, opioid prescriptions, and mortality. The key findings address whether TXA reduces postoperative complications and opioid use, building on prior evidence of improved visualization and reduced operative time. Clinically, the results inform whether routine TXA use can be recommended in arthroscopic rotator cuff repair.
142. Hassebrock JD, Bravman JT. Poster 214. Outcomes of Isolated Arthroscopic Subscapularis Repair with Retained Native Long Headof Biceps Tendon. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00510
A retrospective review of 617 primary rotator cuff repairs identified 23 patients who underwent isolated arthroscopic subscapularis repair with retention of the native long head biceps tendon. At short-term follow-up, patients showed improved function with low complication and reoperation rates when the biceps sling was preserved and no intraoperative biceps instability was present. Biceps tenotomy/tenodesis may be avoidable in select subscapularis repairs.
145. Tokish JM, Iturregui J, Lai C. Poster 245. Improving Rotator Cuff Repair With Tissue Engineering and Biotherapeutics. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00539
In a rat rotator cuff repair model, investigators compared traditional repair against augmentation with an electrospun PCL biomimetic patch, an amnion matrix patch, and a combination patch, using biomechanical, genomic, and histologic endpoints. The study aimed to identify which enthesis-mimicking augmentation best promotes tendon-to-bone healing. Findings may guide selection of biologic patch augmentations to improve rotator cuff repair healing in clinical practice.
148. Cameron RK, Gosnell G, Chen L, et al. Poster 262. A Phase 1 Dose-Escalation Study of Indocyanine Green Fluorescence Imaging for Intraoperative Assessment of Rotator Cuff Vascularity During Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00554
In this Phase 1 dose-escalation study, 21 patients undergoing arthroscopic rotator cuff repair received intravenous indocyanine green (7.5-50 mg) with intraoperative fluorescence imaging via the Stryker AIM system to assess tendon vascularity, with surgeons rating visibility, clinical relevance, and actionability. The study established feasibility, safety, and dose-dependent behaviour of ICG imaging for real-time intraoperative tendon perfusion assessment. This technique could eventually guide intraoperative surgical decision-making to reduce retear risk.
152. Covello MR, Pedaprolu K, Suzuki Y, et al. Poster 212. Repeated Corticosteroid Injections Compromise Tendon Histology and Impair Biomechanical Integrity in a Rotator Cuff Tendinopathy Model. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00509
In a murine rotator cuff tendinopathy model of subacromial impingement, researchers compared single versus repeated corticosteroid injections using structural, molecular, histologic, and biomechanical assessments. Repeated injections compromised tendon histology and impaired biomechanical integrity, extending prior findings from healthy and acutely transected tendon models to a tendinopathy model. The results caution against repeated CSI use in rotator cuff tendinopathy and inform clinical guidance on injection frequency.
159. Hitchens H, Fang WH, Ahmad S, et al. Poster 258. Does Patch Material Matter? A Systematic Review and Meta-Analysis of Graft Augmentation in Rotator Cuff Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00550
This systematic review and meta-analysis (PRISMA-compliant, 14 studies, 922 patients) compared full-thickness rotator cuff repair with versus without patch augmentation and evaluated whether graft material type affects outcomes. Primary outcomes included ASES, Constant-Murley, and UCLA scores plus retear rates at minimum one-year follow-up. Findings guide surgeons on whether and which patch augmentation improves clinical and structural results.
162. Bera S, Brady TT, Parmar RP, et al. Poster 161. Chronic Statin Therapy is Associated with Increased Rates of Rotator Cuff and Achilles Tendon Re-tears After Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00459
Using the PearlDiver Mariner database (2010-2023), this retrospective comparative study examined whether chronic statin therapy affects tendon re-tear rates after primary rotator cuff and Achilles tendon repair in patients aged 40 and older. Chronic statin use was associated with increased rates of re-tear after both repairs, with secondary analysis of time to re-tear. The results suggest clinicians should counsel statin-using patients about a potentially elevated re-tear risk following tendon repair.
169. Bertha N, Bravman JT, Vaver NJ, et al. Poster 238. The Subscapularis Muscular Border Angle (SMBA): A Novel MRI Measurement Predictive of Subscapularis Tear Requiring Arthroscopic Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00532
Investigators measured a novel MRI parameter, the subscapularis muscular border angle (SMBA), in patients undergoing arthroscopic rotator cuff repair, comparing those with Lafosse type I/II subscapularis tears to those with an intact tendon. The study evaluated whether SMBA can discriminate between these groups on preoperative imaging. If validated, SMBA could improve preoperative detection of subtle upper-border subscapularis tears that are frequently missed on standard MRI assessment.
170. Chu E, Sewards JM, Zhao H. Poster 239. Go Ahead and Fix That Rotator Cuff Tear- BMI Isn’t Holding It Back. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00533
This study examined whether overweight/obese status and increasing BMI affect healing, postoperative pain, and shoulder function after arthroscopic rotator cuff repair (ARCR). The title and framing indicate that BMI was not associated with inferior outcomes following ARCR. Clinically, this supports proceeding with ARCR in obese patients without expecting worse healing or functional results based on BMI alone.
172. Schroeder GG, Tummala SV, Koltsov J, et al. Poster 251. Reduced Acromiohumeral Interval on External Rotation Radiographs has a High Discriminatory Power in Identifying Massive Rotator Cuff Tears Involving Three Tendons. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00545
In a retrospective cohort of rotator cuff repair patients, the acromiohumeral interval (AHI) was measured on upright Grashey radiographs in internal and external rotation to assess its relationship with tear severity. A reduced AHI on external rotation views showed high discriminatory power for identifying massive tears involving three tendons. This suggests dynamic (external rotation) AHI measurement is a simple, inexpensive radiographic tool for flagging massive rotator cuff tears preoperatively.
178. Khan ZA, Verma J, Brinkman JC, et al. Poster 236. Neighborhood-Level Socioeconomic Status Predicts Preoperative Symptom State and Postoperative Tendon Healing at Two-Year Follow-Up Following Primary Arthroscopic Rotator Cuff Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00530
This retrospective cohort study leveraged data from a prior randomised trial of arthroscopic rotator cuff repair to examine associations between the Area Deprivation Index (ADI) and clinical/imaging outcomes. The investigators tested whether neighborhood-level socioeconomic disadvantage predicts worse preoperative symptom status and inferior postoperative tendon healing at two years. Results would inform whether socioeconomic deprivation should be considered when counseling patients and allocating resources after rotator cuff repair.
181. Prabhavalkar O, Morriss N, Malin M, et al. Poster 222. Hyperlipidemia Increases the Risk of Secondary Procedures in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Database Study of 144,555 Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00518
Using the TriNetX database, 144,555 adults undergoing primary arthroscopic rotator cuff repair (2015-2020) were stratified into hyperlipidemia without statins, hyperlipidemia with perioperative statins, and no hyperlipidemia cohorts. The study tested whether hyperlipidemia increases rates of secondary procedures (repeat rotator cuff repair, total shoulder arthroplasty). Results clarify whether hyperlipidemia, and potential statin modification, should factor into preoperative risk counseling.
192. Baek J, Yoon E, Jeong J, et al. Machine learning based prediction of retear after arthroscopic rotator cuff repair: a multicenter cohort study. JSES International 2026. doi:10.1016/j.jseint.2026.101782
In this multicenter cohort study, machine learning models were developed to predict retear after arthroscopic rotator cuff repair using preoperative and perioperative variables. The models achieved predictive performance quantified by standard metrics, identifying key risk factors for structural failure. Clinically, such prediction tools could stratify patients for intensified rehabilitation, closer surveillance, or modified repair constructs to reduce retear risk.
219. Tan YCJ, Chiu ST, Tan AHC. Arthroscopic rotator cuff repair: the effect of cuff tear size on outcomes and recovery trajectories. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100791
This retrospective cohort study of 136 patients undergoing arthroscopic rotator cuff repair compared outcomes at 6 months and 2 years stratified by tear size (small, medium, large) using multiple patient-reported and clinical measures. All tear-size groups improved significantly over time, though larger tears showed slower or less complete recovery trajectories. Clinically, tear size should inform patient counseling regarding expected recovery timelines and final functional outcomes.
230. Hochreiter B, Senn R, Castroviejo C, et al. Rotator Cuff Tendon Augmentation and Inter-User Reproducibility Assessment of a Novel Patch Fixation Technique Compared to a Conventional Technique for Rotator Cuff Repair: A Biomechanical Validation Study. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100844
This biomechanical validation study assessed a novel patch fixation technique for rotator cuff augmentation versus a conventional technique, including inter-user reproducibility testing. The novel technique demonstrated comparable or improved biomechanical performance with good reproducibility across users. Clinically, the findings support further clinical evaluation of the simplified patch fixation method for augmenting rotator cuff repair.
237. Limaye D, Contreras A, Liu T, et al. Clinical Outcomes Following Concomitant Arthroscopic Rotator Cuff Repair and Anterior Shoulder Stabilization: A Systematic Review and Meta-Analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100868
This systematic review and meta-analysis evaluated clinical outcomes after concomitant arthroscopic rotator cuff repair and anterior shoulder stabilisation performed in the same setting. The pooled analysis demonstrated favourable outcomes with acceptable complication and recurrence rates when both procedures are combined. Clinically, the findings support performing simultaneous arthroscopic cuff repair and stabilisation in appropriate patients without compromising results.
257. Kocabay SY, BÜKER N, YÖRÜKOĞLU AÇ, et al. Telerehabilitation-Based Motor Control Exercises After Rotator Cuff Surgery: Effects on Shoulder Function and Quality of Life. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.013
In a randomised trial of 34 patients after arthroscopic rotator cuff repair, motor control exercises delivered via telerehabilitation (twice weekly for 12 weeks) were compared with standard telerehabilitation. Both groups improved significantly in pain, active range of motion, muscle strength, and function, with the abstract's between-group results truncated. If motor control training proves non-inferior or superior, remotely supervised motor control exercise could be a viable, accessible postoperative rehabilitation option, though the small sample warrants cautious interpretation.
Shoulder Instability Management (44)¶
2. Gong L, Hou H, Zhou W, et al. Arthroscopic Iliac Crest Bone Grafting for Shoulder Glenoid Defect Augmentation Using a “Three‐Pulley Four‐Point Antirotation” Suture Anchor Technique. Arthroscopy Techniques 2026. doi:10.1002/atn2.70233
A novel arthroscopic technique is described for augmenting severe glenoid bone defects in anterior shoulder instability using autologous iliac crest bone graft fixed with four labrum suture anchors and pulley knots, termed the '3-pulley 4-point antirotation' technique. The four-point fixation with pulley knotting is designed to prevent bone block rotation and avoid hardware complications and graft resorption. It offers a suture-anchor-only alternative to screw or button fixation for glenoid reconstruction.
14. Li X, Li B, Feng J, et al. Labral Augmentation Decreases Humeral Head Displacement and Cartilage Stress in an Anterior Shoulder Instability Model With Subcritical Glenoid Bone Loss: A Finite Element Analysis. Arthroscopy 2026. doi:10.1002/arj.70460
Using finite element analysis models built from CT scans of five patients with anterior instability and subcritical glenoid bone loss (13.5%-25%), the authors compared Bankart repair alone, Bankart repair plus remplissage, and labral augmentation against contralateral normal controls. Labral augmentation best restored native biomechanics, limiting humeral head displacement to control-like levels, normalizing capsular stress, and reducing glenoid and humeral cartilage stress. These findings support labral augmentation as a biomechanically favourable option for instability with subcritical bone loss, though clinical validation is needed.
18. Wu D, Tang Y, Yu G, et al. The “Mooring” Technique for Large Anterior Glenoid Rim Fractures Results in Favorable Clinical and Radiological Outcomes. Arthroscopy 2026. doi:10.1002/arj.70455
A retrospective case series of 56 patients with large displaced anterior glenoid rim fractures (≥20% of glenoid width) treated arthroscopically with a 'mooring' fixation technique was followed for a mean of 27 months with serial CT and clinical scoring. The technique yielded favourable clinical outcomes and radiographic healing with fracture reduction maintained. This offers a reliable arthroscopic option for large glenoid rim fractures that may otherwise require open surgery.
21. Berge T, Garratt AM, Moatshe G, et al. Minimum 5-Year Follow-up After Arthroscopic Latarjet: Outcomes and Complications. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261475810
A prospective cohort of 85 patients (92% male, median age 28) undergoing arthroscopic Latarjet with double-screw fixation was followed a median of 5.2 years with WOSI, EQ-5D-5L, and complication assessment. The study provides mid- to long-term outcome and recurrence data for the increasingly used arthroscopic technique. Results support counseling patients on expected durability and complication risks beyond 5 years.
24. Jos S, Sukumaran S, Paul P, et al. Cortical Button Fixation for Large Bony Bankart Lesions. Arthroscopy Techniques 2026. doi:10.1002/atn2.70210
An arthroscopic technique article describing cortical button fixation for large bony Bankart lesions via a posterior-to-anterior transosseous glenoid tunnel, indicated when fragment size or medial extension makes screw or anchor fixation unreliable. The construct allows controlled reduction and compression with a low-profile, fragment-preserving profile. This provides an alternative solution for challenging bony Bankart morphology in anterior instability.
25. Subramanian KN, Ravichandran A, Raja N, et al. Arthroscopic Bone Block Procedure Using Iliac Crest Autograft and Labral Advancement and Repair. Arthroscopy Techniques 2026. doi:10.1002/atn2.70156
The authors describe an all-arthroscopic technique for glenoid bone block reconstruction using iliac crest autograft with labral advancement and FiberTape fixation for recurrent anterior shoulder instability with significant bone loss. The Technical Note emphasizes simplified preoperative planning, portal placement, graft contouring, and tensioned fixation. It aims to make the procedure more reproducible and accessible for surgeons learning bony augmentation approaches that avoid coracoid transfer morbidity.
26. Maranya S, Coady C, Wong I. Arthroscopic Trillat With Pan Capsulorrhaphy for Management of Shoulder Instability Secondary to Ligamentous Laxity: A Technique Guide. Arthroscopy Techniques 2026. doi:10.1002/atn2.70221
This technique guide presents an all-arthroscopic Trillat procedure combined with pan-capsulorrhaphy for anteroinferior shoulder instability due to ligamentous hyperlaxity without glenoid bone loss. The coracoid osteotomy with medial-inferior shift provides a conjoint tendon sling effect while capsular shift reduces glenohumeral volume. Using only 3 portals, the minimally invasive approach also permits treatment of concurrent intra-articular pathology in patients failing conservative care.
53. Boissinot T, Lefebvre Y. Open Hill-Sachs remplissage associated with glenoid bone block: a single deltopectoral approach. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100706
This technical note describes an open surgical technique combining Hill-Sachs remplissage with a glenoid bone block (Latarjet or Eden-Hybinette) through a single deltopectoral approach for shoulder instability with bipolar bone loss. The approach targets the elevated recurrence risk (up to 18% after Latarjet alone) associated with off-track Hill-Sachs lesions and other risk factors such as hyperlaxity and revision settings. It offers surgeons an alternative strategy for addressing both glenoid and humeral head bone loss without a two-stage or combined arthroscopic-open procedure.
70. Lin RT, Charles S, Dadoo S, et al. Remplissage for “on-track” shoulders yields similar overall but different short-term game participation outcomes vs. Bankart repair alone. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100736
This retrospective study used online sports databases to compare games played and return-to-play rates in athletes aged 14-40 with on-track Hill-Sachs lesions undergoing arthroscopic Bankart repair alone versus Bankart repair with remplissage (2007-2022). Overall relative game participation and return-to-play were similar between the two procedures, though short-term (early postoperative seasons) game participation differed. The results support remplissage for on-track lesions without compromising long-term athletic participation, while counseling athletes about potential early-season differences.
86. Qu X, Li D, Tang X, et al. Episode Count Should Not Substitute for Anatomy in Arthroscopic Bankart Repair: Letter to the Editor. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261464187
In this letter to the editor, Qu et al critique Lin et al's finding that two preoperative dislocation episodes predict recurrence after arthroscopic Bankart repair. They argue that episode count is only a surrogate for accumulated structural damage, glenoid bone loss, off-track Hill-Sachs morphology, and bipolar defects, and should not serve as a biological cutoff for surgical decision-making. They contend that anatomic risk factors, not episode counts alone, should drive operative planning and risk stratification.
87. Lin RT, Gilbert R, Lin A. Episode Count Should Not Substitute for Anatomy in Arthroscopic Bankart Repair: Response. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261464192
Lin et al respond to Qu et al's critique of their instability-episode threshold study, addressing three points: whether episode count functions as a surrogate versus a biological threshold, how anatomic factors integrate with the threshold in surgical planning, and the threshold's clinical utility. The authors defend the preoperative episode count as a practical, evidence-based risk-stratification tool that complements, rather than replaces, anatomic assessment. They frame the threshold as a useful adjunct for counseling and operative decision-making while acknowledging the role of bone loss and track concepts.
101. So S, Seok H, Jeon I. Posterior Translation of the Humeral Head after Arthroscopic Bankart Repair: A Quantitative Analysis of Preoperative and Postoperative Axial MRI. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.031
This retrospective study of 50 patients quantified static humeral head anteroposterior translation (HHAT) on axial MRI before and after arthroscopic Bankart repair for anterior instability, using a posterior-referenced ellipse method to account for glenoid bone loss. The analysis identified demographic, positional, and morphological factors independently associated with pre- and postoperative translation and its change. The findings clarify how Bankart repair affects static humeral head positioning and may inform interpretation of postoperative imaging.
111. Ba S, Macciacchera M, Mikhail N, et al. Current Approaches to Arthroscopic Management of Anterior Shoulder Instability. JBJS Reviews 2026. doi:10.2106/jbjs.rvw.26.00033
This review article summarizes current arthroscopic management of anterior shoulder instability, emphasizing early operative consideration to prevent bone loss and recurrence, and the glenoid track concept for assessing significance of bone loss. It outlines narrowing indications for isolated soft-tissue repair (minimal glenoid bone loss), expanding indications for remplissage including off-track and near-track Hill-Sachs lesions and as an adjunct to Latarjet or bone block procedures, and the role of Latarjet versus arthroscopic glenoid reconstruction. The clinical implication is a framework for individualized surgical decision-making based on glenoid and humeral bone loss to optimise recurrence risk and return to sport.
112. Mitsui Y, Higuchi K, Hara K, et al. A Modified Bankart Repair Technique for the Throwing Shoulder to Prevent External Rotation Loss and Facilitate Return to Play in Baseball Players. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261449195
This Level 4 case series evaluated a modified Bankart repair technique (DAGHT, dynamic anterior glenohumeral capsular ligament tensioning) in 24 competitive baseball players with traumatic anterior instability, in which capsular tension is assessed in abduction and external rotation before suture passage to avoid over-tightening. The study reported clinical outcomes with the goal of preserving external rotation and facilitating return to play in overhead athletes. The clinical implication is that tensioning the capsule in ABER may reduce postoperative external rotation loss and support return to throwing in baseball players.
117. Akrivos VS, Koutalos A, Stefanou N, et al. Subjective Shoulder Instability Following Anterior Stabilization: Incidence and Time to Resolution After Latarjet Versus Bankart Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261470584
A retrospective cohort of 104 patients with minimum 4-year follow-up compared subjective instability after open Latarjet versus arthroscopic isolated Bankart repair for recurrent anterior shoulder instability, alongside Constant and Rowe scores, dislocation, subluxation, and reoperation rates. Postoperative subjective instability occurred in both groups with defined incidence and time to resolution, with comparisons between procedures reported. Results help guide procedure selection and patient counseling regarding transient postoperative instability sensations.
125. Wong IH, Piovesan NO, Licht F. Paper 50. Arthroscopic Treatment of Recurrent Anterior Shoulder Instability: Functional Outcomes from a Two-Year Randomized Controlled Trial for Subcritical Glenoid Bone Loss. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00307
In a double-blind, single-center randomised controlled trial, arthroscopic anatomic glenoid reconstruction was compared with arthroscopic Bankart repair for recurrent anterior shoulder instability with subcritical glenoid bone loss. Re-dislocation rates, WOSI scores, range of motion, and strength were tracked over two years postoperatively. The trial provides high-level evidence to guide procedural selection in this debated clinical scenario.
127. Blaber OK, Shenoy D, Espinosa JV, et al. Poster 228. Association Between Craniocaudal Position of the Hill-Sachs Lesion, Anchor Type, and Postoperative Stiffness After Remplissage. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00524
A retrospective review of 42 patients undergoing remplissage with labral repair examined whether Hill-Sachs lesion craniocaudal position, anchor number, and anchor type (knotted vs knotless) were associated with postoperative stiffness. Lesion position was measured on advanced imaging using established methodology with excellent inter-rater reliability. The findings help surgeons anticipate stiffness risk and refine operative decision-making in instability repair.
129. Feeley SM, Gibbs HP, Hoyt BW, et al. Poster 266. Clinical and Patient-Reported Outcomes After Posterior Distal Tibia Allograft Reconstruction for Glenohumeral Instability: A MultiCenter Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00558
This multicenter retrospective study evaluated arthroscopic posterior distal tibia allograft (pDTA) reconstruction for posterior glenohumeral instability with glenoid bone loss >10% or failed posterior labral repair, comparing outcomes against primary posterior labral repair using PROs (WOSI, SANE, VAS, PROMIS) and imaging measures of graft union, resorption, and arthritis. Key findings on MCID-achieved PRO improvement and graft healing will clarify whether pDTA provides durable stabilisation in this difficult bone-loss population. Clinically, the results can guide surgeons in selecting pDTA over labral repair alone for posterior instability with significant glenoid bone loss.
132. Kucirek NK, Trotter MV, Feeley BT, et al. Poster 225. Latarjet Offers Lower Two-Year Re-operation Rate with Similar Rate of Nerve Injury Compared to Anterior Free Bone Block Procedures. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00521
This PearlDiver database study compared two-year reoperation and nerve injury rates after Latarjet versus anterior free bone block stabilisation (and open Bankart) from 2015-2022, with logistic regression identifying risk factors and national utilisation trends. The key finding was that Latarjet conferred a lower two-year reoperation rate with a similar rate of nerve injury compared to free bone block procedures. Clinically, this supports preferential use of the Latarjet for complex anterior shoulder stabilisation when surgical expertise is available.
134. Epner E, Hettrich CM, Wolf BR, et al. Poster 217. Outcomes of Arthroscopic Treatment of 270-360 Degree Panlabral Tears. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00513
This multicenter database study assessed two-year outcomes after arthroscopic repair of rare 270°-360° panlabral tears, including recurrent instability, reoperation, return to play, multiple PROs (ASES, WOSI, SANE, RAND-36, SST, Shoulder Activity Score), and complications. The key findings characterize short-term outcomes and recurrence/reoperation rates for these extensive labral lesions, which are often under-recognised. Clinically, the data support arthroscopic repair as a viable option for panlabral tears and aid in preoperative counseling for this challenging instability pattern.
138. Gustafson J, Miyadahira R, Gonzalez F, et al. Poster 244. Dynamic Stabilizer Recruitment After Bankart and Latarjet: A Novel Perspective on Surgical Indications. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00538
EMG activation patterns during shoulder elevation were compared in ten patients after arthroscopic Bankart repair and ten after open Latarjet. The study tested whether Bankart patients show greater compensatory recruitment of dynamic stabilizers, providing the first neuromuscular comparison between these procedures. Results may help refine surgical indications for borderline cases of recurrent anterior shoulder instability.
139. Lin RT, Bhardwaj N, Liu A, et al. Poster 233. Resilience Reduces the Impact of Recurrent Shoulder Instability on Patient-Reported Outcomes After Arthroscopic Shoulder Stabilization Surgery. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00528
This retrospective study examined whether psychological resilience (Brief Resilience Scale) modifies patient-reported outcomes after arthroscopic Bankart repair with or without remplissage for on-track Hill-Sachs lesions. Higher resilience was associated with better PROs and appeared to buffer the negative impact of recurrent instability on outcomes. Assessing resilience preoperatively may help identify patients at risk for poorer subjective results after stabilisation surgery.
140. Polousky J, Maier J, Arellano E, et al. Poster 242. New Trauma Drives Recurrent Shoulder Instability Following Primary Stabilization Surgery in Adolescent Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00536
A single-institution paediatric database was reviewed over 10 years to determine the rate and etiology of recurrent instability after primary shoulder stabilisation in adolescents, defining recurrence as revision surgery or ED reduction. New traumatic events, rather than atraumatic failure, drove most recurrences in this heterogeneous population. This suggests reported recurrence rates may reflect reinjury risk rather than surgical failure, informing counseling of young athletes.
144. Pavlenco C, Saper MG, Khilfeh B, et al. Poster 261. Six-month SIRSI Scores and 1-year Return to Sport After Shoulder Stabilization in Adolescent Athletes. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00553
Adolescent athletes aged 14-18 undergoing shoulder stabilisation were assessed with the SIRSI psychological readiness score at 6 months, alongside PROMs (ASES, Tegner, QuickDASH, PASS) and return-to-sport status at 1 year. Higher 6-month SIRSI scores were associated with better 1-year PROMs and RTS rates. The SIRSI score at intermediate follow-up may serve as a prognostic tool to identify adolescents needing additional psychological support before return to sport.
150. Bishop JY, Osborne AM, Cvetanovich GL, et al. Paper 16. Outcomes of Latarjet as a Primary Versus Revision Surgery in the Contact Athlete. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00276
Using the MOON shoulder instability cohort (2012-2023), this study compared outcomes of Latarjet performed as a primary procedure versus revision after failed soft-tissue stabilisation in contact athletes, stratifying glenoid bone loss and tracking recurrent instability and return to sport. The study addresses whether revision Latarjet carries inferior outcomes as prior literature suggests. Results inform surgical decision-making and expectations counseling for contact athletes with recurrent instability.
153. Markes AR, Mohr DS, Arner JW, et al. Poster 252. Diagnostic Utility of Obrien’s, Modified Dynamic Posterior Instability, Modified Whipple, Posterior Apprehension, and Dynamic Scanning in Evaluating Posterior Shoulder Instability in the Throwing Athlete. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00546
This retrospective study evaluated five physical examination maneuvers (O'Brien's, modified dynamic posterior instability, modified Whipple, posterior apprehension, and dynamic scanning), individually and in composite, for predicting the need for posterior labral repair in 77 throwing athletes. Sensitivity, specificity, predictive values, and ROC/AUC analysis were used to determine diagnostic utility. The findings inform which exam maneuvers clinicians can rely on when assessing posterior instability in overhead athletes.
157. Hurley ET, Therien AD, Mullett H, et al. Poster 211. Development and Validation of The BRACE (Bankart Risk Assessment & Clinical Estimator) Score – An International Multicenter Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00508
This international multicenter study developed and validated the BRACE score, a recurrence risk calculator for arthroscopic Bankart repair based on age, sex, glenoid bone loss, Hill-Sachs lesion, dislocation count, laxity, and sport participation, with odds ratios derived from a systematic review of 110 studies. The logistic regression model was validated across 5 institutions in 3 countries using AUC and other discrimination metrics. The tool aims to improve on the inconsistent reliability of the ISIS score for surgical decision-making.
160. Provencher MT, Hurley ET, Lorentz SG, et al. Poster 265. Cost-Effectiveness of Distal Tibial Allograft vs The Latarjet Procedure for Anterior Shoulder Instability: A Markov Analysis. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00557
This Markov model-based cost-effectiveness analysis compared distal tibial allograft (DTA) with open Latarjet for anterior shoulder instability using 1,000 simulated patients over a 10-year horizon. Outcomes included total cost, QALYs, and ICER, with probabilistic and deterministic sensitivity analyses to address input uncertainty. Results inform value-based surgical decision-making between these two bony stabilisation procedures.
161. Dadoo S, Williams TC, Williams TC, et al. Poster 215. Influence of Chronicity, Number, and Type of Anterior Shoulder Instability Events on Hill-Sachs Lesion Size: A Morphometric Analysis of 255 Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00511
This retrospective morphometric study of 255 patients undergoing arthroscopic Bankart repair evaluated whether chronicity, number, and type of prior anterior instability events influence Hill-Sachs lesion size on MRI. The findings support the hypothesis that chronic instability, multiple events, and dislocation (versus subluxation) are associated with larger lesions. Clinically, these factors may help identify patients at risk for larger Hill-Sachs lesions who could require remplissage or other augmentation at the time of surgical planning.
165. Dadoo S, Williams TC, Gilbert R, et al. Poster 260. Patient-Reported Outcomes Decline Over Time following Arthroscopic Bankart Repair for Anterior Shoulder Instability. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00552
This retrospective review of prospectively collected data followed young patients (≤30 years) undergoing arthroscopic Bankart repair with or without remplissage for anterior instability with on-track Hill-Sachs lesions, tracking WOSI, pain VAS, and Subjective Shoulder Value over time. Patient-reported outcomes declined over the follow-up period after Bankart repair. This suggests that although early results may be favourable, surgeons should counsel patients that functional outcomes may deteriorate over time, particularly with recurrent instability.
168. Gibbs HP, McQuade AM, Feeley SM, et al. Poster 218. Morphological Characteristics Following Single versus Recurrent Traumatic Posterior Shoulder Dislocation Events in a High-Risk Population. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00514
This retrospective review of the Military Health System Data Repository (2017-2024) quantified posterior glenoid bone loss, glenoid version, reverse Hill-Sachs lesions, and acromial morphology on CT/MRI in active-duty servicemembers after traumatic posterior shoulder dislocation, comparing single versus recurrent (≥2) dislocators. The study characterized the morphological consequences of posterior dislocation in a high-demand population and differences between primary and recurrent events. These measurements can guide surgical decision-making regarding bony augmentation or glenoid reconstruction in this population.
173. Klemt C, Sueyoshi T, Chan CM. Poster 221. The Glenoid Track Width is Smaller Under Dynamic Loading Conditions during Functional Daily Activities: A Finite Element Analysis Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00517
Finite element analysis using MRI-based 3D shoulder models from 10 patients compared glenoid track width under static versus dynamic loading across activities of daily living, overhead throwing, and extreme shoulder motion. The glenoid track width was smaller under dynamic loading conditions than the static 83% threshold assumes. This implies the conventional static glenoid track concept may underestimate instability risk, and dynamic loading should be considered in surgical planning for bipolar bone loss.
174. Tummala SV, Lai C, Tarabichi S, et al. Poster 248. Posterior Distal Tibial Allograft Better Recreates Glenoid Concavity vs Lateral DTA in Instability. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00542
Using 32 ankle CT scans, the authors compared the traditional lateral distal tibial allograft (DTA) configuration with a congruent-arc DTA using the posterior distal tibial articular surface for glenoid bone loss reconstruction. The CA-DTA provided significantly greater concavity (2.9 mm vs −2.3 mm) and better recreated native glenoid curvature, while traditional DTAs uniformly decreased concavity. These data support the congruent-arc posterior DTA technique as a means of better restoring glenoid concavity and bony stability in instability surgery.
179. McQuade AM, McCarthy CF, Gibbs HP, et al. Poster 263. Revision Posterior Labral Repair: Outcomes and Risk Factors for Failure. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00555
This study reviewed revision posterior labral repairs performed in the Military Health System (2006-2022) to define outcomes and risk factors for failure in young, active patients. Preoperative imaging was assessed for osseous factors (glenoid version, posterior bone loss, acromial tilt/height, humeral head subluxation) hypothesized to drive failure. Findings are intended to guide patient selection and preoperative planning for revision arthroscopic posterior stabilisation.
180. Edgar C, Bauer J, Singh R, et al. Poster 216. Restoring Glenoid Concavity: Angled Bone Blocks Provide Enhanced Function and Restore Glenohumeral Contact Forces Over Flat Repairs in Shoulder Reconstruction. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00512
In nine fresh-frozen cadaveric shoulders with a created 20% anterior glenoid defect, angled versus flat bone block reconstruction was compared using an established shoulder stability model. Angled blocks designed to restore glenoid concavity provided enhanced function and more favourable glenohumeral contact forces and congruence than flat repairs. This biomechanical evidence supports angled graft positioning to optimise stability in bone-loss reconstruction.
184. Kizaki K, Uchida S. Poster 220. Promising Bone Union Rates Following Arthroscopic Free Bone Block Double End-Button Fixation With Iliac Crest Autograft in Patients With Recurrent Shoulder Instability and Glenoid Bone Loss. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00516
This prospective study evaluated bone union rates after arthroscopic free bone block reconstruction using tricortical iliac crest autograft fixed with a double end-button technique in 25 patients with recurrent anterior instability and critical glenoid bone loss. The construct theoretically resists graft fracture, distributes contact forces, and acts as a tension band to promote compression. Promising union rates would support this arthroscopic technique as an alternative to allograft bone block procedures.
185. Dadoo S, Williams TC, Andrade-Bucknor K, et al. Paper 17. Long-Term Outcomes after Arthroscopic Bankart Repair for On-Track Lesions at Mean 10 Year Follow-Up. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00277
A retrospective cohort of 56 patients (mean age 22 years) who underwent isolated arthroscopic Bankart repair for anterior shoulder instability with on-track Hill-Sachs lesions was followed for a mean of 10.7 years with patient-reported outcomes (WOSI, pVAS, SSV) and instability recurrence data. The study quantified long-term recurrence rates and PRO scores, comparing patients with and without recurrent instability. Findings inform shared decision-making regarding the durability of isolated Bankart repair in young active patients with on-track lesions, supporting counseling about recurrence risk and potential need for later surgery.
188. Gibbs HP, McQuade AM, Feeley SM, et al. The Natural History of Traumatic Posterior Glenohumeral Dislocations in a High-Risk Population. JSES International 2026. doi:10.1016/j.jseint.2026.101773
This cohort study described the natural history of traumatic posterior glenohumeral dislocations in a high-risk population, tracking outcomes, recurrent instability, and treatment course. It characterized how often these injuries progress to chronic instability, arthritis, or require operative management. The findings support earlier surgical consideration and informed surveillance strategies for patients with traumatic posterior dislocations.
202. Ruiz JA, López R, Alfredo Moreno L, et al. Clinical and radiographic outcomes following open Latarjet with single button technique. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100763
Clinical and radiographic outcomes were evaluated after open Latarjet procedure using single-button (screwless) fixation for anterior shoulder instability with significant glenoid bone loss. Single-button fixation achieved clinical and radiological results comparable to screw fixation with potentially fewer fixation-related complications. Open Latarjet with button fixation represents a viable alternative that may reduce hardware complications in managing glenoid bone loss.
208. Lamby P, Heine N, Eigenberger A, et al. A local vascularized scapula bone graft to treat posterior glenohumeral instability—an innovative surgical technique. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100772
An innovative surgical technique using a locally pedicled vascularized bone graft harvested from the scapular pillar was introduced to treat posterior glenohumeral instability associated with glenoid hypotrophy. The vascularized graft addresses the ~20% failure rate of avascular allografts due to resorption or aseptic necrosis. This technique offers an alternative for patients with significant bony glenoid defects in posterior instability where conventional grafting carries risk of graft resorption.
212. Kamineni S, Comas Marrero LA, Muench C, et al. Glenoid Augmentation with the Long Head Biceps for Shoulder Instability (GALIN). JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100777
The authors present the GALIN technique, an arthroscopic method of glenoid augmentation using the long head of the biceps tendon to reconstruct a neo-labrum for shoulder instability. The procedure aims to deepen the glenoid and expand the glenoid track as an alternative to Bankart repair, Latarjet, or traditional labrum reconstruction. It offers a biologic, less invasive option for instability with glenoid bone loss, though its durability requires further study.
216. Vadalà A, Benelli C, Carta B, et al. Open capsuloplasty with conjoint tendon augmentation versus Latarjet procedure in young patients with recurrent shoulder dislocation: a comparative study of 53 patients with 4.2-year follow-up. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100783
In a comparative study of 53 young patients with recurrent shoulder dislocation followed for 4.2 years, the authors compared open capsuloplasty with conjoint tendon augmentation against the Latarjet procedure. They hypothesized no significant difference in stability and functional outcomes between the two techniques. The less invasive conjoint tendon augmentation achieved comparable clinical stability and function while avoiding bone-block complications, supporting it as a viable alternative to Latarjet in selected young patients.
232. Werthel JD, Zumstein MA, Sigrist B, et al. SCOPE (Scapular Corrections for Posterior Escape) for Posterior Glenohumeral Instability: Technique of Posterior Acromial Corrective Osteotomy with Optional Glenoid Corrective Osteotomy. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100852
This technique article described SCOPE (Scapular Corrections for Posterior Escape), a posterior acromial corrective osteotomy with optional glenoid corrective osteotomy for posterior glenohumeral instability. The procedure addresses bony anatomy contributing to posterior subluxation or escape. Clinically, it offers an alternative bony correction strategy for posterior instability cases refractory to soft-tissue or glenoid-only procedures.
233. Sensoy AA, Afacan MY, Gruber T, et al. Posterior stabilization and subtotal pectoralis major release for combined dynamic functional and structural posterior instability: A Case Report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100861
This case report describes combined arthroscopic posterior shoulder stabilisation with subtotal pectoralis major release for a patient with both dynamic functional and structural posterior instability. The authors detail the surgical technique and report successful stabilisation. The clinical implication is that addressing both the structural capsulolabral deficiency and the dynamic muscular component may be necessary in select patients with complex posterior instability.
Reverse Shoulder Arthroplasty (44)¶
7. Klein A, Nové-Josserand L, Collotte P, et al. Aseptic glenoid baseplate loosening after reverse total shoulder arthroplasty with a lateralized convex baseplate: helical blade versus central peg fixation. International Orthopaedics 2026. doi:10.1007/s00264-026-07006-8
A multicentre retrospective study of 231 primary reverse shoulder arthroplasties with a lateralized convex baseplate compared aseptic glenoid baseplate loosening (AGBL) between helical blade (n=127) and central peg (n=104) fixation. AGBL occurred in 5.5% versus 1.9% of cases, with no statistically significant difference in loosening rates, survival, revisions, or clinical scores. Both fixation methods showed acceptable, comparable mid-term glenoid stability.
17. Levy G, Charbonnier C, Collin P, et al. Exploratory analysis of shoulder motion strategies for achieving functional hand behind the back in controls and after reverse shoulder arthroplasty. A study from the LaTour group. International Orthopaedics 2026. doi:10.1007/s00264-026-06987-w
Motion capture with 3D reconstructions was used to compare movement strategies for reaching functional hand-behind-the-back in controls versus reverse shoulder arthroplasty patients, with clustering of strategies and correlation to anatomical parameters such as humeral torsion, glenoid version, and scapular type. The study characterizes the complex, variable motion mechanisms underlying this function. Findings may help explain the unpredictable recovery of hand-behind-the-back after reverse shoulder arthroplasty and inform preoperative planning and rehabilitation targeting.
29. Raizah A. Reverse shoulder arthroplasty vs. hemiarthroplasty for proximal humerus fracture: in-hospital outcomes in a national trauma registry. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06453-7
This retrospective cohort study of 3,085 patients from the National Trauma Data Bank (2017-2022) compared in-hospital outcomes of reverse shoulder arthroplasty versus hemiarthroplasty for acute proximal humerus fracture, using multivariable regression and inverse probability of treatment weighting. RSA patients were older and more frequently female than hemiarthroplasty patients. The study addresses whether the rapid shift toward RSA has changed population-level perioperative morbidity, with non-home discharge as the primary outcome.
34. Regling M, Yang Y, de Gast A, et al. Early surgeon experience with a fracture-specific humeral stem for proximal humerus fractures: a multicenter survey of predominantly reverse shoulder arthroplasty cases with an illustrative case. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-10239-8
A prospective multicenter survey collected intraoperative feedback from 26 surgeons on 47 cases using a newly introduced fracture-specific convertible humeral stem, mostly in reverse shoulder arthroplasty for proximal humerus fractures. Early surgeon experience with handling and technical features was generally favourable in this early product surveillance program. Structured early surveillance can help identify usability issues with new fracture stems before widespread adoption.
36. Johri M, Bouzid N, Thibeault JW, et al. Outcomes of primary reverse total shoulder arthroplasty in patients younger than 65 years: A systematic review. Shoulder & Elbow 2026. doi:10.1177/17585732261476954
A systematic review and random-effects meta-analysis of 13 studies (level III, IV) evaluated primary reverse total shoulder arthroplasty in patients younger than 65 years (weighted mean age 55.4 years, follow-up 2-7.8 years). Pooled results showed forward flexion of 133.2°, external rotation of 38.1°, ASES score of 69.5, and notable complication and revision rates. These benchmarks can guide shared decision-making and expectation-setting when offering RTSA to younger patients.
41. Paciotti M, De Rosa A, Franceschetti E, et al. Semi-inlay and onlay humeral stems in reverse shoulder arthroplasty achieve comparable outcomes through different patterns of glenoid and humeral lateralization and distalization: A retrospective study from the FP-UCBM Shoulder Study Group. Shoulder & Elbow 2026. doi:10.1177/17585732261473902
This retrospective study of 199 primary reverse shoulder arthroplasties compared clinical, functional, and radiographic outcomes between onlay and semi-inlay humeral stems, measuring lateralization and distalization angles (LSA, DSA, GLA, HLA, GDA, HDA) on standardised radiographs. Both stem designs achieved comparable clinical results but through different patterns of glenoid and humeral lateralization and distalization. Surgeons can therefore select either design based on bone geometry and preservation preferences, expecting similar functional outcomes.
42. Asaad O, Raval P, Raja H, et al. Management of the dislocated reverse total shoulder arthroplasty: A tertiary centre experience. Shoulder & Elbow 2026. doi:10.1177/17585732261472448
This tertiary centre review of 42 surgically managed dislocated reverse total shoulder arthroplasties (2013-2023) analyzed timing, mechanism, and revision strategies for instability. Most dislocations occurred early (81% within 6 weeks), with loss of compression being the dominant mechanism (78.5%), and stability was restored in 86% of cases, most often via modular component exchange (47.5%). Early postoperative attention to maintaining compression and the availability of modular exchange options are key to successfully managing rTSA dislocation.
51. Stamiris D, Stamiris S, Solovos EM, et al. Primary reverse total shoulder arthroplasty in patients aged ≤65 years: a systematic review and meta-analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100722
This PRISMA-compliant systematic review and meta-analysis of 13 studies evaluated primary reverse total shoulder arthroplasty in patients aged 65 years or younger with at least 2 years of follow-up. Cuff tear arthropathy, massive cuff tears, and glenohumeral osteoarthritis were the leading indications; rTSA significantly improved range of motion and all major patient-reported outcome measures, with an overall complication rate of 14.23%. The results support expanding rTSA use in younger adults while highlighting the need to counsel on complication and revision risk.
57. Isenberg A, Gagnon J, Maunder D, et al. A systematic review of surgical treatment of reverse shoulder arthroplasty associated acromial and scapular spine stress fractures. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100733
This systematic review of 11 studies (88 surgically managed fractures) compared operative versus nonoperative treatment of acromial and scapular spine fractures after reverse shoulder arthroplasty. Surgical fixation achieved higher radiographic union rates (69%-100%) than nonoperative management (30%-79%), though statistical significance was demonstrated in only one study of acute Levy II/III fractures treated within 6 weeks. The findings suggest early surgical fixation should be considered for acute fracture patterns, while better-quality evidence is needed to guide treatment selection for chronic injuries.
66. Moore JW, Northrop MA, Guareschi ME, et al. Biomechanical evaluation of acromion and scapular spine fracture repair techniques systematic review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100714
This systematic review identified 5 biomechanical studies (89 shoulders, including 53 Sawbones and 40 cadaveric scapulae) evaluating fixation techniques for acromion and scapular spine fractures after reverse total shoulder arthroplasty, most commonly Levy type III fractures. The included studies primarily compared double plating (e.g., a 90-90 configured 3.5-mm locking plate combined with a 2.7-mm plate) versus single plating constructs. The review informs surgeons that construct choice for these ~5%-incidence rTSA complications can be guided by available biomechanical evidence, though the literature remains limited.
72. Kosco ED, LaMontagne M, Kapoor N, et al. Surgical management of a traumatic periprosthetic glenoid fracture following a reverse shoulder arthroplasty. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100745
This case report details surgical management of a traumatic periprosthetic glenoid fracture with baseplate failure following reverse shoulder arthroplasty. The authors describe the operative strategy, including fracture fixation and revision considerations. The report provides a management framework for this rare but serious traumatic complication, informing decision-making between fixation and revision surgery.
75. Sewpaul Y, Monga P, Petermann M. Biomechanics of custom glenoid components in reverse total shoulder arthroplasty—a narrative review of concepts for surgeons. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100755
This narrative review synthesizes biomechanical principles and surgical considerations for 3D-printed custom glenoid components in reverse total shoulder arthroplasty used to manage severe glenoid bone loss. Key findings indicate implant stability is optimised through secure central peg fixation, porous press-fit interfaces, maximised bone-implant contact, and avoidance of excessive lateralization, which increases torque and failure risk. The review provides surgeons a framework for CT-based preoperative planning and tailored peg/screw placement, though long-term outcome data validating these designs remain needed.
93. Chul-Hyun Cho B, Sohn H, Kim D. Clinical impact of scapular stress fracture after reverse total shoulder arthroplasty: a single-center propensity score–matched analysis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.024
This single-center propensity score-matched analysis of 551 reverse total shoulder arthroplasties identified 30 cases of postoperative scapular stress fracture and compared outcomes against 84 matched controls. The study evaluated how fracture location, treatment modality, and radiographic union influenced clinical outcomes including VAS, UCLA, ASES scores, and range of motion. The results clarify the clinical significance of scapular stress fracture after rTSA and guide decision-making regarding observation versus intervention based on fracture characteristics.
98. Ulenberg N, Herbstreit S, Dudda M, et al. Risk Factors for instability and dislocation after reverse total shoulder arthroplasty: a systematic review. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.027
This systematic review and meta-analysis of 10 retrospective studies identified 11 significant risk factors for instability or dislocation after reverse total shoulder arthroplasty, including male sex, younger age, opioid use disorder, depressive disorder, revision surgery, nonunion, rotator cuff disease, and prior subluxation, with mechanisms classified per the Abdelfattah (Frankle) system. Meta-analyzed odds ratios quantified factors reported across multiple studies. Clinicians can use these risk profiles to guide implant selection, soft-tissue management, and counseling of higher-risk patients.
103. Martinez-Catalan N, García-Rubio C, Valencia M, et al. Locking Plate Fixation with Cemented Screws versus Delta Xtend Reverse Shoulder Arthroplasty for Complex Proximal Humerus Fractures in the Elderly: A Matched-Pair Comparative Study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.034
This matched-pair comparative study compared cement-augmented locking plate fixation (ORIF-LPc) versus Delta Xtend reverse shoulder arthroplasty in patients over 65 with complex proximal humerus fractures, evaluating clinical and radiographic outcomes, complications, and revision rates with minimum 2-year follow-up. The design directly tests whether cemented screws mitigate the high implant-related complication rates that have driven preference for rTSA. Results inform surgical decision-making between joint-preserving fixation and arthroplasty in this elderly fracture population.
128. Shimada Y, Haraguchi N. Poster 226. Improvement in Glenoid Implant Placement Accuracy in Reverse Shoulder Arthroplasty (RSA) Using Augmented Reality (AR) Goggles, NextAR: A Comparison with Conventional Methods. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00522
This clinical study assessed the accuracy and feasibility of the NextAR augmented reality goggle navigation system for glenoid baseplate positioning in 23 reverse shoulder arthroplasties, comparing results with conventional techniques. It represents the first in vivo evaluation of AR navigation for RSA with this system. Improved placement accuracy would support broader adoption of AR guidance to reduce malposition-related complications.
176. Lin A, McMahon S, Lin R, et al. Paper 24. Self-Removal of Sling Following Reverse Shoulder Arthroplasty Results in No Difference in Outcomes and Complication Rates: Short-Term Results of a Prospective, Single-Blinded, Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00284
In an interim analysis of a prospective, single-blinded randomised controlled trial, reverse shoulder arthroplasty patients were randomised to six weeks of sling wear versus sling removal at their discretion once the nerve block resolved. At three months, range of motion, patient-reported outcomes, and complication rates did not differ between groups. This suggests liberalized, comfort-based sling protocols after RSA are safe and may improve early patient convenience without compromising outcomes.
177. White AE, Varady NH, Finocchiaro A, et al. Paper 25. Patients Return to Sport at Similar Rates Following Reverse and Anatomic Total Shoulder Arthroplasty: A Matched Cohort Study in Active Patients Younger than 65 Years. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00285
In a matched cohort of active patients ≤65 years with glenohumeral osteoarthritis, return to sport rates were compared between anatomic and reverse total shoulder arthroplasty (100 aTSA vs 50 rTSA). Return to sport at any level was similar between groups (76.9% vs 85.7%, p=0.42), with golf the most common sport in both. These findings suggest rTSA is a reasonable option for active younger patients who wish to resume sporting activities.
186. Serbin PA, Noyes C, Johnston GE. Poster 256. Return to Sport Outcomes Following Stemless Total Shoulder Arthroplasty. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00548
In this single-institution series, 401 patients who underwent primary stemless total shoulder arthroplasty were surveyed at minimum 1-year follow-up using a validated return-to-sport instrument alongside ROM, strength, and PROs (SANE, ASES, VAS). The study reported RTS rates, sport levels, limitations, and complications after stemless TSA. Results help counsel active patients considering stemless TSA about expected return to athletic activity and functional recovery.
189. Harjula J, Kanerva M, Kukkonen J, et al. ANTIBIOTIC PROPHYLAXIS IN SHOULDER ARTHROPLASTY – increased number of early infection revisions in patients treated with clindamycin compared to cefuroxime. JSES International 2026. doi:10.1016/j.jseint.2026.101774
Using the Finnish shoulder arthroplasty registry, this study compared early periprosthetic infection revision rates between clindamycin and cefuroxime antibiotic prophylaxis in shoulder arthroplasty patients. Patients receiving clindamycin had a higher number of early infection revisions than those given cefuroxime. The clinical implication is to prefer cephalosporin prophylaxis in shoulder arthroplasty when beta-lactam allergy is not a contraindication, prompting caution with routine clindamycin use.
191. Kawashima I, Takahashi N, Matsuki K, et al. Relationship Between Implant Positioning and Postoperative Scapulohumeral Rhythm Following Reverse Total Shoulder Arthroplasty. JSES International 2026. doi:10.1016/j.jseint.2026.101780
This study examined the relationship between reverse total shoulder arthroplasty implant positioning and postoperative scapulohumeral rhythm using motion analysis. It identified how glenosphere and humeral component placement influences compensatory scapular movement patterns after rTSA. The findings suggest that optimising implant positioning may restore more physiological shoulder mechanics, informing surgical technique and patient expectations for motion quality.
193. Romem R, Joshi T, Boux de Casson F, et al. Navigation-Recorded Plan Execution in Augmented Total Shoulder Arthroplasty Using the Advita GPS System and Implant Platform. JSES International 2026. doi:10.1016/j.jseint.2026.101783
This study evaluated the accuracy of preoperative plan execution in augmented total shoulder arthroplasty using the Advita GPS navigation system and its matched implant platform. Navigation-recorded intraoperative data demonstrated close agreement between planned and achieved implant positioning and sizing. The findings support computer-assisted navigation as a reliable tool for verifying surgical execution in augmented shoulder arthroplasty.
197. Dedeoğlu SS, Ayaz MB, Şahbat Y, et al. Hybrid system design on reverse total shoulder arthroplasty glenoid components. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100757
This technical note presents a hybrid glenoid baseplate design for reverse total shoulder arthroplasty, evaluated with finite element analysis and cadaveric testing. The hybrid construct aimed to improve fixation and stress distribution in compromised glenoid bone stock. The design may reduce the risk of glenoid component loosening, the most common cause of rTSA implant failure.
198. Michael K. Deegan, Gerber CD, Dobrich J, et al. Percutaneous joystick reduction and subsequent reverse total shoulder arthroplasty following chronic anterior dislocation of the shoulder: a case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100758
This case report describes percutaneous joystick (Schanz pin-assisted) reduction of a chronic anterior shoulder dislocation followed by reverse total shoulder arthroplasty. The technique facilitated closed reduction while minimising risk to neurovascular structures in the face of adaptive bony remodeling. It highlights a staged approach for managing chronic dislocation when native joint salvage is not feasible.
199. Garrison C, Bird J, Kamineni S. Reverse total shoulder arthroplasty with total humeral head autograft surgical technique for subtotal glenoid bone loss. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100759
This technical note details a surgical technique for reverse total shoulder arthroplasty with total humeral head autograft reconstruction for subtotal glenoid bone loss. The humeral head is used as a bulk autograft to restore glenoid vault bone stock and support baseplate fixation. The approach offers a biologic alternative to metal augmentation or allograft in severe glenoid deficiency.
200. Gorsky AL, Seilern und Aspang J, Blevins KM, et al. Acromion type III scapular spine nonunion open reduction internal fixation with distal clavicular and pelvic plates. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100761
This technical note describes open reduction and internal fixation of Levy type III acromion/scapular spine nonunions using dual plating with distal clavicular and pelvic reconstruction plates. Dual-plate fixation provided stable construct for healing of these nonunions, which are common after reverse shoulder arthroplasty. The technique addresses a complication associated with pain, dysfunction, and revision risk.
205. Daji A, John DQ, Burzynski C, et al. Prognostic value of the Neer and Mayo-Fundacion Jimenez Diaz classifications in reverse shoulder arthroplasty for proximal humerus fractures. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100767
The prognostic value of the Neer and Mayo-Fundacion Jimenez Diaz (Mayo-FJD) classifications was compared in patients undergoing reverse total shoulder arthroplasty for non-reconstructible proximal humerus fractures. The Mayo-FJD system, which has shown better reliability than Neer, was assessed for its ability to predict outcomes. Findings inform which classification system surgeons should use when counseling patients and planning reverse arthroplasty for proximal humerus fractures.
209. Huff S, Sinkler MA, Gillespie R, et al. Glenohumeral allograft capsular reconstruction for recalcitrant instability of reverse total shoulder arthroplasty: a novel technique. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100774
The authors describe a novel surgical technique using glenohumeral allograft capsular reconstruction to address recalcitrant instability after reverse total shoulder arthroplasty. The technical note outlines the operative steps for augmenting deficient capsular tissue with allograft. It offers surgeons an additional salvage option when instability persists despite standard revision strategies, though outcomes data are needed to validate the approach.
210. Patel M, Eischeid A, Parmar R, et al. Cancellous allograft bone dowels for structural grafting in revision to reverse shoulder replacement. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100775
This technical note presents the use of cancellous allograft bone dowels for structural grafting of contained glenoid defects encountered during revision to reverse shoulder arthroplasty. The technique aims to restore central glenoid volume and support secure baseplate fixation after component removal causes bone loss. It provides a practical grafting option for managing cavitary glenoid deficiency, with clinical results pending formal evaluation.
214. Thorne T, Alvandi B, Guy C, et al. Ligation of the anterior humeral circumflex artery ablates blood flow to the lesser tuberosity osteotomy in a cadaveric model. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100781
In a cadaveric model, the authors quantified lesser tuberosity perfusion after ligation of the anterior humeral circumflex artery (AHCA) in the setting of lesser tuberosity osteotomy (LTO) used during shoulder arthroplasty. Ligation of the AHCA ablated blood flow to the LTO fragment, confirming the artery's dominant role in its perfusion. This suggests surgeons should preserve the AHCA when performing LTO to reduce the risk of the reported nonunion rates as high as 13%.
223. Allen M, Jhaveri A, Zhao S, et al. Preoperative Deltoid Fatty Infiltration as a Predictor of Outcomes After Reverse Total Shoulder Arthroplasty: A Systematic Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100835
This systematic review examined preoperative deltoid fatty infiltration as a predictor of outcomes following reverse total shoulder arthroplasty. The evidence suggests that greater degrees of deltoid fatty infiltration are associated with inferior postoperative outcomes. Preoperative imaging assessment of deltoid quality may help with patient selection and prognostic counseling before reverse shoulder arthroplasty.
226. Quemener-Tanguy A, Ramadan SE, Menu G, et al. CT analysis of glenoid size and bone depth: insights for baseplate fixation in reverse shoulder arthroplasty.. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100846
This CT-based morphometric analysis quantified glenoid size and bone depth to inform baseplate fixation in reverse shoulder arthroplasty. The analysis characterized glenoid dimensions relevant to baseplate purchase and identified variation that may limit fixation in some patients. Clinically, the data support preoperative CT assessment of glenoid bone stock to guide baseplate selection, positioning, and fixation strategy in RSA.
231. Albadran AA, Alqahtani SM, Pacheco VA, et al. Radiographic Assessment of Reverse Shoulder Arthroplasty: A Narrative Review of Postoperative Parameters and Measurements. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100843
This narrative review summarized postoperative radiographic parameters and measurement methods used to assess reverse shoulder arthroplasty. The review compiled definitions and techniques for evaluating RSA positioning, including glenoid and humeral side measurements. Clinically, it provides a reference framework for standardised radiographic follow-up and complication detection after RSA.
235. Beijer E, van den Bekerom MP, Derksen RJ. Successful Glenoid Defect Management with Antibiotic-Eluting Bone Graft Substitute Following Baseplate Removal in Two-Stage Revision Reverse Shoulder Arthroplasty: A Case Report and Surgical Considerations. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100866
This case report presents two-stage revision reverse shoulder arthroplasty in which an antibiotic-eluting bone graft substitute was used to manage a glenoid defect after baseplate removal during the first stage. The authors report successful infection control and glenoid reconstruction allowing successful second-stage reimplantation. The clinical implication is that antibiotic-eluting graft substitutes may offer a viable option for managing glenoid bone loss in infected revision shoulder arthroplasty.
240. Kraus M, Warnhoff M, Endell D, et al. Restoring Glenoid Bone Stock in Failed Anatomic Shoulder Arthroplasty: A Cement-Impression Technique Using Femoral Head Allograft. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100870
This article describes a cement-impression technique using femoral head allograft to restore glenoid bone stock in failed anatomic shoulder arthroplasty. The authors detail the surgical steps of shaping the graft using a cement impression to match the glenoid defect. The clinical implication is that this technique may provide a reproducible option for managing glenoid bone deficiency during revision shoulder arthroplasty.
243. Nguyen TQ, Gill DR, Corfield S, et al. Revision risk of cross-linked versus non-crosslinked polyethylene in reverse shoulder arthroplasty: an analysis of 63,502 cases from the Australian Orthopaedic Association National Joint Replacement Registry. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.003
Using 63,502 primary stemmed reverse total shoulder arthroplasties from the Australian Orthopaedic Association National Joint Replacement Registry (2006-2024), revision rates of highly crosslinked versus non-crosslinked polyethylene glenospheres and humeral cups were compared across osteoarthritis, rotator cuff arthropathy, and fracture diagnoses. Cumulative percent revision and hazard ratios were calculated by implant type and diagnosis. The results provide registry-level evidence on whether crosslinked polyethylene affects revision risk in reverse shoulder arthroplasty, guiding implant selection.
245. Kinnair A, Lädermann A, Daniel C, et al. Reliability of the Classification for Assessing Hand Behind the Back Following Reverse Shoulder Arthroplasty.. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.005
In a prospective observational study of 116 shoulders after reverse shoulder arthroplasty, two blinded observers applied both the traditional vertebral-level method and a new three-type HBB Classification (unable, assisted/non-fluent, fluent unassisted hand-behind-back) during the same clinical session. Interobserver reliability was compared using percent agreement and reliability statistics. The study tests whether this bedside motion-pattern classification is more reliable than vertebral-level measurements for assessing hand-behind-back function, a key activity of daily living after rTSA.
246. Pearsall C, Lachance A, Whittemore C, et al. Comparing Inferiorized and Lateralized Glenospheres in Reverse Total Shoulder Arthroplasty Using the LimaCorporate SMR Reverse Shoulder System: A Single-Center Analysis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.006
A single-surgeon retrospective review compared 329 inferiorized versus 131 lateralized glenospheres in reverse total shoulder arthroplasty using the LimaCorporate SMR system, with competing-risks analysis of reoperation (accounting for death) and inverse probability weighting to adjust for confounding. Patient-reported outcomes (ASES, VAS), reoperation, and mortality were compared between glenosphere designs. The analysis provides comparative effectiveness data to guide glenosphere selection in rTSA.
247. Molokwu BO, Xu JJ, Myerson CL, et al. Clinical and Radiographic Outcomes of Chronic Anterior Dislocations Treated with Reverse Total Shoulder Arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.007
In a retrospective propensity-matched cohort study, patients undergoing reverse total shoulder arthroplasty for chronic locked anterior dislocation were matched 1:3 to rTSA patients treated for proximal humerus fracture at a single academic center. Clinical and radiographic outcomes, complications, stiffness, and instability were compared between the two indications. The study tests the hypothesis that chronic dislocation represents a higher-risk indication with inferior postoperative outcomes, refining expectations for this challenging scenario.
248. Boubekri AM, Zmistowski B, Devana SK, et al. Predictors of External Rotation Recovery following Reverse Shoulder Arthroplasty in Patients with Preoperative Lag Signs. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.009
In a retrospective cohort of 55 primary reverse shoulder arthroplasty patients with preoperative external rotation lag signs, active and passive external rotation in adduction (ER1) and abduction (ER2) were measured pre- and postoperatively, alongside radiographic parameters (LSA, DSA, Hamada grade). ROC analysis identified preoperative motion thresholds predicting functional ER recovery (ER1 ≥30°, ER2 ≥60°). The study defines predictors of external rotation recovery in posterior rotator cuff-deficient patients, aiding preoperative counseling and expectation setting.
250. de Bruin LJ, Brinke BT, Oomen R, et al. Migration patterns of the humeral component of the stemless Simpliciti Shoulder System in stemless anatomic total shoulder arthroplasty A radiostereometric and clinical study with 60-month follow-up. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.011
In a prospective cohort of 23 patients, model-based radiostereometric analysis tracked migration of the stemless Simpliciti humeral component for 60 months after anatomic total shoulder arthroplasty, alongside clinical scores. Most implants showed limited migration, though a subset demonstrated continuous migration between 24 and 60 months, with clinical outcomes reported alongside. The findings suggest stemless humeral fixation is generally stable at 5 years, but continuous migration may serve as an early warning sign for long-term failure.
251. Zabiba A, Menendez ME. Public Perceptions of Robotic-Assisted Shoulder Arthroplasty in the United States. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.012
A cross-sectional survey of 615 US adults recruited via the Prolific crowdsourcing platform assessed public perceptions of robotic-assisted shoulder arthroplasty. Most respondents believed robotics improves implant accuracy, outcomes, complications, and recovery, yet 62% still preferred a higher-volume non-robotic surgeon over a lower-volume robotic surgeon. Surgeon experience appears to outweigh technology in patient decision-making, suggesting robotic adoption should be paired with attention to volume and counseling.
253. Mason TW, Lauck BJ, Glover MA, et al. Why Primary Reverse Total Shoulder Arthroplasties Fail Today? A Systematic Review and Meta-Analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100855
This systematic review and meta-analysis pooled studies reporting reasons for failure of primary reverse total shoulder arthroplasty to characterize contemporary failure modes. The analysis identifies the current leading causes of failure, including infection, instability, periprosthetic fracture, component loosening, and neurologic complications, with updated proportions versus prior eras. Understanding the modern failure profile can guide implant design, surgical technique, and surveillance priorities.
255. Shinwari H, Ceesay B, Chaudhry H, et al. Modifiable Preoperative Physiological Predictors of Length of Stay Following Shoulder Arthroplasty: A Systematic Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100863
This systematic review synthesized evidence on modifiable preoperative physiological factors predicting length of stay after shoulder arthroplasty. Identified predictors include parameters such as anemia, nutritional status, glycemic control, and cardiopulmonary fitness that can be optimised before surgery. Preoperative optimization of these factors may shorten hospitalization and support same-day discharge and enhanced recovery pathways.
Proximal Humerus Fracture Care (17)¶
5. Michelitsch C, Stillhard PF, Zindel C, et al. Locking plate fixation for proximal humerus fractures: are four proximal screws adequate? A clinical and radiological analysis of 105 consecutive cases. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06417-x
In 105 patients with displaced proximal humerus fractures treated with locking plate fixation, outcomes were compared between those with four proximal (cranial) screws and those with more than four. Functional results (Constant-Murley Score) and radiological stability were comparable between groups. Four proximal screws appear adequate when aiming devices limit screw number, challenging the assumption that more screws are needed.
29. Raizah A. Reverse shoulder arthroplasty vs. hemiarthroplasty for proximal humerus fracture: in-hospital outcomes in a national trauma registry. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06453-7
This retrospective cohort study of 3,085 patients from the National Trauma Data Bank (2017-2022) compared in-hospital outcomes of reverse shoulder arthroplasty versus hemiarthroplasty for acute proximal humerus fracture, using multivariable regression and inverse probability of treatment weighting. RSA patients were older and more frequently female than hemiarthroplasty patients. The study addresses whether the rapid shift toward RSA has changed population-level perioperative morbidity, with non-home discharge as the primary outcome.
34. Regling M, Yang Y, de Gast A, et al. Early surgeon experience with a fracture-specific humeral stem for proximal humerus fractures: a multicenter survey of predominantly reverse shoulder arthroplasty cases with an illustrative case. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-10239-8
A prospective multicenter survey collected intraoperative feedback from 26 surgeons on 47 cases using a newly introduced fracture-specific convertible humeral stem, mostly in reverse shoulder arthroplasty for proximal humerus fractures. Early surgeon experience with handling and technical features was generally favourable in this early product surveillance program. Structured early surveillance can help identify usability issues with new fracture stems before widespread adoption.
54. Akhoundzadeh D, van Wonderen SF, Hepkema BW, et al. Treatment of extra-articular scapula fracture malunion using pre-operative three-dimentional printing: a case report and overview of the literature. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100716
This case report with literature overview describes the use of preoperative three-dimensional printing to plan corrective surgery for an extra-articular scapula fracture malunion. The authors detail the workflow of patient-specific 3D modeling and its application in deformity correction of the scapula. The report illustrates how 3D printing technology can aid surgical planning for complex scapular malunions, a rare and technically challenging problem.
62. Phan N, Sayegh G, Cal EM, et al. Scapular open reduction internal fixation using a distal clavicle plate: a surgical technique. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100741
This technical note presents a surgical technique for open reduction internal fixation of displaced scapular body fractures using a distal clavicle plate, typically via a Judet approach with dual plating. Because scapular fractures are rare (<1% of fractures) and most extra-articular injuries are treated nonoperatively, the authors provide guidance for the subset of displaced fractures requiring operative fixation. The technique gives surgeons a practical plating option for restoring anatomic alignment in these uncommon high-energy injuries.
78. Giovannetti de Sanctis E, Bige B, Bronsard N, et al. The ORIN—open reduction and intramedullary nailing—technique for 4-part proximal humerus fractures. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100746
This technical note presents the ORIN technique, combining open reduction with intramedullary nailing, for managing 4-part proximal humerus fractures, a pattern with high complication rates and ongoing debate over optimal fixation. The authors describe a surgical approach that leverages the advantages of antegrade nailing while addressing fragment instability through open reduction. The technique offers surgeons an alternative to locking plates and reverse arthroplasty in select severely displaced or nonimpacted fractures.
103. Martinez-Catalan N, García-Rubio C, Valencia M, et al. Locking Plate Fixation with Cemented Screws versus Delta Xtend Reverse Shoulder Arthroplasty for Complex Proximal Humerus Fractures in the Elderly: A Matched-Pair Comparative Study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.034
This matched-pair comparative study compared cement-augmented locking plate fixation (ORIF-LPc) versus Delta Xtend reverse shoulder arthroplasty in patients over 65 with complex proximal humerus fractures, evaluating clinical and radiographic outcomes, complications, and revision rates with minimum 2-year follow-up. The design directly tests whether cemented screws mitigate the high implant-related complication rates that have driven preference for rTSA. Results inform surgical decision-making between joint-preserving fixation and arthroplasty in this elderly fracture population.
137. Obana KK, Ren M, Luzzi AJ, et al. Poster 247. Bot vs. Doc – Who is Better at Reading Proximal Humerus Fracture X-Rays?. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00541
ChatGPT-5 was tested against orthopaedic surgeons at four training levels for identifying proximal humerus fractures on 70 shoulder radiographs from the MURA dataset. The model achieved only 67.1% overall accuracy (sensitivity 61.8%, specificity 74.3%), underperforming human readers. Current AI chatbots should not be relied upon for radiographic fracture diagnosis in clinical decision-making.
183. Dove H, Aiken C, Dreiling E, et al. Poster 241. Outcomes of Operative and Non-Operative Midshaft Clavicle Fractures in a Young and Athletic Population. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00535
This retrospective cohort compared operative versus nonoperative management of acute midshaft clavicle fractures in adolescents aged 10-18, many of them competitive athletes, with minimum two-year follow-up. Patient-reported outcomes and return-to-sport rates were contrasted between treatments, alongside revision surgery data. Results inform shared decision-making regarding fracture management in young athletes, where operative fixation may facilitate faster return to sport despite reoperation risks.
194. Mennes SR, Meesters AM, van den Bekerom MP, et al. Corrective Osteotomies of Malunited Proximal Humerus Fractures with 3D Patient-specific guides: A Feasibility Study. JSES International 2026. doi:10.1016/j.jseint.2026.101784
This feasibility study assessed corrective osteotomy for malunited proximal humerus fractures using 3D preoperative planning and patient-specific guides. The technique proved feasible with accurate execution of planned corrections and acceptable clinical outcomes. Patient-specific instrumentation offers a practical alternative for managing complex proximal humeral malunions.
203. MacLeay C, Murphy J, Giglio V, et al. In older adults undergoing surgical fixation or arthroplasty following upper limb fractures, does frailty predict post-operative complications and mortality? A systematic review and meta-analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100764
A systematic review and meta-analysis examined whether pre-operative frailty predicts post-operative complications and mortality in older adults undergoing surgical fixation or arthroplasty for upper limb fractures, with secondary outcomes including reoperation, discharge destination, and length of stay. Frailty was associated with increased post-operative mortality and complications. Routine frailty assessment should be incorporated into pre-operative risk stratification and shared decision-making for elderly upper limb fracture patients.
205. Daji A, John DQ, Burzynski C, et al. Prognostic value of the Neer and Mayo-Fundacion Jimenez Diaz classifications in reverse shoulder arthroplasty for proximal humerus fractures. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100767
The prognostic value of the Neer and Mayo-Fundacion Jimenez Diaz (Mayo-FJD) classifications was compared in patients undergoing reverse total shoulder arthroplasty for non-reconstructible proximal humerus fractures. The Mayo-FJD system, which has shown better reliability than Neer, was assessed for its ability to predict outcomes. Findings inform which classification system surgeons should use when counseling patients and planning reverse arthroplasty for proximal humerus fractures.
220. Prifti X, Chapleau J, Sandman E, et al. Retrospective study comparing first- and new-generation proximal humerus locking plates in 152 proximal humerus fracture cases. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100789
This retrospective consecutive cohort study compared radiographic stability and reduction quality between first-generation and new-generation proximal humerus locking plates in 152 patients treated at a level 1 trauma center. Measurements of neck-shaft angle, calcar displacement, greater tuberosity height, humeral head offset, and plate position showed no significant differences between plate generations. The findings suggest newer plate designs do not substantially improve maintenance of reduction, and other factors may be more important determinants of radiographic outcomes.
227. Arnold E, Knusel K, Ranam SS, et al. Implant-Specific Rates of Post-Operative Displacement and Re-operation in Isolated Greater Tuberosity Fracture Open Reduction Internal Fixation. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100849
This study compared implant-specific rates of postoperative displacement and reoperation after open reduction internal fixation of isolated greater tuberosity fractures. The authors found that rates of fragment displacement and reoperation varied by implant type used for fixation. Clinically, the results can guide implant selection for greater tuberosity ORIF and inform counseling regarding fixation failure risk.
241. Haroun HK, Khater AH, Kamel ME, et al. Accuracy of Clinical and Radiographic Measurements for Detecting Significant Shortening in Acute Midshaft Clavicle Fractures: A Cross-Sectional Study with CT Scan as the Reference Standard. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100860
In a cross-sectional study of acute midshaft clavicle fractures, clinical measurements and plain radiographic techniques for assessing fracture shortening were compared against CT scan as the reference standard. The authors determined the accuracy, sensitivity, and specificity of each non-CT method for detecting shortening considered significant for surgical decision-making. The findings inform clinicians about which bedside and radiographic measurements can be trusted when deciding on operative versus nonoperative management without routine CT.
244. Sarıkaş DM, Kapıcıoğlu DM, Şahin DK, et al. Does Immobilization Method Make a Difference in Conservative Management of Proximal Humeral Fractures? A Prospective Randomized Trial. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.004
In a prospective randomised trial, 105 patients with conservatively treated proximal humeral fractures were randomised to a Velpeau bandage, a standard shoulder-arm sling, or a padded shoulder-arm sling. Clinical outcomes (SSV, VAS, ASES, DASH, Constant, range of motion) and radiological outcomes were compared among the three immobilisation methods. The study addresses whether the choice of immobilisation device affects outcomes, helping define optimal conservative treatment protocols for proximal humerus fractures.
256. Mennes SR, de Klerk HH, Spek RW, et al. What Is the Preferred Timing for Surgery after Proximal Humerus Fractures: an e-Modified Delphi Survey Study. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100865
An international consortium of shoulder surgeons participated in an e-modified Delphi survey to establish consensus on preferred surgical timing after proximal humerus fractures. The survey yielded consensus statements on timing windows for operative fixation and arthroplasty relative to injury. These consensus recommendations can standardize care pathways and inform future prospective studies on optimal surgical timing.
Arthroplasty Perioperative Care (24)¶
11. Lorentz S, Hurley ET, Levin JM, et al. Length of stay, discharge disposition, and 90-day emergency department visits and readmissions following primary shoulder arthroplasty in octogenarians vs septuagenarians. Shoulder & Elbow 2026. doi:10.1177/17585732261483462
This retrospective single-center cohort study compared 630 septuagenarians and 168 octogenarians undergoing primary anatomic or reverse total shoulder arthroplasty, analyzing length of stay, discharge disposition, and 90-day emergency department visits and readmissions with multivariable regression adjusting for sex, ASA score, and procedure type. Octogenarians were more often female and more frequently underwent reverse TSA, but the study's key comparison was whether advanced age independently affected short-term perioperative outcomes. The findings help inform preoperative planning and patient counseling regarding age as a risk factor after shoulder arthroplasty.
20. Chebi P, Choubey A, Rutherford R, et al. Investigating the impact of Glucagon-like peptide-1 therapy on total shoulder arthroplasty outcomes. International Orthopaedics 2026. doi:10.1007/s00264-026-06984-z
Using the PearlDiver database, 95,566 total shoulder arthroplasty patients were matched 10:1 on GLP-1 receptor agonist use, obesity status/class, and comorbidities to assess 90-day readmissions, ED visits, and medical and orthopaedic complications. The analysis addresses conflicting prior database findings by stratifying across obesity classes. Results inform perioperative risk counseling for GLP-1 users undergoing shoulder arthroplasty.
22. Omurzakov AM, Omurzakov A, Oquendo Y, et al. Social determinants of health disparities are associated with lower total shoulder arthroplasty utilization and increased medical complications: A propensity-matched analysis. Shoulder & Elbow 2026. doi:10.1177/17585732261476678
A propensity-matched TriNetX analysis of 84,767 patients per cohort with glenohumeral osteoarthritis compared total shoulder arthroplasty utilisation and complications by social determinants of health disparities. Patients with SDOH disparities had lower TSA utilisation (3.14% vs 5.78%) and higher rates of ED visits, cardiac, renal, infectious, pulmonary, and mechanical complications. Findings highlight SDOH as a target for improving access and perioperative outcomes in shoulder arthroplasty.
40. Howard M, Thomas W, Evans J, et al. Pre-operative biopsies in the revision setting – helpful or harmful?. Shoulder & Elbow 2026. doi:10.1177/17585732261474495
A single-center cohort study of 81 presumed aseptic revision shoulder or elbow procedures compared outcomes in 40 patients who had pre-operative biopsies versus 41 who did not. Pre-revision biopsy showed low sensitivity (54%), with some previously positive infections cleared and six new infections emerging among initially negative biopsies, while 13 unbiopsied patients had positive intraoperative cultures successfully treated with antibiotics. Routine pre-revision biopsies for presumed aseptic revisions may be unhelpful and should not replace intraoperative sampling and appropriate postoperative treatment.
58. Shinwari H, Butt A, Shinwari HT, et al. Impact of enhanced recovery after surgery protocols on patient-reported outcomes and satisfaction following shoulder arthroplasty: a systematic review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100725
This systematic review of 18 studies (1,722 patients) evaluated enhanced recovery after surgery protocols, rehabilitation timing and analgesic regimens, following anatomic total shoulder arthroplasty and reverse shoulder arthroplasty. Delayed rehabilitation after reverse arthroplasty improved early pain and function scores at 6 months without compromising long-term outcomes. These results support tailoring early rehabilitation intensity after reverse arthroplasty while confirming that optimised perioperative protocols can improve early patient-reported outcomes without sacrificing durable results.
79. Mili-Schmidt V, Hallberg K, Axenhus M. Swedish trends in excision arthroplasty of the acromioclavicular joint during 2008-2023: a population-based register study. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100751
This population-based register study analyzed 41,555 acromioclavicular joint excision arthroplasties in Sweden from 2008 to 2023, calculating incidence trends and forecasting to 2040. Incidence rose substantially in both sexes, men from 14.6 to 45.3 and women from 10.4 to 32.6 per 100,000, with men consistently undergoing more procedures. The marked and continuing increase suggests growing utilisation of this procedure, with projected further rises that have implications for surgical training and resource planning.
89. Avram GM, Indelli PF, Violante B, et al. GLP‐1 receptor agonists in hip, knee and shoulder arthroplasty: Implications for obesity, osteoarthritis, metabolic optimisation and complications. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70557
This editorial reviews the emerging role of GLP-1 receptor agonists in patients undergoing hip, knee, and shoulder arthroplasty, synthesizing evidence on weight loss, metabolic optimization, inflammation, and perioperative outcomes such as periprosthetic joint infection and readmission. It concludes that while retrospective data suggest benefits, the evidence remains observational with significant confounding and inconsistent reporting of drug class, dose, and duration. Clinicians should consider GLP-1 agonists as a potential tool for metabolic optimization in arthroplasty candidates, but higher-quality trials are needed before firm treatment recommendations can be made.
94. Gill DR, Corfield S, McCau M, et al. The impact of glenoid polyethylene type, humeral head size and composition on revision risk following primary anatomic total shoulder arthroplasty for osteoarthritis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.021
This national registry cohort study of primary anatomic total shoulder arthroplasty for osteoarthritis examined how glenoid polyethylene type (highly cross-linked vs. non-cross-linked), humeral head size, and head composition affect revision risk. Using Kaplan-Meier survivorship and adjusted Cox models, the analysis tested whether the polyethylene-humeral head interaction influences implant longevity. The findings inform implant selection strategies aimed at reducing glenoid loosening and polyethylene wear-related failures.
102. Frappa N, Listopadzki TR, Lutnick E, et al. Evaluation of Acid Production as a Metabolic Phenotype in Cutibacterium acnes Shoulder Periprosthetic Joint Infections. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.032
This exploratory study measured acid production (ΔpH) and growth (ΔOD600) in 40 clinical Cutibacterium acnes isolates from shoulder periprosthetic joint infections, stratified by hemolysis and aerotolerance with clindamycin-resistant isolates force-included, and classified infection status by 2018 ICM criteria. Clindamycin-resistant isolates (27.5%) showed significantly different acid production, suggesting metabolic phenotype may add information beyond culture positivity. Acid production could potentially help distinguish true infection from contamination, though clinical validation is needed.
105. Wang Z, King J, Prentice A, et al. Metabolic Bone Disease Care Practice Patterns and the Correlation Between Computed Tomography and Fracture Risk Assessment Tool Score in Patients Undergoing Total Shoulder Arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.002
This retrospective study of primary total shoulder arthroplasty patients examined metabolic bone disease care practices and correlated CT-derived Hounsfield unit measurements of the humeral head and glenoid with FRAX fracture risk scores. It characterized how often high-risk patients (FRAX major >20 or hip >3) receive metabolic bone workup and treatment, and whether CT HU values can serve as a surrogate for fracture risk assessment. The clinical implication is that routine metabolic bone screening and CT-based bone quality assessment may help identify TSA patients at elevated periprosthetic fracture risk who would benefit from preoperative optimization.
106. Shrirang PS, Bansal P, Abbot V, et al. Comment on "The effect of pretreatment of the pilosebaceous unit on Cutibacterium acnes burden during shoulder arthroplasty: a randomized controlled trial". Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.014
This is a published comment letter responding to a randomised controlled trial on pretreatment of the pilosebaceous unit to reduce Cutibacterium acnes burden during shoulder arthroplasty. As a correspondence piece, it offers the authors' critique or methodological perspective on the original trial rather than presenting new data. Its clinical value lies in contextualizing the trial's findings on preoperative skin/soft tissue preparation strategies for infection prevention in shoulder arthroplasty.
107. Clements J, Shen V, Tan D, et al. Data-Driven Preoperative Hemoglobin Strata Predict Blood Transfusion and Surgical Complication Risk Following Total Shoulder Arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.015
Using the TriNetX database, this study applied stratum-specific likelihood ratio analysis to define data-driven preoperative hemoglobin thresholds predicting 90-day blood transfusion and complications after total shoulder arthroplasty. It identified four risk strata for men (<12, 12-13, 13-14.5, >14.5 g/dL) and five for women (<10, 10-11, 11-12, 12-13, >13 g/dL), with lower strata showing progressively higher transfusion and complication risk. These sex-specific thresholds can guide preoperative anemia screening and optimization protocols to reduce perioperative morbidity.
146. Nazzal EM, Lin RT, McMahon S, et al. Poster 243. Long-Term Survival Rate of Hybrid All-Polyethylene Glenoid Anatomic Total Shoulder Arthroplasty Implants at 2- and 5-Years Postoperatively. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00537
This multicenter retrospective registry study evaluated 120 anatomic total shoulder arthroplasties using a hybrid all-polyethylene glenoid with peripheral cement and central press-fit osseous integration, assessing radiographic loosening (Lazarus classification), revision rates, ROM, and PROs at 2 and 5 years. The key question was whether this hybrid fixation design maintains glenoid survivorship comparable to fully cemented implants. Favourable mid-term results would support hybrid glenoid fixation as a durable option in aTSA.
156. Hyun A, Suhr M, Dines JS. Poster 259. Diagnostic Performance of a Web-Based Shoulder Examination Compared With In-Person Shoulder Examination. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00551
This study compared a web-based, self-guided virtual shoulder examination (six modified special tests) with in-person examination in patients with unilateral shoulder pain regarding interobserver reliability and diagnostic accuracy. Patients completed the virtual exam at the surgeon's office, allowing direct comparison with the clinician-performed exam. Results establish whether telehealth shoulder evaluation can reliably diagnose a broad range of shoulder pathology.
166. Lum ZC, Dallas-Orr D, Zabiba A, et al. Poster 264. Postoperative Follow-Up Visit Reimbursement in Shoulder Surgery - Does CPT Code 99024 Need An Update?. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00556
This claims-based study of 705,388 shoulder arthroscopy and 149,310 total shoulder arthroplasty patients (2017-2023) used CPT code 99024 to quantify postoperative follow-up visit frequency within the 90-day global period. Mean visit frequency exceeded the assumed 2 visits (2.26 for arthroscopy, 2.41 for TSA), with high-utilisation patients showing greater comorbidity burdens. The results support revising the current global period reimbursement model to better reflect actual postoperative care intensity and patient complexity.
182. Hoenecke HR, Gruhonjic I, Penn JK, et al. Poster 257. Interscalene Brachial Plexus Block with and without Liposomal Bupivacaine for Postoperative Pain Control in Total Shoulder Arthroplasty. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00549
In this randomised comparison, 126 total shoulder arthroplasty patients received interscalene brachial plexus blocks with either liposomal bupivacaine (n=56 analyzed) or standard bupivacaine (n=57 analyzed). The trial evaluated whether the longer-acting liposomal formulation improves postoperative analgesia and reduces opioid consumption. Findings guide anaesthetic choice for multimodal pain management in shoulder arthroplasty.
187. Sano T, Obata S, Hasegawa M. Effective range in the proximal shoulder by ultrasound-guided interscalene brachial plexus block. JSES International 2026. doi:10.1016/j.jseint.2026.101772
This cadaveric/anatomic investigation mapped the effective anaesthetic distribution of ultrasound-guided interscalene brachial plexus block across the proximal shoulder. It defined which shoulder regions achieve reliable sensory blockade and where coverage is incomplete. Clinically, the results guide selection of interscalene blocks for shoulder surgery and anticipate need for supplemental regional techniques or local infiltration in poorly covered areas.
189. Harjula J, Kanerva M, Kukkonen J, et al. ANTIBIOTIC PROPHYLAXIS IN SHOULDER ARTHROPLASTY – increased number of early infection revisions in patients treated with clindamycin compared to cefuroxime. JSES International 2026. doi:10.1016/j.jseint.2026.101774
Using the Finnish shoulder arthroplasty registry, this study compared early periprosthetic infection revision rates between clindamycin and cefuroxime antibiotic prophylaxis in shoulder arthroplasty patients. Patients receiving clindamycin had a higher number of early infection revisions than those given cefuroxime. The clinical implication is to prefer cephalosporin prophylaxis in shoulder arthroplasty when beta-lactam allergy is not a contraindication, prompting caution with routine clindamycin use.
213. Giorgini A, Addala H, De Pasquale L, et al. Comprehensive arthroscopic management procedure and autologous microfragmented adipose tissue infiltration in mild-to-moderate glenohumeral osteoarthritis: two-year follow-up outcomes. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100778
This study evaluated two-year clinical outcomes of the Comprehensive Arthroscopic Management (CAM) procedure combined with intra-articular autologous microfragmented adipose tissue (Lipogems) injection in patients with mild-to-moderate concentric glenohumeral osteoarthritis. The combination appeared to provide durable clinical improvement at two years. However, because there was no CAM-only control group, the independent contribution of the mFAT injection cannot be determined, limiting conclusions about its added value.
217. Aguilar-Gonzalez J, Vismara V, Lamo-Espinosa JM, et al. Pyrocarbon implants in shoulder arthroplasty: a systematic review and meta-analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100784
This systematic review and meta-analysis evaluated pyrocarbon implants in shoulder arthroplasty, pooling data on implant survival, clinical outcomes, and complications across included studies. The findings suggest pyrocarbon implants demonstrate favourable outcomes with potentially lower rates of complications such as periprosthetic osteolysis compared with conventional materials. Clinically, pyrocarbon may be a viable alternative implant material in selected shoulder arthroplasty patients, though higher-quality comparative studies are needed.
234. Shinwari H, Chaudhry H, Ceesay B, et al. Determinants of Prolonged Hospitalisation Following Shoulder Arthroplasty: A Systematic Review of Patient and Health System Factors. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100856
This systematic review synthesized patient and health system factors associated with prolonged hospitalization after shoulder arthroplasty. The review identified determinants such as patient comorbidities and demographic factors alongside system-level variables influencing length of stay. Clinically, recognizing these factors can help optimise preoperative planning, discharge planning, and resource allocation for shoulder arthroplasty patients.
243. Nguyen TQ, Gill DR, Corfield S, et al. Revision risk of cross-linked versus non-crosslinked polyethylene in reverse shoulder arthroplasty: an analysis of 63,502 cases from the Australian Orthopaedic Association National Joint Replacement Registry. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.003
Using 63,502 primary stemmed reverse total shoulder arthroplasties from the Australian Orthopaedic Association National Joint Replacement Registry (2006-2024), revision rates of highly crosslinked versus non-crosslinked polyethylene glenospheres and humeral cups were compared across osteoarthritis, rotator cuff arthropathy, and fracture diagnoses. Cumulative percent revision and hazard ratios were calculated by implant type and diagnosis. The results provide registry-level evidence on whether crosslinked polyethylene affects revision risk in reverse shoulder arthroplasty, guiding implant selection.
251. Zabiba A, Menendez ME. Public Perceptions of Robotic-Assisted Shoulder Arthroplasty in the United States. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.012
A cross-sectional survey of 615 US adults recruited via the Prolific crowdsourcing platform assessed public perceptions of robotic-assisted shoulder arthroplasty. Most respondents believed robotics improves implant accuracy, outcomes, complications, and recovery, yet 62% still preferred a higher-volume non-robotic surgeon over a lower-volume robotic surgeon. Surgeon experience appears to outweigh technology in patient decision-making, suggesting robotic adoption should be paired with attention to volume and counseling.
255. Shinwari H, Ceesay B, Chaudhry H, et al. Modifiable Preoperative Physiological Predictors of Length of Stay Following Shoulder Arthroplasty: A Systematic Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100863
This systematic review synthesized evidence on modifiable preoperative physiological factors predicting length of stay after shoulder arthroplasty. Identified predictors include parameters such as anemia, nutritional status, glycemic control, and cardiopulmonary fitness that can be optimised before surgery. Preoperative optimization of these factors may shorten hospitalization and support same-day discharge and enhanced recovery pathways.
Athletic Shoulder and Elbow (16)¶
37. Bojovic M, Hagert E. Bone stress fractures and injuries of the upper limb in athletes. International Orthopaedics 2026. doi:10.1007/s00264-026-06978-x
This narrative review synthesizes mechanisms, risk factors, imaging features, and management of upper-limb bone stress injuries in athletes, covering the shoulder girdle, arm, forearm, wrist, and hand. Early radiographs may be normal while MRI best detects early stress reactions, and continued loading can progress injury from marrow oedema to cortical disruption. Clinicians should maintain a low threshold for advanced imaging in at-risk athletes to avoid diagnostic delay and guide return-to-sport decisions.
38. Santos GAD, Santos MLD, Solon-Júnior LJF, et al. Association between shoulder pain, muscle strength, and closed kinetic chain performance tests in swimming athletes: Cross-sectional study. Shoulder & Elbow 2026. doi:10.1177/17585732261473900
In a cross-sectional study of 62 competitive swimmers (30 with shoulder pain), hierarchical regression examined associations between shoulder pain, kinetic chain muscle strength, and upper limb performance tests (mCKCUEST, UQYBT, ULRT). Shoulder pain and hip stability (HIPSIT) strength were significant predictors of mCKCUEST performance, while knee extensor and scapular protractor strength explained 35% of UQYBT medial-direction variance. Rehabilitation for swimmers should address distal and proximal kinetic chain strength, not just the shoulder, when targeting upper limb performance.
55. Zediker CR, Srivastava A, Taha R, et al. Upper extremity lacrosse injuries presenting to United States emergency departments – 10 year review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100731
Using National Electronic Injury Surveillance System data from 2014 to 2023, this study estimated national trends in lacrosse-related upper extremity injuries presenting to U.S. emergency departments, yielding an estimated 38,731 injuries over the decade. The shoulder (25.6%) and fingers (20.4%) were the most commonly injured sites, followed by the lower arm, wrist, hand, elbow, and upper arm. These epidemiologic data can guide injury prevention programs, protective equipment design, and resource allocation as lacrosse participation grows.
63. Hatori Y, Tajika T, Shitara H, et al. Is the degree of carrying angle associated with ulnar nerve instability? A cross-sectional study of high school baseball pitchers. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100724
This cross-sectional study used ultrasound to examine 106 high school baseball pitchers during the off-season, grading ulnar nerve instability as absent, subluxation, or dislocation and correlating severity with carrying angle, medial joint space laxity, and clinical measures. The study addressed whether the increased carrying angle seen in pitchers is associated with ulnar nerve instability severity, which had not previously been examined in baseball players. Results inform screening and counseling of young throwing athletes regarding elbow alignment as a potential risk factor for ulnar nerve symptoms.
73. Liu S, Chen AL, Mircoff SE, et al. Pectoralis major tendon repair outcomes: comparison of transosseous tunnel and cortical button fixation techniques. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100742
This retrospective cohort study compared cortical button fixation (n=10) with transosseous tunnel repair (n=9) for pectoralis major tendon ruptures, evaluating patient-reported outcomes, strength, range of motion, and complications at a median follow-up of 48 months. Both techniques produced comparable clinical results, suggesting cortical button fixation is a viable alternative that avoids the stress risers associated with bone tunnels. Surgeons may preferentially choose button fixation to reduce the theoretical risk of humeral fracture without compromising outcomes.
95. Tsukahara Y, Jyoto E, Sato R. Risk of Shoulder/Elbow Injuries and Imaging Abnormalities in Female Collegiate Baseball and Softball Players. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.026
This cross-sectional study of 67 female collegiate baseball and softball players used questionnaires and diagnostic ultrasound to assess shoulder and elbow injury prevalence and structural abnormalities. Shoulder pain was reported by 35.9% of softball and 64.3% of baseball players, with abnormal shoulder ultrasound findings in 79.3% and 100% respectively, indicating high rates of asymptomatic structural pathology. These data underscore the need for injury surveillance and prevention programs tailored to female overhead athletes.
113. Cheng K, Zappa RM, Jump IP, et al. Segmental Momentum Sequencing: Implication for Injury and Performance Between Collegiate Pitchers With Different Arm Slots. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261453310
Markerless motion capture and radar ball tracking were used to quantify the timing of peak angular momentum in the torso, upper arm, forearm, and hand among 363 NCAA Division I pitchers grouped by arm slot (overhand, three-quarter, sidearm). The sequencing of segmental momentum peaks differed by arm slot and predicted ball velocity and shoulder/elbow joint loading. Findings support arm slot, specific biomechanical assessment and training to optimise performance while mitigating upper extremity injury risk.
116. Dillon MR, Mastroianni MA, Frappa N, et al. Sidearm Deliveries Are Associated With Lower Shoulder and Elbow Injury Burden and a Favorable Performance Profile in Major League Baseball: A Cohort Study of 927 Pitchers (2020-2025). Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261470537
This cohort study aggregated Hawk-Eye arm-angle and injury/performance data for 927 MLB pitchers (2020-2025), categorizing them as sidearm, three-quarters, or overhand and comparing injured list days and performance metrics. Sidearm pitchers showed lower cumulative shoulder and elbow injured list burden along with a favourable performance profile, including run prevention and stuff metrics. The findings challenge assumptions that lower arm slots increase injury risk and may inform pitching development and workload strategies.
124. Mastroianni MA, Dillon MR, Muscat J, et al. Paper 47. Return to Play and Performance following Shoulder Labral Repair in Major League Baseball Players. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00305
Researchers assessed return to play and return to performance in 67 Major League Baseball players (39 pitchers, 28 position players) after arthroscopic shoulder labral repair using modern advanced analytics and Statcast metrics rather than traditional statistics. The study also identified preoperative predictors of returning to prior performance levels. Results provide athletes, teams, and clinicians with more nuanced prognostic data for counseling after labral surgery.
126. Takata Y, Takemoto N, Nishimura M, et al. Paper 56. Impact of Youth Baseball Rule Changes on Elbow Screening for Osteochondritis Dissecans of the Humeral Capitellum during Annual Elbow Examinations. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00313
This study evaluated whether stepwise Japanese youth baseball rule changes, pitch count limits in 2019 and inning/time restrictions plus home plate enlargement in 2022, reduced suspected osteochondritis dissecans of the humeral capitellum. Incidence was assessed through a mass ultrasound screening program by comparing cohorts defined by rule implementation timing. Results quantify the effectiveness of regulatory measures in preventing this serious overuse injury in young players.
135. Roach RP, Pazik M, LaMonica T, et al. Poster 166. Educational Interventions Can Improve Injury Prevention Awareness in Baseball Caregivers. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00464
This prospective randomised study of nine high school baseball teams compared three educational conditions, formal PowerPoint lecture, facility-displayed flyers, and control, using pre- and post-season caregiver questionnaires on pitching guidelines and injury prevention knowledge. The key finding was that educational interventions, particularly structured formats, improved caregivers' knowledge of injury prevention guidelines over a season. Clinically, low-cost educational tools can be deployed to engage caregivers in reducing overhead-athlete injury risk.
141. Locascio L, Menta S, Nied S, et al. Poster 198. Relationships Between Fastball Characteristics and Upper Extremity Injuries in Major League Baseball Pitchers. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00495
Statcast data and injury reports from 2018-2024 were analyzed with logistic regression to assess associations between fastball velocity, usage, spin rate, and year-to-year changes with upper extremity injuries in MLB pitchers across seven seasons. The findings clarify which pitch characteristics predict subsequent shoulder and elbow injuries. Results can guide workload and pitch-design decisions aimed at injury prevention.
147. Dickens JF, Hurley ET, Henriquez A, et al. Poster 231. Outcomes following Superior Labral Repairs Based on Mechanism of Injury. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00526
A retrospective review of 204 patients undergoing arthroscopic superior labral repair from 2015-2024 compared outcomes by mechanism of injury: trauma, instability, and chronic repetitive overhead activity, using revision surgery, return to play, ROM, VAS, and SANE as endpoints. Traumatic injuries showed modestly greater forward flexion than instability cases, though the abstract is truncated before full results. The findings suggest mechanism of injury may influence outcomes after superior labral repair and could inform patient counseling.
149. Menta S, Locascio L, Sciascia A, et al. Poster 173. Leg Up or Letdown? Exploring the Link Between Lower-Body Injury and Upper Extremity Injury in MLB Pitchers. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00471
This retrospective cohort study of MLB pitchers (2017-2024) used public injury data and Statcast metrics with multivariable logistic regression to test whether prior lower-extremity injury predicts subsequent same-season upper-extremity injury, adjusting for age, workload, fastball velocity, and a novel pitch-mix entropy metric. It provides large-scale epidemiologic evidence for the kinetic chain hypothesis in professional pitchers. If confirmed, the findings support LE conditioning and injury prevention as a strategy to reduce UE injuries in pitchers.
153. Markes AR, Mohr DS, Arner JW, et al. Poster 252. Diagnostic Utility of Obrien’s, Modified Dynamic Posterior Instability, Modified Whipple, Posterior Apprehension, and Dynamic Scanning in Evaluating Posterior Shoulder Instability in the Throwing Athlete. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00546
This retrospective study evaluated five physical examination maneuvers (O'Brien's, modified dynamic posterior instability, modified Whipple, posterior apprehension, and dynamic scanning), individually and in composite, for predicting the need for posterior labral repair in 77 throwing athletes. Sensitivity, specificity, predictive values, and ROC/AUC analysis were used to determine diagnostic utility. The findings inform which exam maneuvers clinicians can rely on when assessing posterior instability in overhead athletes.
154. Kamijo H, Matsuki K, Takahashi N. Poster 237. Clinical Characteristics and Diagnostic Accuracy of First Rib Stress Fractures in Baseball Players: A Comparative Study with Non-fracture Cases. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00531
This retrospective study compared baseball players with first rib stress fractures to those with shoulder/scapular pain without fracture (2013-2019) to define clinical characteristics and diagnostic accuracy of initial plain radiographs. The authors hypothesized that posterior scapular pain during batting is a distinguishing feature and that fractures are often underdiagnosed despite being visible radiographically. Results guide clinicians toward earlier recognition and appropriate imaging of this rare injury.
Other articles this month¶
3. Saad Berreta R, Villarreal‐Espinosa JB, Vega TF, et al. Improvements in Patient‐Reported Outcome Measures and Range of Motion After Rotator Cuff Repair, Superior Capsular Reconstruction, and Tendon Transfer May Not Necessitate Increases in Acromiohumeral Interval for Massive or Irreparable Rotator Cuff Tears: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70479
This systematic review of 42 studies (1868 patients) examined whether changes in the acromiohumeral interval (AHI) correlate with improvements in patient-reported outcomes and range of motion after rotator cuff repair, superior capsular reconstruction, or tendon transfer for massive/irreparable tears. Improvements in clinical outcomes were not consistently accompanied by AHI increases. AHI change may therefore not be a reliable surrogate for clinical success in treating these tears.
6. Hovsepian JM, Cartaya MA, Glaser J, et al. Surgical anatomy, biomechanics and clinical outcomes of latissimus dorsi transfer for irreparable rotator cuff tears: a review. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-026-07200-9
This review integrates surgical anatomy, biomechanics, fixation strategies, outcomes, and patient selection for latissimus dorsi transfer in irreparable rotator cuff tears. For posterosuperior tears, pain relief and external rotation gains are sustained beyond ten years, with pseudoparesis patients benefiting most, while subscapularis insufficiency and teres minor fatty infiltration predict failure. Careful patient selection and technique choice (including anterosuperior and combined latissimus-teres major transfers) are key to success.
8. Albdewi MJ, Malessy MJ, Saadeh YS. Intraoperative electrodiagnostic testing as a decision-making tool for neonatal brachial plexus palsy: a scoping review. Journal of Hand Surgery (European Volume) 2026. doi:10.1177/17531934261478357
This scoping review of nine studies assessed whether intraoperative electrodiagnostic testing (nerve action potentials, SSEPs, MEPs, CMAPs, EMG) guides surgical decision-making in neonatal brachial plexus palsy. Strategies varied widely across studies, and evidence supporting a clear role in distinguishing neurolysis from nerve reconstruction candidates remains limited. Standardised protocols and further prospective research are needed before routine reliance on intraoperative electrodiagnosis in these infants.
9. Geng Y, Gao J, Bo X, et al. Arthroscopic Glenoid Bone Tunnel and Half Bundle of Peroneus Longus Tendon‐Based Subscapular Sling Procedure and Labral Reconstruction for Anterior Shoulder Instability. Arthroscopy Techniques 2026. doi:10.1002/atn2.70246
The authors describe an arthroscopic subscapular sling technique for recurrent anterior shoulder instability using a half bundle of the peroneus longus tendon routed around the upper two-thirds of the subscapularis and fixed to the anterior glenoid rim via a glenoid bone tunnel. The modified graft harvest and bony fixation aim to provide combined dynamic and static stability with more secure tendon-bone healing while reducing donor-site complications. This technique offers an alternative arthroscopic option for treating recurrent anterior shoulder instability.
12. Kim BT, Kim HJ, Cho HW, et al. A Biologic Hybrid Approach Combining Superior Capsular Reconstruction, Long Head of the Biceps Tendon Rerouting, and Rotator Cuff Repair. Arthroscopy Techniques 2026. doi:10.1002/atn2.70245
This technical note describes a hybrid arthroscopic technique for large to massive posterosuperior rotator cuff tears combining long head of the biceps tendon rerouting as a biologic static stabilizer, dermal allograft superior capsular reconstruction, and triple-row augmentation of remnant cuff tissue. The rationale is to overcome the graft failure, donor-site morbidity, and unpredictable stability associated with isolated techniques for each component. The integrated construct aims to restore superior glenohumeral stability and maximise healing potential in irreparable-appearing cuff tears.
13. Wilkinson M, Groch N, Freestone C, et al. Risk factors and management of atraumatic distal clavicular osteolysis: A scoping review. Shoulder & Elbow 2026. doi:10.1177/17585732261479715
This PRISMA-ScR scoping review of eight studies (483 patients) mapped risk factors, clinical and radiographic features, and surgical indications for atraumatic distal clavicular osteolysis. Bench pressing (49.1%) and weight training (24.4%) were the dominant activity-based risk factors, with loading frequency and intensity implicated; most patients recovered with conservative care, though 16% required surgery after failed nonoperative management. Primary contact clinicians should consider sporting and loading history when evaluating ACJ pain, and MRI findings such as marrow oedema and subchondral fracture aid diagnosis.
19. Daliri M, Khosravi F, Jamali J, et al. What clusters exist among the health care personnel screened for upper extremity musculoskeletal conditions?. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-025-09107-8
Latent class analysis was applied to 4,635 screened healthcare workers to identify subgroups of common self-limiting upper extremity musculoskeletal conditions (e.g., carpal tunnel syndrome, lateral epicondylitis, rotator cuff tendinopathy) among those not seeking care, incorporating biopsychosocial factors. Distinct latent classes of co-occurring conditions were identified. These patterns can inform personalized, comprehensive care strategies for patients presenting with upper extremity complaints.
23. Qin K, Xu Y, Liang W. Regarding “Glenoid Labral Articular Disruption Lesions in the Setting of First‐Time Anterior Shoulder Instability”. Arthroscopy 2026. doi:10.1002/arj.70461
This is a letter to the editor responding to Dvorsky et al.'s matched comparative study of GLAD lesions in first-time anterior shoulder instability, commending the finding that GLAD lesions do not affect outcomes after arthroscopic Bankart repair. The authors raise methodological and interpretive concerns they felt were insufficiently addressed. Clinicians should interpret the original study's conclusions with these caveats in mind.
27. Torres HC, Latorre Jaramillo V, Moreno LA, et al. Arthroscopic Superior Capsule Reconstruction Using Hamstring Allograft in V‐Shaped Configuration. Arthroscopy Techniques 2026. doi:10.1002/atn2.70212
The authors describe an all-arthroscopic superior capsule reconstruction using a hamstring allograft configured in a V-shape for massive irreparable rotator cuff tears in active, young patients without arthritis. The technique aims to reduce humeral head superior migration and restore the glenohumeral fulcrum. It is proposed as a technically reproducible, lower-cost alternative to existing procedures that carry substantial retear rates and high costs.
28. Nishiura R, Nakazawa K, Manaka T, et al. Correction: Prevalence and risk factors for stem subsidence following reverse shoulder arthroplasty using on-lay press-fit short stems. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06446-6
This is a correction notice for a previously published article on stem subsidence after reverse shoulder arthroplasty with on-lay press-fit short stems. The only change is the correction of an author's name, which was misspelled as 'Katumasa Nakazawa' instead of 'Katsumasa Nakazawa'. No scientific content or findings were altered.
30. Yin H, Ma L, Dai Y, et al. Segmented Double‐Unit Bridging Technique Using Autologous Semitendinosus Graft for Massive Irreparable Rotator Cuff Tears. Arthroscopy Techniques 2026. doi:10.1002/atn2.70232
The authors present a segmented double-unit bridging technique using autologous semitendinosus tendon for massive irreparable rotator cuff tears, where the supraspinatus defect is irreparable but subscapularis and infraspinatus can be repaired. The tendon is divided into two folded segments implanted sequentially to bridge the anterior and posterior portions of the supraspinatus defect. This approach provides an anatomical, dynamic reconstruction intended to simplify graft handling compared with single-graft techniques and static alternatives like superior capsule reconstruction.
32. Singh P. They Built Their Lives with Their Bodies. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00856
This is a perspectives piece in the arts and humanities reflecting on orthopaedics as restoration of human function and dignity rather than mere mechanical repair. Through personal narrative about the author's father's spinal degeneration and silent suffering, it portrays the shoulder and spine as the means by which people labor, lift loved ones, and live. The essay emphasizes the humanistic dimension of surgical practice beyond technical precision.
33. Zhang H, Lee A, Liu M, et al. Role of Hypoxia-Inducible Factor–1α in Regulating Muscle Degeneration After Rotator Cuff Tears. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261469689
In murine rotator cuff tear models, including inducible HIF-1α knockout mice, the authors examined HIF-1α colocalization with fibroadipogenic progenitors and satellite cells and modulated HIF-1α in FAPs via CRISPR-Cas9 and prolyl hydroxylase domain inhibitors. HIF-1α was found to regulate FAP differentiation and downstream fibrosis, fatty infiltration, and myofiber atrophy after tendon transection. Targeting the HIF-1α pathway may offer a strategy to mitigate secondary muscle degeneration following rotator cuff tears.
35. Duquin TR, Riley R. To Repair or Not to Repair . . . That Is the Question. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00444
This commentary discusses a patient-blinded randomised controlled trial comparing repair versus non-repair of a lesser tuberosity osteotomy during reverse total shoulder arthroplasty, with ASES score at minimum 2 years as the primary outcome. The trial found superior ASES scores with LTO repair, informing the controversial subscapularis management debate. Surgeons should weigh these randomised data when deciding on subscapularis/lesser tuberosity repair in rTSA.
39. Aleem AW, Zmistowski BM, Sefko J, et al. The Impact of Lesser Tuberosity Osteotomy Repair After Reverse Total Shoulder Arthroplasty. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01330
In a patient-blinded single-institution randomised controlled trial, 85 shoulders undergoing reverse total shoulder arthroplasty with lesser tuberosity osteotomy were randomised to repair or no repair of the LTO fragment. At 2 years, the repair group achieved significantly better ASES scores than the no-repair group. These findings support routine repair of the lesser tuberosity/subscapularis during rTSA when the subscapularis is intact enough for reattachment.
43. Zari DS, Norman D. Mechanical failure of the Latitude total elbow prosthesis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100726
This report describes mechanical failure of the Latitude total elbow prosthesis, focusing on failure mechanisms such as ulnar cap tab breakage in the context of revision surgeries and distal humerus fractures. The case highlights specific vulnerable components of this convertible third-generation prosthesis. Awareness of these failure modes is important for surveillance and surgical planning in patients with Latitude implants.
44. Judkins BL, Marston GA, Broughton P, et al. Large-volume hydrodilatation under suprascapular nerve block for the treatment of shoulder adhesive capsulitis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100704
Seventy-one patients with adhesive capsulitis or postoperative shoulder stiffness underwent ultrasound-guided large-volume glenohumeral hydrodilatation (up to 110 cc saline with lidocaine and triamcinolone) performed under suprascapular nerve block. Range of motion improved immediately after the procedure and patient-reported outcomes were assessed at 6+ months follow-up. This protocol offers an effective, well-tolerated office-based treatment option that avoids more invasive interventions for refractory shoulder stiffness.
45. Satalich J, Savsani K, Setliff J, et al. Total elbow arthroplasty—a historical review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100717
This historical review traces the evolution of total elbow arthroplasty implant designs, identifying common failure mechanisms including aseptic loosening, wear, periprosthetic fracture, infection, and instability. Advances such as titanium and cobalt-chromium alloys and highly cross-linked polyethylene have reduced wear and improved longevity, though challenges persist in younger, higher-demand patients. Understanding this design history informs implant selection and strategies to mitigate failure in modern TEA.
47. Nocek M, Villegas Meza AD, Herrmann CB, et al. A bibliometric and thematic analysis of the 100 most cited articles on posterior shoulder instability. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100710
This bibliometric analysis identified and characterized the 100 most-cited articles on posterior shoulder instability through June 2025, extracting citation metrics, level of evidence, and thematic focus. The top-cited articles spanned 1978-2021 (mean 60.3 citations), were predominantly published in the 2010s, and revealed trends in collaboration patterns and research themes. The findings map the intellectual foundations of the field and highlight areas where higher-quality evidence remains needed.
49. Ohlsen SM, Pirkle SB, Yang J, et al. Do ChatGPT and Gemini provide accurate answers to patient questions about glenohumeral arthritis?. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100715
ChatGPT and Gemini were queried with patient questions based on strong- and moderate-strength recommendations from the AAOS clinical practice guideline for glenohumeral arthritis, with responses graded by independent reviewers as agree, neutral, or disagree. Interobserver reliability was assessed with Cohen's kappa and between-model differences with Fisher's exact test. The study addresses whether large language models can safely supplement patient education, with implications for counseling patients who increasingly turn to AI for orthopaedic information.
50. Saini J, Morrison L, Bugajski T, et al. Comparison of functional and patient-reported outcomes following acute, chronic, and nonoperative distal biceps tendon rupture treatments. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100728
A single-center retrospective study compared strength, endurance (isokinetic dynamometry of supination and elbow flexion), and patient-reported outcomes across 60 patients treated for complete distal biceps tendon rupture by direct repair, allograft reconstruction, high-flexion angle repair, or nonoperative management at minimum 1-year follow-up. Surgical timing differed markedly between groups, with direct repair performed earliest (13.8 days) versus delayed reconstruction (208.9 days). The findings inform shared decision-making regarding operative versus nonoperative treatment and the timing of surgical intervention.
52. Cassin S, Vismara V, Zagarella A, et al. The Use of Flexion Arthrography Computed Tomography Signs (FACTS) to detect minor instability of the lateral aspect of the elbow. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100692
A retrospective case-control study of 130 patients evaluated flexion arthrography CT signs (FACTS), the loose collar sign and capsular tear, in 109 patients with clinically suspected minor lateral elbow instability versus 21 asymptomatic controls. The loose collar sign (56.9% vs 23.8%) and capsular tears (35.8% vs 9.5%) were significantly more prevalent in cases, with cases over 4 times more likely to show these findings. FACTS may help identify lateral elbow instability as an underlying cause of recalcitrant lateral elbow pain misattributed to extensor tendinopathy.
56. Sumpter AE, Mathews CG, Kuhn JE. Pectoralis major sternal head tendon transfer for neurogenic scapular winging: technique and case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100727
This technical note and case report presents a pectoralis major sternal head tendon transfer for medial scapular winging caused by long thoracic nerve injury and serratus anterior palsy. The authors describe the operative technique and clinical outcome in a treated patient. The transfer offers a salvage option for persistent, disabling neurogenic scapular winging that fails to recover spontaneously after long thoracic nerve palsy.
59. Walch A, Jacquot A, Grosclaude S, et al. Rotator cuff sparing approach for shoulder arthroplasty. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100738
This technical note describes a rotator cuff-sparing approach for shoulder arthroplasty that preserves the subscapularis rather than performing peel, tenotomy, or lesser tuberosity osteotomy. The rationale is based on reported subscapularis healing rates of roughly 74%-76% with conventional techniques versus 95.8% with lesser tuberosity osteotomy, motivating strategies that avoid tendon violation altogether. The technique offers surgeons an alternative aimed at improving subscapularis healing and reducing postoperative instability after shoulder arthroplasty.
60. Kolac UC, Paksoy A, Erkan DD, et al. Shoulder and genetics: what orthopedic surgeons need to know. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100730
This narrative review synthesizes genetic and molecular evidence for common shoulder disorders, drawing on family-based studies, genome-wide association studies, transcriptomics, and causal inference approaches. Rotator cuff disease and adhesive capsulitis show the strongest evidence for inherited susceptibility, implicating extracellular matrix remodeling, inflammation, and fibrosis pathways, while glenohumeral osteoarthritis is characterized mainly by altered gene expression and instability by collagen-related gene variation. Clinicians should recognize that genetic factors contribute to shoulder disease susceptibility, which may eventually inform risk stratification and personalized treatment, though current evidence does not yet support routine genetic testing.
61. Dong K, Davis DE, Ilyas AM. The impact of nicotine dependence on postoperative complications following humeral shaft fracture repair. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100732
This propensity score-matched database study using the TriNetX US Collaborative Network compared postoperative complications after humeral shaft fracture fixation (plate or intramedullary) between adults with and without nicotine dependence from 2005 to 2025. The study tested the hypothesis that nicotine dependence increases complications and reoperations after surgical fixation. The findings underscore nicotine dependence as a modifiable risk factor, supporting smoking cessation counseling and optimization before operative management of humeral shaft fractures.
64. Ghabi A, Guetari C, Di Gioia D, et al. Reconstruction of complex distal humeral bone loss with osteoarticular massive allograft, latissimus dorsi flap, and ligament–tendon allograft reconstruction: a technical note. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100737
This technical note describes reconstruction of massive distal humeral bone loss, typically from ballistic trauma, using an osteoarticular massive allograft combined with a latissimus dorsi flap and ligament-tendon allograft reconstruction for elbow stability. The multi-tissue approach addresses both the bony defect and the soft-tissue envelope in complex upper limb injuries. It offers surgeons a limb-salvage reconstructive strategy when standard fixation or arthroplasty options are inadequate for severe distal humeral bone loss.
65. Arvesen JE, Dinulescu AL, Lampe KC, et al. Osteochondritis dissecans of the humeral head: a pediatric case series. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100739
This paediatric case series from a children's hospital describes the presentation and management of osteochondritis dissecans of the humeral head, a rare osteochondral lesion of the glenohumeral joint, including cases treated with osteochondral allograft transplantation. It provides clinical and rehabilitation outcome data for this uncommon diagnosis in skeletally immature patients. The findings help guide recognition and operative decision-making for humeral head OCD in young athletes, a population where this lesion is easily overlooked.
67. Möckel LFF, Scheibel M, Imiolczyk J. Clinical and structural midterm follow-up after surgical treatment of a traumatic delaminating chondral lesion of the humeral head using the minced cartilage technique: a case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100729
This case report presents midterm clinical and structural follow-up after surgical treatment of a traumatic delaminating chondral lesion of the humeral head using the minced cartilage (AutoCart) technique. Follow-up evaluation included clinical outcomes and arthroscopic/structural assessment of cartilage repair. It suggests minced cartilage implantation can provide durable cartilage repair in the shoulder at midterm follow-up, supporting its consideration for traumatic humeral head chondral defects.
68. Pulido Cloquell I, Sepulle J, Silva Corten LC, et al. Recurrent upper limb ischemia caused by clavicular pseudarthrosis: an orthopedic cause of arterial thoracic outlet syndrome. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100740
This case report describes recurrent upper limb ischemia caused by clavicular pseudarthrosis acting as an orthopaedic source of arterial thoracic outlet syndrome, with vascular and radiologic workup detailed. Treatment addressed the underlying clavicular nonunion/malunion to relieve arterial compression. The report highlights that clinicians evaluating upper extremity ischemia or arterial TOS should consider clavicular pseudarthrosis as a treatable, orthopaedic cause.
71. Mizuno N, Kotani Y, Nakagawa S, et al. Coracoid bending for refractory anterior upper arm pain after reverse total shoulder arthroplasty. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100750
This report describes coracoid bending as a cause of refractory anterior upper arm pain after reverse total shoulder arthroplasty, attributed to impingement/strain on the coracoid process and conjoint tendon from humeral distalization. The authors detail recognition and management of this entity in patients with persistent anterior pain following rTSA. Awareness of coracoid bending as a pain generator can guide evaluation and avoid unnecessary revision in rTSA patients with refractory anterior upper arm pain.
74. Yoshimura S, Fujita K, Yamazaki M, et al. The entrapment of a rotator cuff tendon in a child: a rare case of low-energy traumatic rotator cuff tear. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100743
This case report describes a rare low-energy traumatic rotator cuff tear with tendon entrapment in a child, presenting as shoulder pseudo-paralysis. The authors detail arthroscopic rotator cuff repair as the treatment, highlighting an unusual paediatric presentation typically seen in adults. Clinicians should consider rotator cuff tears in children even after low-energy trauma when pseudo-paralysis is present, rather than assuming the injury is neurologic in origin.
76. Nyffeler RW. Intraoperative assessment of glenohumeral impingement during total shoulder arthroplasty. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100744
This technical note describes a method for intraoperatively assessing glenohumeral impingement during anatomic total shoulder arthroplasty to optimise prosthetic fit. The technique addresses the common long-term failure modes of anatomic arthroplasty, rotator cuff dysfunction and glenoid component loosening, which are linked to impingement-driven polyethylene wear and periprosthetic bone resorption. Intraoperative impingement checking may help surgeons improve implant positioning and potentially extend implant longevity.
77. Sun L, Lu C, Ji T, et al. An observation of the relation between the cyst on magnetic resonance imaging at bare-area of humeral head and the adhesive capsulitis of the shoulder. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100749
This retrospective study compared 138 patients with primary idiopathic adhesive capsulitis to 114 controls to determine whether bare-area cysts of the humeral head on MRI are associated with the condition. The findings suggest bare-area cysts represent a useful diagnostic imaging marker for adhesive capsulitis, evaluated alongside other MRI features. Recognizing this finding on MRI may aid earlier diagnosis, particularly when clinical presentation is ambiguous.
80. Kawa Shaheen S, Doyscher R, Scheibel M. Metal-free interconnected knotless anchor fixation for arthroscopic posterior glenoid bone block augmentation with subscapularis transfer in a professional soccer goalkeeper: a case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100756
This case report describes arthroscopic posterior glenoid bone block augmentation using iliac crest autograft fixed with metal-free interconnected knotless PEEK anchors, combined with subscapularis transfer, in a professional soccer goalkeeper with posterior instability and glenoid bone loss. The technique achieved stable graft fixation while avoiding metal hardware complications and addressing a reverse Hill-Sachs lesion. This all-arthroscopic, metal-free approach may allow athletes with posterior shoulder instability to return to high-demand sports.
81. Ketelaar E, Hoenecke H, Valk J, et al. Open transosseous repair of proximal deltoid muscle rupture following reverse total shoulder arthroplasty in a patient with os acromiale: a case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100753
The authors report a case of proximal deltoid muscle rupture occurring after reverse total shoulder arthroplasty in a patient with an os acromiale, managed with open transosseous repair of the deltoid origin (sleeve advancement). The report details the surgical technique of intraosseous fixation to restore deltoid attachment. It highlights that deltoid origin insufficiency is a serious complication in this setting and that transosseous repair may be a viable salvage strategy, with os acromiale anatomy warranting attention during exposure.
82. Redler A, Maggiori A, Caiolo V, et al. Closed reduction of acute posterior shoulder dislocation via intra-articular anesthesia: a case report and technical note. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100747
This case report and technical note describes closed reduction of an acute posterior shoulder dislocation using intra-articular local anaesthetic alone, without procedural sedation or general anaesthesia. The technique achieved painless, successful reduction in the emergency setting. The authors suggest intra-articular anaesthesia is a simple, effective option for managing acute posterior dislocations, potentially avoiding systemic sedation risks.
83. Vijittrakarnrung C, Temtheerakij T, Lertwiram P. Recurrent inferior shoulder subluxation secondary to incidental traumatic plexitis following arthroscopic rotator cuff repair. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100754
The authors present a case of recurrent inferior shoulder subluxation that developed after arthroscopic rotator cuff repair, attributed to incidental traumatic brachial plexitis rather than a direct surgical nerve injury. Electromyography supported the diagnosis of plexitis, and the subluxation was managed accordingly. The report underscores that delayed neurologic complications such as plexitis (with double-crush physiology) should be considered in postoperative deltoid atony and inferior subluxation, and that EMG aids diagnosis and prognostication.
84. Bushnell BD, Boes N, Cil A, et al. Augmentation for rotator cuff repair – clinical use patterns and limited patient access: the American Shoulder and Elbow Surgeons bio-advocacy work group survey. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100748
The ASES bio-advocacy work group distributed a 12-question survey to 1,210 ASES members (103 respondents, 8.5%) to quantify real-world use of rotator cuff repair augmentation and barriers to access. Respondents reported frequent use of augmentation, particularly to reduce retear rates, along with substantial restrictions on patient access to augmentation materials. The findings support consensus statements advocating broader payor coverage and clearer clinical guidance for selecting patients who may benefit from augmented repair.
85. Adan FO, Harley JD, Banks EM, et al. Open reduction and pin fixation of displaced adolescent proximal humerus fractures: surgical technique and illustrative case series. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100752
This technical note presents a surgical technique for open reduction and percutaneous/retrograde pin fixation of displaced proximal humerus fractures in adolescents, illustrated with a case series. The authors describe operative steps and fixation strategy aimed at anatomic restoration while respecting the proximal humeral physis. The technique offers a reliable option for severely displaced adolescent fractures unsuitable for closed reduction, with the illustrated cases demonstrating favourable alignment and healing.
88. (Jed) Kuhn JE, Mallon WJ. Introduction of a JSES Manuscript Processing Fee. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.019
The Editors-in-Chief announce the introduction of a manuscript processing fee for the Journal of Shoulder and Elbow Surgery, detailing the new charge structure for submitted manuscripts. The editorial explains the rationale for the fee in the context of journal operations and publishing costs. Authors submitting to JSES should anticipate this processing fee as part of the submission workflow.
91. Afshar A, Tabrizi A, Shariyate MJ. Letter regarding “The Association of Long Thoracic Nerve Variants with Medial Scapular Winging in Thoracic Outlet Syndrome: A Clinical and Anatomical Study”. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.04.017
This letter responds to a study linking long thoracic nerve intramuscular variants to medial scapular winging in neurogenic thoracic outlet syndrome, acknowledging the reported 40.2% prevalence of intramuscular LTN root course. The author raises the concern that scapular winging and dyskinesia may also arise from or be exacerbated by dorsal scapular nerve entrapment rather than LTN anatomy alone. This highlights the need to evaluate multiple nerve contributions when assessing medial scapular winging in TOS patients.
92. Irshad TB, Pascoletti G, Zanetti EM. The biomechanics of the sternoclavicular joint: an experimental and computational study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.025
This combined experimental-computational study quantified sternoclavicular joint biomechanics using inertial sensor motion capture in live subjects feeding an OpenSim musculoskeletal model, validated against transcortical pin and instrumented prosthesis data. The SCJ demonstrated at least 25° of elevation and 35° of retraction, with joint forces peaking at 75% of body weight, though IMU-based tracking underestimated clavicle retraction due to skin motion artifact. These findings inform SCJ reconstruction planning and highlight limitations of non-invasive motion analysis for clavicular rotation.
96. Mi Y, Jiang B, Pan S, et al. Gärtner Type and Outcomes After US PAL Versus Arthroscopic Debridement for Calcific Tendinitis: A Retrospective Cohort Study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.029
This propensity score-matched retrospective cohort of 72 patients with refractory calcific tendinitis compared ultrasound-guided percutaneous aspiration and lavage versus arthroscopic debridement, stratified by Gärtner calcification type. Both treatments improved outcomes at 12 months, but a significant treatment-by-Gärtner-type interaction showed that calcification morphology influences treatment response, with arthroscopic debridement favored in Type I lesions. Surgeons should consider Gärtner type when selecting between these minimally invasive and arthroscopic approaches.
97. Gupta R, Johnston TR, Lee C, et al. Modified Partial Radial to Axillary Nerve Transfer as the Index Procedure for Isolated Axillary Nerve Injury. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.023
This single-surgeon retrospective series evaluated partial radial-to-axillary nerve transfer as the primary (index) intervention for isolated axillary nerve injury after failed conservative management, with minimum 2-year follow-up in 16 patients. Intraoperative deltoid biopsies from 8 patients allowed motor endplate morphometric analysis, and outcomes included shoulder range of motion and MRC strength scores. The study supports nerve transfer as an earlier, definitive option beyond expectant management or salvage procedures, with donor-site morbidity assessment informing patient selection and timing.
99. Driad C, Sonesaksith-Turcotte X, Sandman É, et al. Healthcare Professionals Produce Higher Quality Content for Shoulder Dislocation on TikTok. JAAOS: Global Research and Reviews 2026. doi:10.5435/jaaosglobal-d-24-00337
This cross-sectional study assessed the quality and content of 173 TikTok videos on glenohumeral dislocation using the validated DISCERN instrument, comparing videos from healthcare professionals (HCPs) versus general users across six content categories. HCP-produced videos demonstrated higher information quality, supporting the study hypothesis. The findings suggest steering patients toward HCP-created social media content while highlighting the variable quality of user-generated material.
100. Al-Badaineh M, Josan H, Imran B, et al. Spin in Systematic Reviews on Patch-Augmented Rotator Cuff Repair: Prevalence, Predictors, and Methodological Implications. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.030
This methodological systematic review of systematic reviews and meta-analyses comparing patch-augmented versus non-augmented rotator cuff repair assessed methodological quality and the prevalence and predictors of 'spin' (distorted interpretation) in abstracts, following Cochrane and PRISMA guidelines with duplicate independent assessment. Spin was found to be prevalent, particularly in abstracts, alongside notable heterogeneity and outcome variability. The results underscore the need for cautious interpretation of the patch augmentation literature and more rigorous reporting standards.
104. Harkin W, Shen A, Hussain ZB, et al. Anatomic Total Shoulder Arthroplasty with the Tornier Perform Posterior Augmented Glenoid versus Reverse Total Shoulder Arthroplasty for the Treatment of Walch B2 and B3 Glenoids: A Propensity Score Matched Analysis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.001
This propensity score-matched retrospective cohort compared anatomic total shoulder arthroplasty with a posterior augmented glenoid (PAG) versus reverse total shoulder arthroplasty for glenohumeral osteoarthritis with Walch B2/B3 glenoids and intact rotator cuffs, using PROMs, range of motion, and complications with minimum 2-year follow-up. This is the first direct comparison of these two options for eccentric posterior wear. The findings help guide implant strategy for B2/B3 glenoids, a longstanding area of surgical controversy.
108. Fiandeiro M, Patil R, Su F, et al. Clinical Outcomes and Predictors of Dissatisfaction Following Revision Surgery After Distal Clavicle Excision. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.016
This retrospective cohort study evaluated clinical outcomes after revision surgery (repeat distal clavicle excision or AC/CC reconstruction) for persistent pain or instability following prior distal clavicle excision between 2005 and 2024. It assessed PROMs (ASES, SANE, VAS pain and instability) and identified predictors of satisfaction, subjective instability, and complications, including radiographic measures such as AC/CC distances and resection length. The findings help counsel patients on expected outcomes of revision AC joint surgery and identify factors associated with persistent dissatisfaction.
110. Baek CH, Lim C, Kim JG, et al. Comparison of Clinical Outcome and Return to Work Following Exactech Equinoxe Reverse Total Shoulder Arthroplasty: Pectoralis Major Tendon Transfer versus Subscapularis Repair. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.019
This retrospective comparative study compared clinical outcomes and return to work after reverse total shoulder arthroplasty using subscapularis repair versus pectoralis major tendon transfer for subscapularis management. Primary outcomes included the Activities of Daily Living involving Internal Rotation score and return-to-work rate, with secondary PROMs, range of motion, and complication measures. The findings inform surgical decision-making when the subscapularis cannot be reliably repaired, suggesting whether pectoralis major transfer achieves comparable function and work resumption.
114. Chandasir AB, Lew RM, Hyeamang LJ, et al. How to Manage the Spinoglenoid Notch Cyst: A Systematic Review and Meta-analysis. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261456937
A PRISMA-guided systematic review and meta-analysis of operative and nonoperative management of spinoglenoid notch cysts pooled patient-reported outcomes, recurrence, reoperation, and complication rates across approaches. Results compared open versus arthroscopic techniques and informed a management algorithm based on cyst characteristics. Clinically, the review provides evidence-based guidance for selecting among decompression, cyst excision, and related procedures for suprascapular nerve compression.
115. Pawłuś N, Turkiewicz S, Lesman J, et al. Functional and Neurotrophic Outcomes After Physical Therapy and Injection-Based Treatments for Rotator Cuff Tendinopathy: The FORTIS Pilot Randomized Trial. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261468532
The FORTIS pilot randomised trial assigned 29 patients with MRI-confirmed supraspinatus tendinopathy and sleep disturbance to physical therapy alone or PT combined with subacromial steroid injection, suprascapular nerve block, or platelet-rich plasma, with clinical outcomes at baseline, 1, and 3 months and serum BDNF measured early. All groups improved, with preliminary comparisons of clinical and neurotrophic (BDNF) effects between adjuncts. As a pilot trial, it informs the design and feasibility of larger comparative studies of injection-based augmentation of PT for rotator cuff tendinopathy.
118. Alhussain AH, Alzahrani MT, Aljaafri ZA, et al. Rotator Cuff Reconstruction Using Biceps Tendon Autograft Versus Acellular Dermal Allograft: A Systematic Review and Meta-analysis of Clinical Outcomes. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261470960
A PRISMA-compliant systematic review and meta-analysis compared clinical outcomes, functional improvement, and graft healing after rotator cuff repair augmented with human dermal allograft versus biceps tendon autograft. Pooled analyses supported the hypothesis that both techniques yield comparable clinical outcomes, with potential differences in graft integrity and complication rates. Surgeons can use these findings when choosing graft type for augmentation of massive or complex rotator cuff repairs.
120. Tchangou N, Scheiderer J, Peterson JC, et al. Paper 05. Traumatic Rotator Cuff Tears following Shoulder Dislocation Demonstrate Increased Tear Complexity but Similar Postoperative Outcomes: A Matched Cohort Analysis of Elderly Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00266
A matched cohort analysis compared rotator cuff repair outcomes in elderly patients (≥55 years) with traumatic tears following shoulder dislocation versus tears without dislocation history. Dislocation-associated tears showed greater tear complexity, but postoperative functional outcomes, tendon integrity, and failure rates were similar between groups. Clinically, surgical repair remains effective after dislocation-related tears in elderly patients despite more complex tear patterns.
131. Haskell A, Comer G, McGrew D, et al. Poster 157. Validity and Responsiveness of the Two-Question Universal Pain and Function Score for Common Sports Medicine Surgeries. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00456
This prospective validation study tested the two-question Universal Pain and Function (UPAF) score, combining VAS pain and SANE function, against longer instruments (PROMIS Global, ASES, KOOS-JR) in 1648 patients undergoing arthroscopic rotator cuff repair, meniscectomy, and ACL reconstruction. UPAF demonstrated validity and responsiveness across these common sports medicine procedures, with results benchmarked against satisfaction (SOS) data. Clinically, UPAF offers a minimal-burden alternative for routine outcome tracking without sacrificing measurement quality.
143. Shah IK, Shah A, Burkhart RJ, et al. Poster 246. HRT Decreases the Odds of Soft Tissue Disorders of the Shoulder in Post-Menopausal Females. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00540
Using the TriNetX database, postmenopausal women aged 40-60 prescribed systemic estrogen or progesterone HRT were compared with unmatched/unprescribed controls for rates of shoulder soft tissue disorders including adhesive capsulitis, biceps tendinitis, calcific tendinitis, rotator cuff tendinopathy, impingement, and synovitis. HRT prescription was associated with decreased odds of these disorders. These data support a potential protective role of estrogen against menopause-related shoulder soft tissue pathology, warranting further study.
151. Peterson JC, Tchangou N, Justice W, et al. Poster 254. Anatomic Total Shoulder Arthroplasty Following Healed Rotator Cuff Repair Leads to Worse Functional Outcomes Compared to Those Without Prior Rotator Cuff Repair: A Matched Analysis. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00547
This matched analysis compared functional outcomes of anatomic total shoulder arthroplasty in patients with a prior healed ipsilateral rotator cuff repair versus those without, addressing conflicting prior literature (e.g., Erickson and Schoch studies). The key finding, per the title, is that prior healed rotator cuff repair leads to worse functional outcomes after aTSA. This suggests surgeons should consider prior RCR history when selecting between aTSA and other arthroplasty options.
155. Wittstein JR, Ivasyk I, Weaver K, et al. Poster 232. Menopausal Shoulder Symptoms and Hormone Therapy: A cross sectional survey of 13,946 women. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00527
This cross-sectional survey of 13,946 menopausal women aged 45-65 examined the relationship between menopausal symptoms, upper extremity function, and menopausal hormone therapy (MHT), with particular attention to adhesive capsulitis. Self-reported data were analyzed using t-tests and chi-squared tests. The results may clarify whether MHT influences shoulder pathology risk, informing management of perimenopausal and menopausal shoulder symptoms.
158. Modest JM, Testa EJ, Zhang C, et al. Poster 240. PASS or Fail: Predictors of Poor Outcome After Arthroscopic Posterior Labral Repair in a Multi-Surgeon Prospective Cohort Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00534
This multi-surgeon prospective cohort study of 177 patients (mean age 19) identified preoperative, intraoperative, and demographic predictors of failing to achieve the Patient Acceptable Symptom State (PASS) after arthroscopic posterior labral repair. Secondary analyses addressed predictors of 1-year ASES and SANE scores. Results help clinicians counsel patients and identify those at risk for suboptimal outcomes after posterior instability surgery.
163. White AE, Varady NH, Finocchiaro A, et al. Poster 249. Dominant-Sided Surgery is Associated with Lower Rates of Return to Sport Following Anatomic Total Shoulder Arthroplasty in Active Patients Aged 65 Years and Younger. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00543
This retrospective cohort study of 165 active patients aged 65 or younger who underwent primary anatomic total shoulder arthroplasty compared return to sport between dominant-sided and nondominant-sided surgery. Dominant-sided arthroplasty was associated with lower rates of return to sport, despite similar baseline characteristics and ASES score improvements. Surgeons should counsel younger, active patients that surgery on the dominant shoulder may compromise their ability to resume sporting activities.
164. Nembhard O, Berkman EF, Sambasivan A, et al. Poster 227. Safety and Effectiveness of Placental Connective Tissue Matrix Allograft Versus Corticosteroid Injection in Adhesive Capsulitis: A Double-Blinded Prospective Randomized Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00523
In this double-blinded prospective randomised trial, 52 patients with adhesive capsulitis received either intra-articular flowable placental connective tissue matrix allograft with lidocaine (n=25) or corticosteroid injection with triamcinolone (n=27). The study compared safety and clinical effectiveness between the biologic allograft and standard-of-care steroid injection. The findings inform treatment selection for adhesive capsulitis, where steroid injection offers only short-term relief and carries known side effects.
167. Curtis A, Efremov K, Beckles M, et al. Poster 219. Effectiveness of Ultrasound-Guided Cyst Aspiration and Injection of Corticosteroid for the Treatment of Superior Glenoid Paralabral Ganglion Cysts. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00515
This retrospective series of 97 consecutive patients evaluated ultrasound-guided aspiration combined with corticosteroid injection (bupivacaine plus methylprednisolone) for superior glenoid paralabral ganglion cysts. The study assessed success rates of this minimally invasive, office-based approach as an alternative to arthroscopic decompression with labral repair. The findings support ultrasound-guided aspiration and injection as a viable first-line treatment option that may help selected patients avoid surgery.
171. Morriss N, Jain S, Prabhavalkar O, et al. Poster 223. Racial Differences in Rates of Surgical and Non-Surgical Treatment Of Complete Rotator Cuff Tears: A Propensity-Matched Database Study with of 75,918 Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00519
Using a propensity score-matched TriNetX cohort of 75,918 patients with complete rotator cuff tears, the authors compared surgical versus nonoperative treatment utilisation between Black and White patients over 5 years of follow-up. As hypothesized, Black patients were less likely to undergo rotator cuff repair and more likely to receive conservative management (injections, physical therapy). The findings highlight persistent racial disparities in rotator cuff treatment that warrant attention to equitable surgical decision-making.
175. Roylance J, Brewer M, Copling S, et al. Poster 250. Predictors of Baseline PROMIS Categorization in Patients with Shoulder Injuries. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00544
Data from a prospective registry of patients presenting with shoulder pain were analyzed with multinomial logistic regression to identify predictors of mild, moderate, or severe baseline PROMIS Pain Interference and Physical Function T-score categories. Odds of worse PROMIS categorization varied by diagnosis (rotator cuff pathology, arthritis, adhesive capsulitis) and patient characteristics including age, sex, BMI, and operative status. These findings can help clinicians anticipate baseline disability levels and interpret PROMIS scores in context at initial presentation.
190. Lorenzen ND, Budtz CR, Christiansen DH. Longterm shoulder-related secondary healthcare contact among people with subacromial pain: a secondary analysis of a randomized controlled trial of home-based versus supervised exercise regimens. JSES International 2026. doi:10.1016/j.jseint.2026.101779
This was a secondary analysis of a randomised controlled trial comparing home-based versus supervised exercise regimens for subacromial pain, examining long-term shoulder-related secondary healthcare contacts. The study determined whether exercise regimen type influenced subsequent utilisation of specialist care, imaging, or surgery over long-term follow-up. Results inform healthcare resource planning and support home-based exercise as a viable, resource-sparing initial management strategy if contact rates were comparable.
195. Staub SP, Gerber C, Hess H, et al. Antero-inferior glenohumeral instability is associated with an abnormal position of the coracoid process. JSES International 2026. doi:10.1016/j.jseint.2026.101785
This study investigated whether the position of the coracoid process differs between patients with antero-inferior glenohumeral instability and controls using imaging analysis. An abnormal, more lateral/inferior coracoid position was found to be associated with instability, suggesting a potential anatomic predisposition. This finding may inform evaluation of instability and procedures such as coracoid-based transfers.
196. Irlenbusch U. Comment on: Sarang Agarwal et al (2025) polyethylene wear rates in reverse total shoulder arthroplasty: a systematic review of biomechanical studies. JSES Reviews, Reports, and Techniques, Volume 5, Issue 4, November 2025, Pages 916-921. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100734
This comment discusses a systematic review of polyethylene wear rates in reverse total shoulder arthroplasty biomechanical studies. The author emphasizes that while types 1-2 Nerot-Sirveaux notching stem from mechanical impingement, types 3-4 with osteolysis likely reflect polyethylene wear-induced inflammation threatening baseplate fixation. The comment underscores the need to identify implant design and material factors that reduce wear to prevent late loosening.
201. Ochiai N, Hashimoto E, Ohtori S, et al. Prevalence of rotator cuff tear concomitant with neuropathy: analysis of 659 cases using needle electromyography. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100762
Needle electromyography was used to assess the prevalence of neuropathies (suprascapular, cervical radiculopathy, brachial plexopathy) in 659 patients with rotator cuff tears, and findings were correlated with tear size and pseudoparalysis. Neuropathy proved common in rotator cuff tear patients and related to tear size and pseudoparalysis status. Clinicians should consider electrodiagnostic evaluation of rotator cuff tear patients, especially those with pseudoparalysis or large tears, as concomitant neuropathy may influence treatment decisions and outcomes.
204. Bilsel K, Keçeci T, Çelik M, et al. A practical technique to facilitate glenosphere insertion in reverse shoulder arthroplasty: Bilsel’s Ice Cream Scoop Maneuver. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100766
This technical note describes Bilsel's Ice Cream Scoop Maneuver, a practical surgical technique to facilitate glenosphere insertion during reverse shoulder arthroplasty. The maneuver simplifies delivery and seating of the glenosphere, particularly in settings with difficult exposure such as revision surgery. Surgeons performing reverse shoulder arthroplasty can adopt this pearl to ease glenosphere insertion and reduce intraoperative technical difficulty.
206. Vervaecke AJ, Chevallier R, Housset V, et al. Treatment of humeral shaft nonunion by exchange intramedullary nailing and circumferential cortical strut allograft: the Sarcophagus technique. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100768
Clinical and radiographic outcomes of the Sarcophagus technique, exchange intramedullary nailing combined with circumferential (360°) cortical strut allografting, were evaluated for humeral shaft nonunion. The technique proved safe and effective, achieving union rates comparable to conventional methods. This approach offers surgeons a reliable option for managing challenging humeral shaft nonunions, particularly when revision fixation and biologic augmentation are needed.
207. Hirosawa N, Kuniyoshi K, Kajiwara D, et al. Conjoint tendon split approach for humeral head extraction in acute anterior-to-inferior glenoid rim–incarceration fracture-dislocation and chronic locked anterior dislocation. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100769
The conjoint tendon split approach (CSA) was evaluated as an adjunct to the deltopectoral approach for humeral head extraction in acute anterior-inferior glenoid rim, incarceration fracture-dislocations and chronic locked anterior dislocations. CSA facilitated humeral head extraction under direct visualization without increasing the risk of new musculocutaneous or axillary nerve deficits. Surgeons facing these difficult exposure scenarios can use this technique to improve safety and feasibility of head removal.
211. Howell D, Kamineni S. Cosmetic outcomes of surgical neck humeral osteotomy for the flail limb: a case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100776
This case report describes surgical neck humeral osteotomy performed for a flail upper limb, with specific attention to the cosmetic appearance of the resulting transhumeral-level amputation. The authors document the aesthetic outcome of converting a nonfunctional limb to a shorter, more functional residual limb. The report informs shared decision-making for patients considering amputation of flail limbs, highlighting that cosmetic results can be acceptable.
215. Ricker E, Stehling L, Klute L, et al. Comparison of nonsurgical treatment approaches for partial rotator cuff tears: a systematic review and meta-analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100782
This systematic review and meta-analysis compared nonsurgical treatment modalities, specifically physical therapy versus injection therapies, for symptomatic partial-thickness rotator cuff tears, for which no consensus on optimal first-line management exists. The analysis synthesized outcomes across nonsurgical approaches to determine relative effectiveness. The findings help guide clinicians in selecting initial nonsurgical treatment for partial tears, informing a field currently lacking standardised recommendations.
218. Movassaghi A, Lubert J, Baran JV, et al. Geographic retention and gender-based trends among orthopedic shoulder and elbow surgeons in the United States. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100771
This cross-sectional database study of American Shoulder and Elbow Surgeons members mapped training locations (medical school, residency, fellowship) against current practice locations by U.S. Census region and analyzed gender-based trends. Key findings showed that surgeons tend to practice near where they trained, with certain regions retaining more subspecialists, and gender representation remains uneven. The results inform workforce planning strategies to improve geographic distribution of and equitable access to shoulder and elbow specialists.
221. Garces IA, Herrera AE, Gupte KA, et al. Cutibacterium acnes infection of the acromioclavicular joint: a case report and review of the literature. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100785
This case report and literature review described a native Cutibacterium acnes infection of the acromioclavicular joint, highlighting its indolent presentation and diagnostic challenges. The review emphasized that C. acnes, though slow-growing and often mistaken for a contaminant, is an increasingly recognised pathogen in shoulder infections. Clinicians should maintain a low threshold for considering anaerobic infection in patients with persistent shoulder pain, particularly after distal clavicle resection or implant placement.
222. Agarwal S, Ting RS, Farrelly R, et al. Response to the letter to the editor. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100735
This response to a letter to the editor clarified that the authors' original review focused specifically on polyethylene wear rates measured in biomechanical simulator studies rather than on scapular notching, which was discussed only for clinical context. The authors acknowledged that simulator models do not reproduce in vivo total polyethylene loss or end-range scapular abutment. The exchange underscores the importance of interpreting biomechanical wear data within the limitations of controlled testing environments.
224. Thiru SS, Joy M, Onor GI, et al. YouTube Recommendations for Indications and Surgical Decision-Making in Arthroscopic Rotator Cuff Repair Show Low Concordance with 2025 AAOS Clinical Practice Guidelines. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100837
This study analyzed YouTube content on indications and surgical decision-making for arthroscopic rotator cuff repair and assessed concordance with the 2025 AAOS Clinical Practice Guidelines. The key finding was that most videos showed low guideline concordance, raising concerns about the quality of information patients encounter online. Clinicians should be prepared to direct patients toward more reliable educational resources when discussing rotator cuff surgery.
225. Baek CH, Lim C, Kim JG, et al. High Retear Rate of Superior Capsular Reconstruction Graft following Combined Anterior Latissimus Dorsi–Teres Major Transfer in Anterosuperior Irreparable Rotator Cuff Tears. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100839
This study evaluated outcomes of superior capsular reconstruction (SCR) combined with anterior latissimus dorsi, teres major (LDTM) transfer for anterosuperior irreparable rotator cuff tears. The authors found a high retear rate of the SCR graft in this combined procedure setting. Clinically, the findings caution against routine combination of anterior LDTM transfer with SCR for anterosuperior tears, suggesting graft failure risk should be weighed when planning reconstruction.
228. Athari M, Koh J, Amirouche F. Association of Frailty Indices with Postoperative Outcomes in Shoulder Surgery: A Systematic Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100850
This systematic review examined the association of frailty indices with postoperative outcomes across shoulder surgery. The review found that frailty measures were consistently associated with adverse postoperative outcomes, including complications and revision. Clinically, the findings support incorporating frailty assessment into preoperative risk stratification and shared decision-making for shoulder procedures.
229. Clarke R, Tao BS, Boufadel P, et al. Comparative Outcomes and Complication Rates of Lower Trapezius Versus Latissimus Dorsi Tendon Transfer for Irreparable Posterosuperior Rotator Cuff Tears: A Systematic Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100841
This systematic review compared outcomes and complication rates of lower trapezius transfer versus latissimus dorsi transfer for irreparable posterosuperior rotator cuff tears. The review found broadly comparable functional outcomes between techniques, with differing complication profiles. Clinically, the results help guide choice of tendon transfer technique based on patient factors and surgeon experience.
236. Wiley N, Jo S, Satalich J, et al. Reconstruction of Sternoclavicular Joint with Excision of Medial Clavicle and Internal Fixation to the First Rib. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100867
This article describes a surgical technique for sternoclavicular joint reconstruction involving medial clavicle excision with internal fixation of the reconstruction to the first rib. The authors outline the operative steps and rationale for this approach to restore stability after medial clavicular resection. The clinical implication is that this technique may provide a durable solution for complex sternoclavicular joint pathology requiring excision and reconstruction.
238. Shehadeh TH, Lohre R, Elhassan B. Evaluation and Management of Neuropathic Arthropathy of the Shoulder: Narrative Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100869
This narrative review summarizes the evaluation and management of neuropathic arthropathy (Charcot joint) of the shoulder. The authors review etiologies, diagnostic workup including imaging characteristics, and treatment options ranging from conservative management to arthroplasty. The clinical implication is that heightened awareness and systematic evaluation of this rare condition can guide appropriate management decisions and improve outcomes.
239. George A, Paull TZ, Winter JD, et al. The forequarter lateral implosion injury: A diagnostic paradigm and Ch-Sh (chɛ-shɑ) classification. Injury 2026. doi:10.1016/j.injury.2026.113373
This retrospective study of 354 patients with rib fractures and ipsilateral shoulder girdle injury at a Level 1 trauma center developed the Ch-Sh classification for forequarter lateral implosion injuries, grouping chest wall injuries (Ch1-3) and shoulder girdle injuries (Sh1-3) into nine subgroups. The classification organized injury patterns and associated pathology to predict morbidity. Clinically, this framework may aid risk stratification and management decisions for patients with combined chest wall and shoulder girdle trauma.
242. Vera-Valencia G, Bloch A, Amaya-Aguilar F, et al. Customized Cement Spacer as a Definitive Implant in Proximal Humerus Osteomyelitis: Technical Note. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100862
This technical note describes the fabrication and use of a customized antibiotic-loaded cement spacer as a definitive implant for proximal humerus osteomyelitis, rather than as a temporary stage before reimplantation. The authors detail the operative technique, spacer molding, and patient outcomes after infection eradication. The report suggests this approach may be a practical single-stage solution in selected patients with proximal humeral bone infection where conventional prosthetic reconstruction is not feasible.
249. Lent-Koop J, Orbay J, Kelley N, et al. Humeral Head Geometry: An Analysis of Global Offset against Intramedullary Shaft Diameter and Humeral Head Size: A CT Scan Study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.010
Using 3D CT models from age- and sex-matched cadaveric shoulder scans, the authors measured humeral head diameter, intramedullary shaft diameter, and global offset (perpendicular distance between the humeral head's geometric center and the shaft axis). The study defines normative relationships between these parameters across age and sex for the first time. These reference values can guide anatomic implant selection and reconstruction of native biomechanics in shoulder arthroplasty.
252. Weltlin G, Zaccheo K, Williams DP. Minocycline-Induced Black Bone Disease in Shoulder Arthroscopy: A Case Report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100854
This case report describes black discoloration of bone encountered during shoulder arthroscopy in a patient taking minocycline, consistent with minocycline-induced 'black bone disease.' The authors document the clinical presentation and intraoperative appearance of this rare medication-related phenomenon. Surgeons should recognize minocycline use as a benign cause of dark bone pigmentation to avoid misattributing it to infection or necrosis.
254. Lee S, Jayne C, Kim MT, et al. Patients with Cervical Degenerative Disease Have Greater Postoperative Opioid Use and Reoperation Following Shoulder Instability Procedures. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100859
Using a retrospective comparative database analysis, the authors compared postoperative opioid use and reoperation rates after shoulder instability surgery between patients with and without cervical degenerative disease. Patients with cervical degenerative disease had significantly greater postoperative opioid consumption and higher reoperation rates. This comorbidity should be factored into preoperative counseling, pain management planning, and risk stratification for instability procedures.