Skip to content

Clinicians › Medicolegal

Outcomes & Recovery After Upper-Limb Injections and Surgery

Expected outcomes, recovery milestones, risks/sequelae and post-operative timeframes for corticosteroid injections (subacromial, ACJ, carpal tunnel) and common shoulder/wrist procedures — including the 6-12 month timeframe to stability after shoulder arthroscopy, the risk of premature loading to a rotator cuff repair, and the acute-phase QuickDASH trajectory.

Overview

This topic summarises the expected outcomes, recovery milestones, risks and post-operative timeframes for the injections and operations commonly encountered in upper-limb WorkCover claims: corticosteroid injections for subacromial impingement, acromioclavicular (ACJ) arthropathy and carpal tunnel syndrome; and arthroscopic subacromial decompression, rotator cuff repair, shoulder stabilisation and carpal tunnel release. Recovery is graduated and structure-dependent, image guidance improves the accuracy and effect of injections, and a premature return to load is the principal modifiable threat to a good surgical result [1][2][23][26].

Corticosteroid injection outcomes

Corticosteroid and local-anaesthetic injection produces meaningful short-term improvement in pain and function for subacromial impingement and ACJ arthropathy, and is an established first-line measure while the underlying condition is managed [1][5][9][10]. The effect is characteristically time-limited, and injection is best understood as a symptom-controlling adjunct rather than a definitive cure [1][5]. In carpal tunnel syndrome, corticosteroid injection provides effective symptomatic relief but the benefit frequently wanes, and comparative effectiveness has been examined across different injection strategies [6][31]. Injection is a legitimate step in the non-operative pathway for ACJ osteoarthritis before surgery is considered [9][10].

Injection accuracy and image guidance

The accuracy and outcome of an injection depend on placement. Image (ultrasound)-guided injection about the shoulder is more accurate than blind/landmark technique and yields better short-term pain and function [2][3], and ultrasound guidance improves the rate of successful intra-articular ACJ placement [7]. Carpal tunnel injection accuracy is likewise imperfect with a purely landmark approach [8]. This is relevant when weighing the therapeutic value and interpretation of a documented injection.

Subacromial decompression: surgery versus non-operative care

A substantial proportion of patients with subacromial impingement settle with non-operative care, and surgery is reserved for those who fail an adequate conservative trial [11][14]. The comparative evidence is genuinely mixed: some randomised and long-term data show subacromial decompression outperforming therapy alone [13], while systematic review and placebo-controlled data question the added benefit of the bony decompression over structured rehabilitation or arthroscopy alone [12]. Prognosis and treatment choice should therefore be framed as condition-specific rather than assuming surgery is invariably superior [11][12][13].

Time to stability after shoulder stabilisation

Stability following shoulder arthroscopy and stabilisation is typically approached around 6 to 12 months post-operatively: after arthroscopic Bankart stabilisation the mean time to return to sport is approximately 5 to 7 months, with return to the pre-injury level often nearer 9 to 12 months [15], and long-term series confirm that durable stability is judged over this horizon rather than in the early weeks [16][22]. An upgrade to full, unrestricted duties — particularly heavy or overhead manual work — is therefore often not appropriate before around 6 months [15][20].

Recurrence, revision and complications of stabilisation

Recognised risks and sequelae of surgical stabilisation include recurrent instability, stiffness and loss of terminal range, and — for a subset — an incomplete return to the pre-injury level of activity or work despite a technically satisfactory procedure [20][22]. The risk of recurrent instability is strongly influenced by patient factors: younger age, higher-demand or collision activity, the number of pre-operative dislocations and a higher Instability Severity Index score all raise the recurrence rate, and younger patients in particular have high long-term failure rates after arthroscopic Bankart repair [17][18][19]. A proportion of patients ultimately require revision surgery, and revision or recurrent-instability stabilisation can still achieve outcomes comparable to primary repair [20][21]. These outcomes should be discussed and documented as part of the expected outcome envelope [22].

Protecting the rotator cuff repair — healing, retear and load

Rushing the return to full load can compromise the structural integrity of a rotator cuff repair while the tendon is still remodelling [23][24]. Retears cluster in the early post-operative window, when healing is incomplete, and serial imaging shows failure of the repair concentrated in this vulnerable period [23][24]. Because the integrity of tendon healing is a principal determinant of the clinical result [25], progression to resisted and loaded activity must be graduated; premature loading before biological healing is complete risks re-tear and a compromised structural outcome [24][25]. Continued exposure to vibrating-tool use and heavy manual demand during this window can likewise impede tendon remodelling [23].

Rehabilitation timing after rotator cuff repair

The evidence on early versus delayed rehabilitation is nuanced rather than absolute. Systematic reviews and meta-analyses of randomised trials show comparable functional scores between early-motion and delayed-motion protocols, with early controlled passive motion generally preserving range of motion [26][27][30]. However, some data associate more aggressive early motion with a higher rate of failure of healing, particularly for larger tears, which is why protocols are individualised to tear size and repair quality [28][29]. The consistent message for return-to-work planning is that protected early motion is acceptable but loaded, resisted use should be deferred until healing is established [27][29].

Carpal tunnel: injection and surgical outcomes

Carpal tunnel syndrome responds to a graded pathway. Corticosteroid injection and night splinting give useful non-operative symptom control, though many patients ultimately proceed to surgery [31][32][36]. Carpal tunnel release is highly effective; open and endoscopic techniques yield comparable symptom relief, with differences chiefly in early recovery and complication profile [33][34]. Recovery is nonetheless not instantaneous — patient-perceived recovery is measured in weeks to months [35] — and the procedure carries a small but defined risk of neurovascular injury that informs technique and consent [37].

Return to work

Return to work after upper-limb surgery is graduated and strongly modified by occupational demand and by patient- and work-related factors rather than the procedure alone. After primary rotator cuff repair a weighted average of about 62% of patients return to their previous level of work at a mean of roughly 8 months, with manual labourers later than sedentary workers [38]. Comparable months-long timeframes apply after subacromial decompression [39] and carpal tunnel release [40][41], and workers'-compensation status and psychosocial and demographic factors independently influence both the timing and the likelihood of return [42][43][45]. Broader trauma cohorts confirm that a substantial minority have not returned to work at one year [44]. Documented restricted-then-full duty progression, rather than a single fixed date, best reflects the evidence [38][39].

Patient-reported outcomes and their interpretation

Patient-reported outcome scores such as the QuickDASH may transiently worsen or plateau in the acute post-operative phase after shoulder surgery before improving, reflecting the early rehabilitation period rather than a failed procedure [46]. Interpretation of any single score must be anchored to the minimal clinically important difference for that instrument, because a change smaller than the MCID may be statistically real but not clinically meaningful [47][48]. A single early post-operative score should therefore be read against this expected trajectory and threshold rather than taken at face value [46][47].

References

  1. Subacromial corticosteroid injections. J Shoulder Elbow Surg. 2008. DOI: 10.1016/j.jse.2007.07.009
  2. Ultrasound-Guided Versus Blind Subacromial Corticosteroid Injections for Subacromial Impingement Syndrome. Am J Sports Med. 2015. DOI: 10.1177/0363546515618653
  3. Image-guided versus blind corticosteroid injections in adults with shoulder pain: a systematic review. BMC Musculoskelet Disord. 2011. DOI: 10.1186/1471-2474-12-137
  4. Efficacy of a single, image-guided corticosteroid injection for glenohumeral arthritis. J Shoulder Elbow Surg. 2021. DOI: 10.1016/j.jse.2020.08.008
  5. Use of Injections for Osteoarthritis in Joints and Sports Activity. Clin Sports Med. 2005. DOI: 10.1016/j.csm.2004.08.001
  6. A Bayesian network meta-analysis comparing the clinical effectiveness of local corticosteroid injection strategies for carpal tunnel syndrome. BMC Musculoskelet Disord. 2015. DOI: 10.1186/s12891-015-0815-8
  7. The influence of ultrasound guidance on the rate of success of acromioclavicular joint injection. J Shoulder Elbow Surg. 2012. DOI: 10.1016/j.jse.2011.11.036
  8. Accuracy of Carpal Tunnel Injection: A Prospective Evaluation of 756 Patients. Hand (N Y). 2018. DOI: 10.1177/1558944718787330
  9. Surgical Treatment of Symptomatic Acromioclavicular Joint Problems. Clin Orthop Relat Res. 2007. DOI: 10.1097/blo.0b013e31802f5450
  10. Acromioclavicular osteoarthritis and shoulder pain: a review. J Ultrasound. 2020. DOI: 10.1007/s40477-020-00498-z
  11. Impingement syndrome: temporal outcomes of nonoperative treatment. J Shoulder Elbow Surg. 2009. DOI: 10.1016/j.jse.2008.09.005
  12. Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis. Br J Sports Med. 2019. DOI: 10.1136/bjsports-2018-100486
  13. Subacromial decompression yields a better clinical outcome than therapy alone: a prospective randomized study with minimum 10-year follow-up. Am J Sports Med. 2018. DOI: 10.1177/0363546518755759
  14. Subacromial Impingement Syndrome. J Am Acad Orthop Surg. 2011. DOI: 10.5435/00124635-201111000-00006
  15. Return to sport following arthroscopic Bankart repair: a systematic review. J Shoulder Elbow Surg. 2018. DOI: 10.1016/j.jse.2018.02.044
  16. Bankart repair for anterior instability of the shoulder: long-term outcome. J Bone Joint Surg Am. 1997. DOI: 10.2106/00004623-199706000-00008
  17. High long-term failure rates after arthroscopic Bankart repair in younger patients with recurrent dislocations. Knee Surg Sports Traumatol Arthrosc. 2024. DOI: 10.1002/ksa.12391
  18. Outcomes after arthroscopic Bankart repair: patients with first-time versus recurrent dislocations. Am J Sports Med. 2017. DOI: 10.1177/0363546517698692
  19. A lower Instability Severity Index score threshold may better predict recurrent anterior shoulder instability after arthroscopic Bankart repair. J ISAKOS. 2021. DOI: 10.1136/jisakos-2020-000584
  20. Anterior shoulder instability part III — revision surgery, rehabilitation and return to play: an international consensus statement. Arthroscopy. 2021. DOI: 10.1016/j.arthro.2021.07.019
  21. Outcomes of arthroscopic stabilization for recurrent instability are equal to stabilization after a primary event. Bone Joint J. 2024. DOI: 10.1302/0301-620x.106b10.bjj-2024-0396.r1
  22. Shoulder Instability. Clin Sports Med. 2018. DOI: 10.1016/j.csm.2017.12.001
  23. When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive tears. Am J Sports Med. 2011. DOI: 10.1177/0363546511413372
  24. Timing of retears after arthroscopic rotator cuff repair and associated factors. J Shoulder Elbow Surg. 2023. DOI: 10.1016/j.jse.2023.01.026
  25. Functional outcome of arthroscopic rotator cuff repairs: a correlation of anatomic and clinical results. J Shoulder Elbow Surg. 2007. DOI: 10.1016/j.jse.2007.03.020
  26. Early versus delayed mobilization for arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2023. DOI: 10.1186/s12891-023-07075-5
  27. Early versus delayed motion after rotator cuff repair: a systematic review of overlapping meta-analyses. Am J Sports Med. 2017. DOI: 10.1177/0363546517692543
  28. Early versus delayed passive range of motion after rotator cuff repair. Am J Sports Med. 2014. DOI: 10.1177/0363546514552802
  29. Does early motion lead to a higher failure rate or better outcomes after arthroscopic rotator cuff repair? J Shoulder Elbow Surg. 2017. DOI: 10.1016/j.jse.2017.04.004
  30. Delayed versus early motion after arthroscopic rotator cuff repair: a meta-analysis. J Shoulder Elbow Surg. 2014. DOI: 10.1016/j.jse.2014.05.021
  31. Corticosteroid Injections for Carpal Tunnel Syndrome. Plast Reconstr Surg. 2017. DOI: 10.1097/prs.0000000000003511
  32. Nonsurgical treatment for symptomatic carpal tunnel syndrome: a randomized clinical trial comparing local corticosteroid injection versus night orthosis. J Hand Surg Am. 2021. DOI: 10.1016/j.jhsa.2020.11.014
  33. Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res. 2015. DOI: 10.1007/s11999-014-3835-z
  34. Carpal tunnel release: a prospective, randomised assessment of open and endoscopic methods. J Bone Joint Surg Am. 1994. DOI: 10.2106/00004623-199408000-00020
  35. Patient-perceived time to recovery after carpal tunnel release. J Hand Surg Glob Online. 2026. DOI: 10.1016/j.jhsg.2026.100973
  36. Randomized clinical trial of surgery versus conservative therapy for carpal tunnel syndrome. BMC Musculoskelet Disord. 2005. DOI: 10.1186/1471-2474-6-2
  37. Risk of neurovascular injury with limited-open carpal tunnel release: defining the safe zone. J Hand Surg Eur. 2001. DOI: 10.1054/jhsb.2001.0583
  38. Return to Work After Primary Rotator Cuff Repair: A Systematic Review and Meta-analysis. Am J Sports Med. 2021. DOI: 10.1177/0363546520975426
  39. Return to work after subacromial decompression and diagnostic arthroscopy. BMC Musculoskelet Disord. 2021. DOI: 10.1186/s12891-021-04768-7
  40. Return to work after carpal tunnel release surgery: a qualitative interview study. BMC Musculoskelet Disord. 2019. DOI: 10.1186/s12891-019-2638-5
  41. A prospective study of prognostic factors for duration of sick leave after endoscopic carpal tunnel release. BMC Musculoskelet Disord. 2009. DOI: 10.1186/1471-2474-10-144
  42. Workers' Compensation and Outcomes of Upper Extremity Surgery. J Am Acad Orthop Surg. 2013. DOI: 10.5435/jaaos-21-02-67
  43. Prediction of 2-year work participation in sickness absentees with neck or shoulder pain. BMC Musculoskelet Disord. 2019. DOI: 10.1186/s12891-019-2906-4
  44. Prevalence and predictors of return to work in hospitalised trauma patients during the first year after discharge. Injury. 2012. DOI: 10.1016/j.injury.2011.03.038
  45. A review of a workers' compensation database 2003–2013: patient factors influencing return to work after rotator cuff repair. Geriatr Orthop Surg Rehabil. 2017. DOI: 10.1177/2151458517732209
  46. Measures of Adult Shoulder Function. Arthritis Care Res. 2020. DOI: 10.1002/acr.24230
  47. Statistics in brief: minimum clinically important difference — availability of reliable estimates. Clin Orthop Relat Res. 2017. DOI: 10.1007/s11999-016-5204-6
  48. Minimal clinically important differences of 3 patient-rated outcomes instruments. J Hand Surg Am. 2013. DOI: 10.1016/j.jhsa.2012.12.032

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.