What's New — Shoulder — September 2026¶
200 new articles published this month.
Themes: Rotator Cuff Repair Techniques · Irreparable Tears and Tendon Transfers · Shoulder Arthroplasty Outcomes · Arthroplasty Technology and Planning · Glenohumeral Instability Management · Perioperative Risk and Complications
Digest generated 2026-10-04 16:13:04+00:00.
Highlights¶
Rotator Cuff Repair Techniques¶
This month featured a dense cluster of rotator cuff repair innovation and evidence synthesis. International consensus statements updated guidance on diagnosis, nonoperative care, posterosuperior tear repair, subscapularis management, augmentation, tendon transfers, reverse arthroplasty, and rehabilitation [22][23][36], complemented by ESSKA-ESA consensus on partial-thickness posterosuperior tears [28][52]. Technical advances included remplissage with direct visualization [4], hybrid double-row fixation with cancellous screws in osteoporotic bone [8], margin convergence without anchors [15], biceps-rerouting superior capsular reconstruction [13], and miniopen dermal matrix augmentation [12]. Biologic augmentation studies examined allograft with bursal tissue [5], PRP effects on healing [48], collagen scaffolds [172], and patch comparisons [91], while biomechanical work defined repair-tension sweet zones [63] and low-tension strategies [56].
Irreparable Tears and Tendon Transfers¶
Management of massive irreparable rotator cuff tears generated substantial output. Comparative studies evaluated static superior capsular reconstruction versus dynamic middle trapezius transfer with latissimus dorsi/teres major transfer [7], biceps-augmented partial repair versus fascia lata SCR in a randomised trial [192], and LHBT versus fascia lata-polypropylene mesh SCR [196]. Secondary middle trapezius transfer after failed repair achieved outcomes comparable to primary transfer [11]. Technical notes described arthroscopic latissimus dorsi transfer in lateral decubitus [35]. Biomechanical investigations supported cable reconstruction with biologic tuberoplasty [24], reinforced polyester patch augmentation of thin fascia grafts [45], and middle trapezius transfer effects on glenohumeral translation [164]. Long-term MRI showed progressive fascia lata graft thinning associated with retear after SCR [66], and muscle strength recovery was compared between RSA and tensor fascia lata SCR [86].
Shoulder Arthroplasty Outcomes¶
Arthroplasty dominated the digest with large outcome series and registry analyses. A single-surgeon consecutive series of 458 anatomic replacements supported aTSA durability [49], while Equinoxe revision risk was scrutinized following the polyethylene recall [19][37]. Stem design questions featured prominently: humeral osteotomy rates during revision of standard uncemented stems [1], alignment guides improving stem positioning [27], distal filling ratios for neutral alignment [100], early radiographic findings and instability with metaphyseal-fixated stems [108][121], onlay design comparisons [181], and humeral bone resorption patterns [128]. Stemless reverse arthroplasty was systematically reviewed [59], with radiographic view affecting migration detection [169]. Fracture-related RSA studies examined greater tuberosity volume [50], lateralized versus Grammont implants [110], tuberosity healing with lateralization [84], and outcomes in patients over 80 [115][179].
Arthroplasty Technology and Planning¶
Emerging technologies in shoulder arthroplasty formed a distinct cluster. Robotic-assisted reverse arthroplasty showed a learning curve breakpoint between three and five cases [6], and robotic assistance enhanced stemless implant stability [73]. Mixed reality navigation achieved low deviations in glenoid inclination and version [89], while extended reality meta-analysis demonstrated training efficiency and improved guidewire accuracy [126]. Three-dimensional CT-guided simulation with scapulothoracic motion optimised implant selection and positioning [125], and artificial intelligence enabled quantitative muscle assessment predicting RSA outcomes [90] plus postoperative radiographic evaluation [175]. Patient education about innovative technology improved perceptions and outcomes [104], and AI-based literature search tools matched trainee performance [137]. Custom 3D-printed glenoid components showed promising early outcomes for severe bone loss [118][120].
Glenohumeral Instability Management¶
Instability articles spanned bone loss assessment, stabilisation techniques, and athlete outcomes. Adolescent cohorts showed bipolar bone loss and low distance to dislocation commonly present, limiting isolated Bankart repair indications [21], while Hill-Sachs lesion size correlated with dislocation versus subluxation rather than chronicity [65]. A systematic review of Hill-Sachs measurement techniques highlighted classification heterogeneity [143]. Six o'clock anchor placement reduced recurrence [42], knotless and knotted all-suture anchors performed comparably [39], and suture tape constructs showed low failure rates in military populations [147]. Long-term bony Bankart fixation outcomes extended to 18 years [32]. Latarjet studies examined immediate rehabilitation without sling [38], five-year outcomes stratified by glenoid bone loss [183], and reinjury mechanisms in rugby players [188]. Novel techniques included dynamic anterior stabilisation with biceps transfer [26][47], free bone block fixation [46], and posterior acromial bone block [154].
Perioperative Risk and Complications¶
Perioperative risk stratification and complication avoidance emerged as a coherent theme. Infection risk was elevated in diabetic patients with foot ulcers undergoing TSA [10], preoperative sepsis increased 90-day and 2-year complications [182], and 16S rRNA PCR showed utility in periprosthetic joint infection diagnosis [101] alongside arthroscopic pre-revision biopsy [133]. Medical comorbidity studies linked recent myocardial infarction [31], alcohol use disorder [43], GLP-1 agonist exposure [53], and dementia [119] to adverse outcomes. Smoking cessation duration affected retear rates [60][61][83]. Perioperative proton pump inhibitor use increased aseptic loosening and dislocation [55], while tranexamic acid was evaluated in cuff repair [102]. Regional anaesthesia meta-analysis compared single-shot versus continuous interscalene blockade [135], and predictors of failed same-day discharge were identified [122].
Articles by Theme¶
Rotator Cuff Repair Techniques (22)¶
4. Tao C, Chen K, Chiang E, et al. Arthroscopic Rotator Cuff Remplissage Technique to Limit Soft Tissue Interposition. Arthroscopy Techniques 2026. doi:10.1002/atn2.70268
This technical note describes a simplified arthroscopic Remplissage technique for Hill-Sachs lesions in anterior shoulder instability, enabling direct visualization and retrieval of all suture limbs through a single posterior portal and a guided lateral accessory portal. The technique minimizes soft tissue interposition, preserves deltoid integrity, and reduces operative time compared with conventional blind suture retrieval in the subacromial space. Clinically, it offers surgeons a more efficient and safer method for augmenting Bankart repair in off-track instability patterns.
5. Smith MD, Ahmadi SK, Gregory JM. Augmentation of Arthroscopic Rotator Cuff Repair Using Enthesis Interpositional Allograft and Minced Autologous Subacromial Bursa. Arthroscopy Techniques 2026. doi:10.1002/atn2.70273
This technical note presents a rotator cuff repair augmentation technique combining an interpositional biphasic (enthesis) allograft scaffold with autologous minced subacromial bursal tissue, leveraging the complementary mechanisms of structural reinforcement and local delivery of mesenchymal stem cells. The approach addresses the difficulty of maintaining bursal tissue at the repair site by incorporating it with a scaffold that supports healing at the enthesis. Clinically, it offers a combined biologic and structural strategy to promote tendon healing and potentially reduce retear rates.
8. Chawanpaiboon P, Chotiwatanadilok B, Munshid M, et al. An Arthroscopic Technique for Hybrid Double‐Row Repair Using a Cancellous Screw and Washer for Enhanced Lateral‐Row Fixation in Osteoporotic Massive Rotator Cuff Tears With Long‐Head Biceps Augmentation. Arthroscopy Techniques 2026. doi:10.1002/atn2.70299
This technical note describes an arthroscopic hybrid double-row rotator cuff repair using a unicortical cancellous screw and washer for lateral-row fixation, combined with biceps superior capsular reconstruction, for massive tears in osteoporotic bone. The technique secures multiple suture limbs through a single screw, providing reliable bone purchase and footprint compression where anchor fixation is prone to failure. Clinically, it offers a cost-effective, practical alternative to conventional anchors in osteoporotic patients with massive rotator cuff tears.
12. Cho C, Choi B, Sohn H, et al. Anterolateral Miniopen Triple‐Row Repair With Acellular Human Dermal Matrix Patch Augmentation for Larger Rotator Cuff Tears. Arthroscopy Techniques 2026. doi:10.1002/atn2.70266
This technical note describes an anterolateral miniopen triple-row rotator cuff repair combined with onlay acellular human dermal matrix patch augmentation for large to massive tears. The approach combines arthroscopic evaluation and subacromial decompression with a miniopen repair, simplifying patch handling while providing strong fixation. It offers a practical, less technically demanding alternative to fully arthroscopic patch augmentation for tears at high risk of structural failure.
13. Devigne J, Mitrousias V, Cunningham G. Arthroscopic Superior Capsular Reconstruction With Long‐Head Biceps Tendon Rerouting Using Knotless Anchors. Arthroscopy Techniques 2026. doi:10.1002/atn2.70302
This technical article presents an arthroscopic superior capsular reconstruction technique for irreparable rotator cuff tears in young, active patients without significant glenohumeral arthritis, using the long head of the biceps tendon rerouted onto the greater tuberosity. Fixation is achieved with knotless anchors, providing stable tendon compression to bone and easy incorporation of the posterior cuff. The knotless construct offers fast, versatile, bone-preserving fixation with a simple surgical workflow.
15. Ghasemi SA, Fabregas A, Naja A, et al. Marginal Convergence Repair Technique for Partial Articular‐Sided Rotator Cuff Tears. Arthroscopy Techniques 2026. doi:10.1002/atn2.70240
This technical note describes an arthroscopic margin convergence repair for partial articular-sided rotator cuff tears performed entirely side-to-side without suture anchors, using a nonlocking loop configuration for tension-free convergence. The technique preserves the native footprint, avoids hardware complications, reduces cost, and permits accelerated rehabilitation. It is best suited for high-grade partial-thickness tears of varying configurations that fail conservative treatment.
22. Hurley ET, Twomey‐Kozak J, Lorentz SG, et al. Rotator Cuff Tears Part II: Subscapularis Repair, Augmentation, and Tendon Transfer—An International Expert Consensus Statement. Arthroscopy 2026. doi:10.1002/arj.70366
This international consensus statement, developed by 97 shoulder and sports surgeons from 15 countries, established evidence-based guidance on subscapularis repair, graft/patch augmentation, superior capsular reconstruction, and tendon transfers for rotator cuff tears. Of 48 statements, only 1 achieved unanimous consensus, 21 achieved strong consensus, 10 achieved consensus, and 16 failed to reach any consensus level. The results highlight both areas of agreement and substantial ongoing controversy in managing subscapularis and complex irreparable rotator cuff pathology, providing a framework for shared surgical decision-making.
23. Hurley ET, Droz LG, Lorentz SG, et al. Rotator Cuff Tears Part I: Diagnosis, Nonoperative Management, and Repair of Posterosuperior Tears—An International Expert Consensus Statement. Arthroscopy 2026. doi:10.1002/arj.70365
This companion international consensus statement from 97 surgeons across 15 countries addressed diagnosis, nonoperative management, and repair of posterosuperior rotator cuff tears. Of 50 statements, 30 achieved strong consensus, 17 achieved consensus, and 3 did not reach consensus, with strong agreement across all diagnostic domains. The statement establishes a standardised approach to history, examination, imaging, and treatment selection for posterosuperior cuff tears, supporting more consistent clinical practice.
28. Kany J, Iban MR, Calvo E, et al. The 2026 ESSKA‐ESA formal consensus on partial‐thickness posterosuperior rotator cuff tears (Part 2): Treatment strategies, rehabilitation, return to sport and complications. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70622
This second part of the 2026 ESSKA-ESA formal consensus used a standardised methodology with a 13-member steering group and 20-member rating group across three rounds to generate evidence-graded recommendations for partial-thickness posterosuperior rotator cuff tears. Of 33 question-statement pairs, 21 achieved strong agreement, yielding 30 recommendations (1 Grade A, 6 Grade B, 10 Grade C, 13 Grade D), including Grade A evidence that trans-tendon repair of articular-sided tears carries higher stiffness risk than tear completion, and Grade B support for at least 6 months of conservative treatment. The consensus provides clinicians with a graded framework for treatment, rehabilitation, return-to-sport, and complication management decisions.
36. Hurley ET, Glover MA, Lorentz SG, et al. Rotator Cuff Consensus Part III: Reverse Total Shoulder Arthroplasty, Revisions, Rehabilitation, and Follow‐Up—An International Consensus Expert Statement. Arthroscopy 2026. doi:10.1002/arj.70367
This international consensus process involving 97 shoulder and sports surgeons from 15 countries produced 47 statements on reverse total shoulder arthroplasty, revision surgery, and rehabilitation for rotator cuff tears, with 1 unanimous, 33 strong consensus, 10 consensus, and 3 non-consensus statements. The statements reflect updated evidence and evolving techniques across diagnosis through follow-up. The document provides clinicians with consensus-based guidance while highlighting ongoing areas of controversy in rotator cuff tear management.
48. Pitsilos C, Rigkos D, Chalidis B. Injection of Leukocyte‐Poor Platelet‐Rich Plasma During Rotator Cuff Repair Can Increase Healing Rate but Does Not Affect Clinical Outcomes: A Systematic Review and Meta‐analysis of Randomized Controlled Trials. Arthroscopy 2026. doi:10.1002/arj.70537
This systematic review and meta-analysis of 5 randomised controlled trials (470 patients) evaluated injectable leukocyte-poor platelet-rich plasma applied during arthroscopic rotator cuff repair. LP-PRP increased tendon healing rates, with repair failure occurring in 15.9% of the LP-PRP group versus a higher rate in controls, but did not improve clinical outcomes or patient-reported function. These findings suggest LP-PRP may benefit structural healing without translating to short-term clinical advantage.
52. Kany J, Iban MAR, Rosso C, et al. The 2026 ESSKA‐ESA formal consensus on partial‐thickness posterosuperior rotator cuff tears (Part 1): Definitions, classifications, etiologies, natural history and diagnosis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70587
The ESSKA-ESA formal consensus used a structured methodology with a steering group, literature review, and independent rating panel to generate 12 graded recommendations on definitions, classification, etiology, natural history, and diagnosis of partial-thickness posterosuperior rotator cuff tears. Grade A recommendations endorsed using multiple classification systems in combination and distinguishing acute from chronic tears. Clinicians should apply combined classification schemes and consider tear chronicity when evaluating these injuries, though several recommendations rest on lower-level evidence.
56. Vu DA, Nguyen TT, Pham TN, et al. Low-tension rotator cuff repair for retracted tears: Balancing mechanical relaxation and footprint coverage. Shoulder & Elbow 2026. doi:10.1177/17585732261485551
This systematized narrative review synthesized clinical, biomechanical, and cadaveric evidence on repair tension, footprint coverage, medialization, margin convergence, and partial repair for retracted rotator cuff tears. Evidence indicates repair tension is measurable, correlates with tear severity, and may relate to poorer tendon integrity and microvascular flow, with Level III data favoring tension-reducing repair at 24 months, but no universal threshold supports one strategy. Surgeons should adopt a tension-aware, individualized approach, reserving mobilization, medialization, or partial repair for tears where anatomic restoration would create excessive tension.
63. Liu Q, Bai L, Li X, et al. A Repair‐Tension Sweet Zone Maximizes Tendon‐to‐Bone Healing in a Rat Rotator Cuff Model. Arthroscopy 2026. doi:10.1002/arj.70471
In a rat supraspinatus repair model with four graded repair tensions, medium tension (~0.110 N/mm²) produced superior tendon-to-bone healing at 4 weeks, with the highest failure load and better enthesis organization than minimal- or high-tension repairs. The findings define a 'sweet zone' of repair tension, implying surgeons should avoid both excessive laxity and overtensioning to optimise healing.
91. Strony JT, Sinkler MA, Piper M, et al. A comparison of outcomes after arthroscopic rotator cuff repair with a bioinductive collagen implant, acellular dermal allograft, or no patch augmentation. JSES International 2026. doi:10.1016/j.jseint.2026.101754
This retrospective cohort compared functional outcomes and repair integrity (MRI ≥6 months postoperatively) after arthroscopic rotator cuff repair augmented with a bioinductive collagen implant, an acellular dermal allograft, or no patch in patients with full-thickness tears. Tear characteristics and fatty infiltration were matched/assessed across groups with outcomes at 3, 6, and 12 months. The findings inform selection of patch augmentation strategies based on tear severity and expected healing.
138. Faith H, Baker T, Williamson M, et al. “The Box" allograft augmentation for at risk rotator cuff repairs. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100871
This technical note describes 'The Box' allograft augmentation technique for rotator cuff repairs deemed at high risk of failure. The authors outline the surgical technique and its rationale for reinforcing compromised repairs. It offers surgeons an augmentation option for patients with poor tendon quality or high failure risk.
156. Lim JJ, Belk JW, Keeter C, et al. Platelet Concentration Is Not Associated With Improved Pain for Partial-Thickness Rotator Cuff Tears Treated With Platelet-Rich Plasma: A Systematic Review and Meta-analysis With Meta-regression of Level 1 Randomized Controlled Trials. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261480483
This systematic review and meta-analysis of level 1 randomised controlled trials examined whether platelet concentration in platelet-rich plasma (PRP) injections affects pain outcomes in partial-thickness rotator cuff tears, classifying studies as high- or low-dose (>4-fold over whole blood). Meta-regression showed no association between platelet concentration and improved visual analog scale pain scores. The results suggest no clinical basis for selecting higher-concentration PRP formulations for this indication.
172. Kumar VRS, Venugopal V, Neogi D, et al. Bioinductive collagen scaffolds for partial- and full-thickness rotator cuff repair: a systematic review. Clinics in Shoulder and Elbow 2026. doi:10.5397/cise.2025.01326
This systematic review evaluated clinical outcomes, imaging-based structural findings, and safety of bioinductive collagen scaffolds in adults with partial-thickness and selected full-thickness rotator cuff tears. The key finding was that scaffolds were associated with improvements in patient-reported outcomes and tendon healing on imaging across included studies. Clinically, this supports bioinductive scaffolds as a biologic adjunct for rotator cuff management, though study quality and heterogeneity should temper expectations.
190. Moriya S, Tomizawa A, Shibuya K, et al. Aseptic Synovitis After Arthroscopic Rotator Cuff Repair Augmented With a Bioinductive Collagen Implant: A Case Report and Literature Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100887
The authors report a case of aseptic synovitis following arthroscopic rotator cuff repair augmented with a bioinductive collagen implant, accompanied by a literature review. The report raises awareness of this potential inflammatory complication of collagen augmentation, suggesting clinicians should consider it in the differential for postoperative synovitis and that further surveillance of this widely used implant is warranted.
192. Hashad RM, El Gafary MK, El Gafary MK. Biceps-Augmented Partial Rotator Cuff Repair Versus Tensor Fascia Lata Superior Capsular Reconstruction for Irreparable Massive Rotator Cuff Tears in Young Adults: A Randomized Controlled Trial. JSES International 2026. doi:10.1016/j.jseint.2026.101802
This randomised controlled trial compared biceps-augmented partial rotator cuff repair against tensor fascia lata superior capsular reconstruction for irreparable massive rotator cuff tears in young adults. The study addresses the lack of comparative data between these two joint-preserving options, with results guiding surgical decision-making for this challenging population in whom arthroplasty is undesirable.
196. Yan D, Tang Y, Fang D, et al. Autologous Fascia Lata Combined With Polypropylene Mesh Versus the Long Head of the Biceps Tendon for Superior Capsular Reconstruction: A 2-Year Retrospective Comparative Cohort Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261475471
In a retrospective cohort of 62 patients with massive irreparable rotator cuff tears, arthroscopic superior capsular reconstruction using autologous fascia lata reinforced with polypropylene mesh was compared with long head of the biceps tendon graft at minimum 2-year follow-up. Both groups showed significant and comparable improvements in pain, functional scores, range of motion, and acromiohumeral distance, with similar graft integrity. Either graft option appears acceptable, with graft choice potentially tailored to patient factors.
198. Özdemir E, Topsakal FE, Altay N, et al. Comparable Twelve-Month Clinical Outcomes but Higher Environmental Impact of Arthroscopic Versus Mini-Open Rotator Cuff Repair: A Comparative Cohort Study. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104909
In a retrospective cohort of 927 patients, arthroscopic and mini-open rotator cuff repair showed comparable 12-month pain, function, and complication rates, but life-cycle assessment revealed a higher per-procedure environmental footprint for arthroscopy due to powered instrumentation, video equipment, and fluid-management systems. Predictors of carbon emissions were identified to inform greener practice. Clinically equivalent outcomes suggest environmental impact could be a consideration when selecting between the two techniques.
Irreparable Tears and Tendon Transfers (11)¶
7. Baek CH, Lim C, Kim JG, et al. Static versus dynamic superior augmentation in anterior latissimus dorsi and teres major tendon transfer for anterosuperior irreparable rotator cuff tears with narrow acromiohumeral distances. Shoulder & Elbow 2026. doi:10.1177/17585732261493884
This retrospective study compared static superior augmentation (superior capsular reconstruction) versus dynamic augmentation (arthroscopy-assisted middle trapezius tendon transfer) when combined with anterior latissimus dorsi and teres major transfer for anterosuperior irreparable rotator cuff tears with narrow acromiohumeral distances (<6 mm). Dynamic augmentation (aMTT) produced significantly greater improvements in forward elevation, elevation strength, and acromiohumeral distance than static SCR. Clinically, this favours dynamic augmentation for restoring superior stability and function in these challenging tear patterns.
11. Baek CH, Kim BT, Sokołowski A, et al. Secondary Middle Trapezius Tendon Transfer After Failed Rotator Cuff Repair Achieves Outcomes Comparable to Primary Transfer. Arthroscopy 2026. doi:10.1002/arj.70551
This retrospective study compared middle trapezius tendon transfer performed primarily (n=39) versus as a salvage procedure after failed supraspinatus repair (n=14) in 53 patients with irreparable supraspinatus tears. Clinical scores, range of motion, strength, and radiologic outcomes were assessed preoperatively and at final follow-up. Secondary transfer after failed repair achieved outcomes comparable to primary transfer, supporting MTT transfer as a viable salvage option for failed rotator cuff repair.
24. Haddara M, Guggenbach N, Sun K, et al. Cable Reinforcement Combined With Biologic Tuberoplasty Restores Muscle Forces and Scapular Strain in an Irreparable Rotator Cuff Tear Model: A Cadaveric Study. Arthroscopy 2026. doi:10.1002/arj.70530
This cadaveric study using a dynamic shoulder simulator tested eight shoulders with an irreparable rotator cuff tear (100% supraspinatus, 50% infraspinatus) to compare rotator cable reconstruction and biologic tuberoplasty, alone and combined. The tear alone markedly altered muscle loading (supraspinatus forces up to +75%, deltoid and infraspinatus reductions), while combined cable reconstruction with biologic tuberoplasty restored muscle forces and scapular strain to near-intact levels, whereas isolated biologic tuberoplasty was insufficient. These biomechanical findings support combining cable reconstruction with biologic tuberoplasty for irreparable rotator cuff tears.
35. Yang Y, Zhang J, Wang P, et al. Arthroscopic Latissimus Dorsi Transfer in the Lateral Decubitus Position for Irreparable Posterosuperior Massive Rotator Cuff Tears. Arthroscopy Techniques 2026. doi:10.1002/atn2.70253
This arthroscopic technique article describes latissimus dorsi tendon transfer performed in the lateral decubitus position for irreparable posterosuperior massive rotator cuff tears, detailing tendon release through the interval between the long head of the biceps and humeral shaft, with attention to the radial and axillary nerves and anterior circumflex humeral artery. Limited pectoralis major release and colour-coded suture weaving facilitate tendon passage and transfer. The technique provides a minimally invasive option for surgeons managing these challenging tears while emphasizing neurovascular safety.
45. Mihata T, Chalmers CE, Carbone J, et al. Reinforced Polyester Patch Augmentation Improves Biomechanical Properties of Thin Fascia Lata Grafts for Superior Capsule Reconstruction. Arthroscopy 2026. doi:10.1002/arj.70550
In a biomechanical study, thin fascia lata grafts for superior capsule reconstruction were augmented with a reinforced polyester patch placed between two fascia layers and compared with thin and thick grafts alone. The augmented thin graft showed significantly greater linear stiffness (85.0 vs 51.4 N/mm) and ultimate load (1144 vs 435 N) than the thin graft alone, matching thick graft performance. Patch augmentation may allow use of thinner autografts while preserving biomechanical integrity in superior capsule reconstruction.
66. Baek CH, Lim C, Kim JG, et al. Progressive Thinning of Autologous Fascia Lata Graft Is Associated With Graft Retear After Superior Capsular Reconstruction: A 5‐Year Magnetic Resonance Imaging Study. Arthroscopy 2026. doi:10.1002/arj.70497
Serial MRI over 5 years was used to track fascia lata graft thickness and humeral head migration in patients with Sugaya-classified healed superior capsular reconstruction for massive irreparable rotator cuff tears. Grafts that later retear showed progressive thinning on MRI before failure, correlating with clinical outcomes. Serial graft thickness measurement may serve as an early warning sign allowing surveillance and timely intervention after SCR.
86. Takayama K, Ito H. Evaluation of muscle strength recovery following reverse total shoulder arthroplasty versus superior capsular reconstruction using tensor fascia lata graft in patients with irreparable rotator cuff tears. JSES International 2026. doi:10.1016/j.jseint.2026.101749
This study compared muscle strength recovery (abduction, external and internal rotation via handheld dynamometry) and range of motion after reverse total shoulder arthroplasty (n=20) versus superior capsular reconstruction with tensor fascia lata graft (n=22) for irreparable rotator cuff tears, with ≥2-year follow-up. Strength on the affected side was referenced to the unaffected side and compared between groups, but the abstract excerpt does not report the final comparative results. Clinical implication: the comparison addresses which procedure better restores strength relevant to daily living in irreparable cuff tears.
131. Vauclin C, Flaig B, Haynes A, et al. A Comparison of the Agreement of Four AI Models on Surgical Recommendations of MIRCTs Using the ASES Neer Circle Delphi Recommendations as a Baseline. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.021
Sixty-one massive irreparable rotator cuff tear scenarios from the ASES Neer Circle Delphi consensus were entered into four large language models (OpenEvidence, ChatGPT-4o, Google Gemini, DeepSeek) with standardised prompts, and concordance with expert surgical recommendations was quantified, including testing with diabetes and smoking modifiers. The study measured agreement between AI-generated and expert consensus recommendations and identified predictors of model accuracy. Findings clarify the reliability of LLMs as decision-support tools in complex, patient-specific rotator cuff surgery planning.
164. Rupp M, Garcia AR, Drumm A, et al. The Effect of Middle Trapezius Transfer using SwiveLocks on Glenohumeral Translation and Subacromial Pressure in Irreparable Supraspinatus Tears – A Static and Dynamic Robotic Biomechanical Investigation. JSES International 2026. doi:10.1016/j.jseint.2026.101797
In a static and dynamic robotic biomechanical model of irreparable supraspinatus tears, middle trapezius transfer fixed with SwiveLocks was tested for its effects on glenohumeral translation and subacromial pressure. The results clarify the biomechanical effects of this transfer technique, supporting its potential role in managing irreparable posterosuperior cuff tears.
192. Hashad RM, El Gafary MK, El Gafary MK. Biceps-Augmented Partial Rotator Cuff Repair Versus Tensor Fascia Lata Superior Capsular Reconstruction for Irreparable Massive Rotator Cuff Tears in Young Adults: A Randomized Controlled Trial. JSES International 2026. doi:10.1016/j.jseint.2026.101802
This randomised controlled trial compared biceps-augmented partial rotator cuff repair against tensor fascia lata superior capsular reconstruction for irreparable massive rotator cuff tears in young adults. The study addresses the lack of comparative data between these two joint-preserving options, with results guiding surgical decision-making for this challenging population in whom arthroplasty is undesirable.
196. Yan D, Tang Y, Fang D, et al. Autologous Fascia Lata Combined With Polypropylene Mesh Versus the Long Head of the Biceps Tendon for Superior Capsular Reconstruction: A 2-Year Retrospective Comparative Cohort Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261475471
In a retrospective cohort of 62 patients with massive irreparable rotator cuff tears, arthroscopic superior capsular reconstruction using autologous fascia lata reinforced with polypropylene mesh was compared with long head of the biceps tendon graft at minimum 2-year follow-up. Both groups showed significant and comparable improvements in pain, functional scores, range of motion, and acromiohumeral distance, with similar graft integrity. Either graft option appears acceptable, with graft choice potentially tailored to patient factors.
Shoulder Arthroplasty Outcomes (21)¶
1. Vismara V, Murillo Nieto C, Glanz L, et al. Humeral osteotomy rate during revision shoulder arthroplasty for a standard-length uncemented low-filling humeral stem: a multicenter study. International Orthopaedics 2026. doi:10.1007/s00264-026-07053-1
This multicenter study determined the incidence of humeral osteotomy required during revision shoulder arthroplasty for a standard-length uncemented, low-filling-profile humeral stem (Arrow, FH Orthopedics) with metaphyseal coating and smooth diaphyseal stem. The findings inform surgeons about the likelihood of needing osteotomy, and its associated longer operative time, bone stock loss, and potentially worse outcomes, when revising this stem design. Clinically, this helps preoperative planning and patient counseling for revision procedures involving this implant.
19. Ho JC. Equinoxe Revision Risk: Is It the Polyethylene or Not?. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.01072
This commentary discusses a large Kaiser Permanente registry study by Prentice et al. assessing revision risk after primary anatomic and reverse total shoulder arthroplasty with the Exactech Equinoxe device compared with other implants, addressing whether the Exactech polyethylene recall affected device survivorship. The commentator praises the authors' transparency and rigor in objectively examining this controversial question. The clinical implication is that registry-based comparative data can inform surgeons' implant selection decisions in the wake of the polyethylene recall.
27. Nakazawa K, Manaka T, Ito Y, et al. A novel humeral alignment guide for improving stem alignment in reverse shoulder arthroplasty: a retrospective comparative study. International Orthopaedics 2026. doi:10.1007/s00264-026-07041-5
This retrospective comparative study of 100 patients undergoing cementless short-stem reverse shoulder arthroplasty evaluated a novel extramedullary humeral alignment guide (HAG) introduced mid-study, comparing consecutive cases before and after its adoption. The authors assessed whether use of the guide improved postoperative stem alignment in coronal and sagittal planes. The clinical implication is that an inexpensive extramedullary guide may reduce varus/valgus malalignment of short stems, which are otherwise prone to malpositioning.
37. Prentice HA, Chang RN, Yian E, et al. Revision Risk Following Primary Anatomic and Reverse TSA with an Exactech Equinoxe Compared with Other Devices. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01594
This registry cohort study of 13,901 patients evaluated all-cause revision risk following primary anatomic total shoulder arthroplasty, elective reverse total shoulder arthroplasty, and reverse arthroplasty for fracture using Exactech Equinoxe devices versus other devices, prompted by the 2024 packaging recall. Adjusted multivariable Cox regression analyses compared revision risk between device types. The results inform clinicians and patients about the comparative performance of the recalled Equinoxe implants in routine practice.
49. Schiffman C, Chin E, Whitson A, et al. Anatomic shoulder arthroplasty: a single surgeon’s consecutive series of four hundred and fifty eight patients. International Orthopaedics 2026. doi:10.1007/s00264-026-07017-5
A single-surgeon consecutive series of 458 patients undergoing anatomic total shoulder arthroplasty for rotator cuff-intact glenohumeral arthritis was evaluated with minimum two-year follow-up using Simple Shoulder Test outcomes and Kaplan-Meier survivorship analysis. The study assessed durability of patient-reported outcomes and implant survival, addressing concerns that have driven increasing use of reverse arthroplasty in this population. The findings support anatomic TSA as a durable option with sustained outcome improvements, informing implant choice in cuff-intact arthritis.
50. Elbaz E, Maman E, Factor S, et al. Greater tuberosity fragment volume does not predict clinical outcomes or tuberosity healing after reverse shoulder arthroplasty for proximal humerus fractures: a retrospective cohort study. International Orthopaedics 2026. doi:10.1007/s00264-026-07023-7
In a retrospective cohort of 153 patients treated with reverse total shoulder arthroplasty for proximal humerus fracture, preoperative CT-measured greater tuberosity fragment volume was correlated with range of motion, pain scores, and tuberosity healing. Contrary to the hypothesis, greater tuberosity volume did not predict clinical outcomes or healing. Preoperative fragment size alone should therefore not guide surgical decision-making or prognostication in fracture reverse arthroplasty.
59. Chan A, Shah A, Nam D, et al. Short- to midterm outcomes of stemless reverse total shoulder arthroplasty: a systematic review. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100021
This systematic review of 13 studies (592 patients, ~42-month follow-up) synthesized outcomes of stemless reverse total shoulder arthroplasty. Functional outcomes and complication profiles were generally comparable to stemmed designs, though concerns about malpositioning and loosening warrant ongoing surveillance; stemless rTSA appears a reasonable option offering bone preservation and reduced operative time.
84. Gómez D, Moya D, Viollaz G, et al. Does excessive lateralization influence tuberosity healing in reverse total shoulder arthroplasty for proximal humeral fractures?. JSES International 2026. doi:10.1016/j.jseint.2026.101737
This retrospective two-institution study of reverse total shoulder arthroplasty for acute proximal humeral fractures compared very highly lateralized (Arrow, >20 mm) versus lateralized (Humelock II, Unique; 10-15 mm) stems for tuberosity consolidation, radiographic angles, and functional outcomes at ≥12 months. The abstract reports the design and outcome measures (consolidation, forward flexion, external rotation, VAS, Constant score, LSA/distalization angle, complications) without stating the final comparative findings. Clinical implication: the study addresses whether stem lateralization degree compromises tuberosity healing, a key determinant of outcomes in fracture rTSA.
100. Hollo D, Soproni I, Toft F, et al. Standard-length stems require lower distal filling ratios than short stems to achieve neutral alignment in reverse total shoulder arthroplasty. JSES International 2026. doi:10.1016/j.jseint.2026.101765
This radiographic study compared coronal alignment between short and standard-length humeral stems in reverse total shoulder arthroplasty and identified implant- and bone-related factors associated with malalignment. It found that standard-length stems require lower distal filling ratios than short stems to achieve neutral alignment, informing stem selection and sizing to avoid coronal malalignment.
108. Boubekri A, Devana S, Chen L, et al. Early radiographic findings are not associated with instability for reverse total shoulder arthroplasty with the Perform metaphyseal-fixated humeral stem. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100030
This retrospective single-surgeon series evaluated early radiographic outcomes, stem alignment, metaphyseal fill, stem tip-to-greater tuberosity distance, and subsidence, after primary reverse total shoulder arthroplasty using a short metaphyseal-fixated humeral stem, with radiographs at 2 weeks and minimum 1-year follow-up. Early radiographic findings were not associated with postoperative instability, suggesting that minor stem malalignment or positioning variations with this metaphyseal stem do not predict instability. This supports the use of shorter metaphyseal-fixated stems without undue concern that early radiographic imperfections compromise stability.
110. Yu KE, Weir TB, Hart CM, et al. Reverse shoulder arthroplasty for fracture: how does a contemporary lateralized prosthesis compare with a Grammont-style implant?. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100024
This retrospective single-institution series compared 31 Grammont-style medialized and 43 contemporary lateralized reverse shoulder arthroplasties performed for acute geriatric proximal humerus fractures, assessing pain, ASES scores, range of motion, and radiographic tuberosity healing. Lateralized implants achieved greater external rotation (45° vs. 31°) and higher tuberosity healing rates (86% vs. 48%), supporting the authors' hypothesis. These findings favour contemporary lateralized prostheses for fracture rTSA when aiming to maximise motion and tuberosity healing.
115. Candela V, Piccolo Y, Giovinazzo L, et al. Enovis SMR reverse shoulder arthroplasty for complex proximal humerus fractures in patients over 80 years of age. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100039
Twenty-six patients over 80 years of age underwent cementless reverse shoulder arthroplasty for four-part proximal humerus fractures with tuberosity fixation, evaluated at a mean 38-month follow-up. Tuberosity healing occurred in 88% of patients and, while Constant scores were similar regardless of greater tuberosity healing, healed greater tuberosities showed significantly better active external rotation. Surgeons can counsel elderly fracture patients to expect reasonable function, with greater tuberosity healing particularly influencing external rotation recovery.
121. Bauer S, Shirinskiy I, Blakeney WG. Concavity compression, liner constraint, and instability risk in cuff-deficient 135° reverse shoulder arthroplasty. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100046
The authors present a biomechanical argument, drawing on Lippitt and Matsen's stability principles, that cuff-deficient 135° reverse shoulder arthroplasty may be prone to instability because reduced glenohumeral concavity compression and liner constraint limit the range of stabilizable joint force angles. They suggest the radiographic data from Boubekri et al. can be reinterpreted through this lens. Clinically, this implies that implant design features affecting constraint deserve attention when assessing instability risk in cuff-deficient patients.
128. Nozu T, Hirakawa Y, Manaka T, et al. Radiographic bone resorption after reverse total shoulder arthroplasty using a single onlay platform: risk factors and distribution patterns in a Japanese cohort. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100053
In this multicenter Japanese study of 128 cementless reverse total shoulder arthroplasties using a single onlay platform, propensity score matching compared standard and short stems regarding humeral bone resorption graded by the Inoue classification across metaphyseal and diaphyseal zones. Canal filling ratios and stem alignment were assessed, with multivariable logistic regression identifying factors associated with grade ≥3 resorption. The results clarify risk factors and distribution patterns of bone resorption in an Asian cohort, informing stem selection to mitigate stress shielding.
141. Shinwari H, Tahir U, Popal A, et al. Serious Adverse Events and 30- and 90-Day Readmission Rates Following Anatomical Versus Reverse Total Shoulder Arthroplasty: A Systematic Review and Meta-Analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100875
The authors performed a systematic review and meta-analysis comparing serious adverse events and 30- and 90-day readmission rates after anatomic versus reverse total shoulder arthroplasty. The analysis quantified and compared perioperative complication and readmission risks between the two procedures. These findings can inform preoperative risk counseling and procedural selection.
165. Dieu V, Puga TB, Haechten T, et al. Stemmed versus stemless humeral implants in anatomic total shoulder arthroplasty (aTSA): A systematic review and meta-analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100881
This systematic review and meta-analysis compared stemmed versus stemless humeral implants in anatomic total shoulder arthroplasty. The pooled evidence informs implant selection by weighing outcomes such as revision, complications, and functional scores between the two designs.
168. Bahu E, Saab M, Chantelot C, et al. Humeral Fractures After Reverse Total Shoulder Arthroplasty: Functional Outcomes and Complications. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104876
This multicenter French study (14 centers, 121 patients, SOFCOT 2024 symposium) compared nonoperative treatment, osteosynthesis, and prosthetic revision for periprosthetic humeral fractures after reverse shoulder arthroplasty. It found no clear superiority of one strategy in complications or function, supporting treatment individualized to fracture pattern and patient factors.
169. Antoni M, Obert L, Quemener A, et al. Radiographic view strongly influences detection of humeral component migration after stemless shoulder arthroplasty. JSES International 2026. doi:10.1016/j.jseint.2026.101793
This study examined how different radiographic views affect the detection of humeral component migration after stemless shoulder arthroplasty. The key finding was that the radiographic view used strongly influenced whether migration was detected, with some views substantially underestimating or missing component movement. Clinically, this implies that standardised or carefully selected radiographic projections are essential for reliable postoperative surveillance of stemless humeral implants.
179. Pasqualini I, Jevnikar BE, Turan O, et al. Reverse Total Shoulder Arthroplasty for Proximal Humerus Fractures Using the Biomet Comprehensive Shoulder System: One-Year Results Reflect Clinically Meaningful Recovery. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.004
Sixty-four patients treated with reverse total shoulder arthroplasty using the Biomet Comprehensive Shoulder System for acute proximal humerus fractures were followed for two years with VAS, SANE, ASES, and range-of-motion assessments. Paired comparisons of one- and two-year outcomes, along with PASS and individual-level MCID analyses, showed that one-year results already reflect clinically meaningful recovery. This supports using one-year benchmarks for counseling fracture patients and suggests limited additional benefit accrues between one and two years.
181. Daher N, Mazeh M, Castle J, et al. Comparing Outcomes of Onlay Humeral Stem Designs in Reverse Total Shoulder Arthroplasty: A Systematic Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100882
This systematic review compared outcomes across different onlay humeral stem designs in reverse total shoulder arthroplasty. By synthesizing the available literature, the authors sought to determine whether stem design influences clinical and functional results. The findings help guide implant selection and inform surgeons about the relative performance of onlay stem options in rTSA.
191. Massardier E, Bourbotte-Salmon F, Vaz G, et al. High prevalence of radiographic changes at prothesis-bone interface after cemented and uncemented massive prosthesis replacement following proximal humeral resection for bone tumor. A retrospective study of 45 surgeries. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104905
A retrospective review of 45 massive proximal humeral prostheses (41 patients) implanted after bone tumour resection (median follow-up 23 months; 53.6% reverse designs) found radiolucent lines at the bone-implant interface in 19.5% of patients. These radiographic changes may signal early mechanical stress in a construct known for frequent complications, arguing for routine radiographic surveillance to identify implants at risk of reoperation.
Arthroplasty Technology and Planning (11)¶
6. Boekel P, Grant A, Doma K, et al. The learning curve associated with robotic-assisted shoulder arthroplasty: A feasibility study. Shoulder & Elbow 2026. doi:10.1177/17585732261493942
This feasibility study evaluated the learning curve for robotic-assisted (MAKO) shoulder arthroplasty in the first 19 cases performed by a single surgeon, assessing operative time and NASA Task Load Index (NASA-TLX) scores. The NASA-TLX identified a learning curve breakpoint between three and five cases, whereas operative time showed no significant correlation with case progression, indicating cognitive workload is a more sensitive learning metric. Clinically, this suggests surgeons can achieve proficiency with robotic shoulder arthroplasty relatively quickly, supporting its safe introduction into practice.
73. Hatta T, Fleps I, lopez picazo M, et al. Impact of robotic-assisted surgery on enhancing stability of stemless shoulder arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.013
Human supraspinatus tendon cells from rotator cuff repair patients were cultured in standard or high-glucose medium with or without losartan, and assessed for gene expression, viability, ROS production, and apoptosis. Losartan reduced oxidative stress and apoptosis in a concentration-dependent manner, particularly under high-glucose conditions. ARBs may represent a repurposable adjunct therapy to improve tendon-bone healing, especially in diabetic patients undergoing cuff repair.
89. Antoni M, Marzolf G, Mariotte B, et al. Mixed reality with real-time navigation grants low deviations from planned inclination and version of the glenoid for reverse total shoulder arthroplasty. JSES International 2026. doi:10.1016/j.jseint.2026.101752
This case series evaluated glenoid implant version and inclination in reverse total shoulder arthroplasty using mixed reality holographic guidance with real-time navigation, superimposing the planned scapular trajectory on the patient's anatomy. The technique achieved low deviations from planned glenoid inclination and version. This suggests mixed reality navigation may improve implant positioning accuracy over freehand reproduction of on-screen plans, potentially reducing notching, instability, and loosening.
90. Mitsuzawa S, Fujita A, Takeuchi H, et al. Artificial intelligence–based quantitative computed tomography assessment of shoulder muscle and its association with outcomes after reverse total shoulder arthroplasty. JSES International 2026. doi:10.1016/j.jseint.2026.101753
In this retrospective study of 14 shoulders undergoing reverse total shoulder arthroplasty for cuff tear arthropathy, an artificial intelligence, based automated segmentation of preoperative 1-mm CT scans quantified shoulder muscle volume and fatty composition. AI-derived muscle measures were associated with postoperative range of motion at minimum 1-year follow-up. Automated quantitative CT muscle assessment may help preoperatively predict ROM outcomes and guide patient counseling in rTSA.
104. Movassaghi A, Chan EW, Lubert J, et al. Patient Education for innovative technology in shoulder arthroplasty: does knowledge improve outcomes?. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100026
This prospective cohort study of 154 primary total shoulder arthroplasty patients compared those who viewed a pre-operative educational video about innovative surgical technologies (3D planning, navigation, mixed reality) with controls. It determined whether improved patient perceptions of technology from education translated into better PROMs and range of motion, informing the value of pre-operative education in shoulder arthroplasty.
118. Petermann M, Monga P, Pap G. Clinical and radiological results of custom-made glenoid implants in reverse total shoulder arthroplasty with a mean follow-up of 36 months. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100040
The first 12 consecutive patients receiving custom-made glenoid implants for severe glenoid bone deficiency in reverse shoulder arthroplasty were followed a mean of 36 months with clinical scoring and radiographic assessment. Significant improvements were seen in Constant score, Simple Shoulder Test, and motion, with no osteolysis or loosening and only mild (grade 1) notching in 30%. Early results suggest custom glenoid implants achieve stable fixation and meaningful functional gains in complex bone-deficient shoulders.
120. Wesorick B, Hasbrook T, Jerman C, et al. Early clinical outcomes of restor3D custom three dimensional-printed glenoid components in complex shoulder arthroplasty. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100042
Eighteen patients with severe glenoid bone loss underwent primary or revision reverse shoulder arthroplasty with a patient-specific 3D-printed custom glenoid implant, with clinical and radiologic outcomes reviewed at a mean 18-month follow-up. The study evaluated patient-reported outcomes, imaging, and complications, comparing patients with and without complications. Early results inform the evolving role of custom 3D-printed glenoids in complex arthroplasty, though longer follow-up is needed to address cost and durability concerns.
125. Parsons KE, Shenoy DA, Lorentz SG, et al. Optimization of implant selection and positioning for reverse total shoulder arthroplasty using three-dimensional computed tomography–guided simulation software with scapulothoracic motion. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100049
Using a 3D simulation model (CORIOGRAPH MODELER) incorporating scapulothoracic motion in 49 reverse total shoulder arthroplasty patients, the authors evaluated the impact of implant variables, glenosphere size, eccentricity, lateralization, insert thickness, neck-shaft angle, and component version, on impingement-free range of motion across 12 motions. The study quantifies how individual implant parameters affect both standard ROM and activities of daily living. This supports more precise, simulation-guided implant selection and positioning to optimise postoperative function.
126. Ruiz ML, Abrams GD, Freehill MT, et al. Utility of extended reality in shoulder arthroplasty: a meta-analysis of training efficiency and glenoid guidewire accuracy. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100051
Two meta-analyses examined extended reality in shoulder arthroplasty: 3 studies (55 participants) for surgical training and 7 studies (349 guidewire placements) for glenoid guidewire accuracy. XR-trained participants completed procedures faster than controls, though Objective Structured Assessment of Technical Skills scores did not differ significantly; guidewire placement error results were also analyzed. The findings quantify XR's value for educational efficiency and intraoperative accuracy, informing its adoption in training and guidance.
137. MacLeod JS, Lee MS, Baker H, et al. A Focused PubMed AI Search Program Creates Better Literature Reviews than General Purpose AI and is Comparable to Trainees in Shoulder and Elbow Surgery. JSES International 2026. doi:10.1016/j.jseint.2026.101790
The authors compared literature reviews generated by a PubMed-focused AI search program against general-purpose AI and trainee-prepared reviews in shoulder and elbow surgery. The focused AI tool produced better literature reviews than general-purpose AI and performed comparably to trainees. Clinically, specialty-specific AI search tools may serve as reliable adjuncts for surgeons preparing literature reviews.
175. Chung SW, Park S, Yoon YS, et al. Artificial intelligence for postoperative plain radiographic assessment after reverse total shoulder arthroplasty: current evidence, clinical readiness, and limitations. Clinics in Shoulder and Elbow 2026. doi:10.5397/cise.2026.00661
This narrative review surveyed current evidence on artificial intelligence applications for postoperative plain radiographic assessment after reverse total shoulder arthroplasty. The key finding was that AI-based implant identification and automated glenosphere orientation measurement demonstrated the highest clinical readiness with reproducible accuracy, whereas detection of scapular notching progression, component loosening, and baseplate migration remains limited. Clinically, AI tools are not yet fully ready to replace expert radiographic interpretation and should be used as adjuncts in postoperative RTSA surveillance.
Glenohumeral Instability Management (15)¶
21. Arvesen JE, Ellis HB, Do D, et al. Indications for Isolated Arthroscopic Bankart Repair in the Adolescent Shoulder May Be Limited: Bipolar Bone Loss and Low Distance to Dislocation Found Commonly in an Adolescent Population With Glenohumeral Instability. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261483327
This retrospective cohort study of 181 adolescents (ages 10-19) with anterior shoulder instability measured glenoid bone loss, Hill-Sachs interval, on-track/off-track status, and distance to dislocation on MRI to determine the prevalence of bipolar bone loss at initial presentation. Contrary to the assumption that bone loss is uncommon in adolescents, bipolar bone loss and low distance to dislocation were found commonly, suggesting the indications for isolated arthroscopic Bankart repair in this population may be limited. Clinicians should assess bony pathology on imaging before committing to soft-tissue-only stabilisation in adolescent instability patients.
26. Mendes R, Mello M, Garcia Jr JC, et al. Inlay Dynamic Anterior Stabilization of the Shoulder With Long Head Biceps Tendon Using All‐Suture Anchor. Arthroscopy Techniques 2026. doi:10.1002/atn2.70262
This technical note describes an inlay dynamic anterior stabilisation technique using the long head of the biceps tendon transferred through a trans-subscapularis route and fixed in a 5-mm anterior-inferior glenoid bone tunnel with all-suture anchors and Krakow sutures, combined with a modified Bankart repair. The construct provides sling and hammock stabilizing effects while preserving external rotation and avoiding bone grafting, and remains adaptable intraoperatively when labral tissue is insufficient. It offers a reproducible, cost-effective soft-tissue option for anterior instability with subcritical (<20%) glenoid bone loss and does not preclude later bone-block procedures.
32. Jessen M, Hinz M, Plath J, et al. Long‐Term Clinical Outcomes of Arthroscopic Suture Anchor Fixation of Bony Bankart Lesions at a Mean 18‐Year Follow‐Up. Arthroscopy 2026. doi:10.1002/arj.70565
This single-center retrospective study evaluated long-term outcomes after arthroscopic single-row suture anchor fixation of bony Bankart lesions performed between 1999 and 2010, with a minimum 14-year follow-up (mean 18 years). Patients reported shoulder stability, reoperation, satisfaction, and validated outcome measures including Constant Score, SSV, ASES, Oxford Instability Score, and WOSI, analyzed against cohort-specific minimal clinically important difference thresholds. The study provides rare long-term data on whether arthroscopic bony Bankart fixation durably maintains stability and function, informing surgical decision-making for glenoid rim fractures.
38. Goetti P, Bothorel H, Martinho T, et al. Immediate Self-Rehabilitation With Versus Without Sling Immobilization After Open Latarjet Procedures for Recurrent Anterior Shoulder Instability. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.00560
This monocentric randomised controlled trial of 86 patients compared immediate self-rehabilitation with versus without 3 weeks of sling immobilisation after open Latarjet procedures for recurrent anterior shoulder instability, using PROMs, motion-capture analysis, and CT at 6 months and 2 years. The primary outcome was the Rowe score, with secondary outcomes including pain, instability (SANE), range of motion, return to activity, graft union, and osteolysis. The findings address whether avoiding immobilisation compromises outcomes and may support earlier, sling-free rehabilitation protocols.
39. Townsend CB, Vega TF, Ithurburn MP, et al. Knotless and knotted all-suture anchors have comparable clinical outcomes and return to sport rates following arthroscopic anterior labral (Bankart) repair. Shoulder & Elbow 2026. doi:10.1177/17585732261472078
This retrospective study of 192 patients (mean age 23.8 years, 3.1-year follow-up) compared knotless versus knotted all-suture anchors for arthroscopic Bankart repair, finding no differences in revision surgery rates, return to sport, or ASES and WOSI scores between anchor types. Among competitive athletes attempting return to preinjury sport, 95% succeeded. The results indicate that anchor configuration choice does not affect clinical outcomes, giving surgeons flexibility in anchor selection for labral repair.
42. Lee JH, Hwang K, Song CM, et al. Arthroscopic Bankart Repair With a 6 o’Clock Anchor Reduces Recurrence and Improves Clinical Outcomes in Recurrent Anterior Instability. Arthroscopy 2026. doi:10.1002/arj.70560
This retrospective study compared arthroscopic Bankart repair with versus without a 6 o'clock inferior anchor in patients with recurrent anterior instability and minimal glenoid bone loss. Placement of the 6 o'clock anchor reduced recurrence rates and improved clinical scores (Korean Shoulder Score for Instability, Rowe, UCLA) beyond the minimal clinically important difference. These results support routine inferior anchor placement at the 6 o'clock position during Bankart repair.
46. Bahadir B, Sarikaya B, Tosun MF, et al. Arthroscopic Free Bone Block Transfer Technique Using Iliac Crest Autograft With Anchor‐Button Fixation for Glenohumeral Instability and Glenoid Bone Loss. Arthroscopy Techniques 2026. doi:10.1002/atn2.70250
This technical note describes an arthroscopic free bone block transfer using iliac crest autograft fixed with a specially designed anchor-button unit for glenohumeral instability with significant glenoid bone loss. The anchor-button mechanism provides more rigid fixation and improved rotational stability of the graft compared with conventional screw or suture anchor techniques. Clinical validation is needed to confirm these proposed advantages.
47. Su W, Wei X, Zhao J, et al. Arthroscopic Dynamic Anterior Stabilization and Augmentation of Bony Bankart Lesions With Transfer of the Long Head of the Biceps. Arthroscopy Techniques 2026. doi:10.1002/atn2.70251
This technical report presents a novel arthroscopic technique for bony Bankart lesions using long head of the biceps tendon transfer, in which the tendon is positioned beneath the glenoid fragment to act as a dynamic sling that elevates and stabilizes the fragment during suture anchor fixation. The technique addresses fragment displacement and nonunion associated with conventional fixation. Long-term clinical validation is required.
65. Dadoo S, Lin RT, Williams TC, et al. Hill‐Sachs Lesion Size Is Not Associated With Chronicity of Anterior Shoulder Instability But Is Larger After Anterior Shoulder Dislocation Versus Subluxation. Arthroscopy 2026. doi:10.1002/arj.70484
In a retrospective review of 255 patients undergoing arthroscopic Bankart repair, Hill-Sachs lesion area was measured on MRI and compared across instability chronicity (acute ≤6 vs chronic >6 months), number of events, and event type. HSL size was not associated with chronicity or number of instability events, but lesions were larger after true dislocation than subluxation. Clinicians should base bony defect assessment on event severity rather than symptom duration when planning instability surgery.
143. Kennedy OT, Yang W, Jain S, et al. Clinical Classification of Hill-Sachs Lesions: A Systematic Review of Radiographic Measurement Techniques. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100874
The authors conducted a systematic review of radiographic measurement techniques used to classify Hill-Sachs lesions. They found substantial heterogeneity and variability in measurement methods across the literature. Standardised classification is needed to enable consistent clinical decision-making regarding engagement and treatment.
147. Feeley SM, Yow BG, Hoyt BW, et al. Failure Rate After Shoulder Stabilization Procedures in the Military With Use of Knotless Suture Tape: A Case-Control Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261477910
This retrospective case-control study compared failure rates of arthroscopic shoulder stabilisation using knotless suture tape versus traditional knotted suture constructs in a high-demand military population. The study assessed recurrent instability and construct survivability following the institution's 2015 transition to suture tape. The results inform construct selection for labral repair in young, high-demand patients at elevated risk of recurrence.
183. Billaud A, Lajoinie L, Collotte P, et al. Results and return to sports at 5 years after Latarjet for anterior instability with or without pre-operative glenoid bone loss. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104898
This multicenter retrospective study evaluated patients at least 5 years after open Latarjet for anterior shoulder instability, grouped by preoperative glenoid bone loss (<5%, 5-15%, >15%) on CT. The authors hypothesized that the degree of bone loss would not affect clinical outcomes or return to sport, assessed via Rowe, Walch-Duplay, SSV, and SIRSI scores. The results inform whether the expanding indication for Latarjet beyond significant bone loss is supported by long-term data.
188. Kawasaki T, Yoshimatsu T, Hasegawa Y, et al. Graft Condition, Position, and Reinjury Mechanisms in Competitive Rugby Players Experiencing Reinjury After Coracoid Transfer for Shoulder Dislocation. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261483808
A case series of 21 competitive rugby players who sustained reinjury after coracoid transfer (15 Bristow, 6 Latarjet) for shoulder dislocation used CT and video analysis to characterize graft condition and reinjury mechanisms. Graft status varied widely at reinjury, including failures in Bristow patients despite prior bone union, and reinjury mechanisms often differed from the initial injury, highlighting that coracoid transfer does not confer absolute protection in collision athletes and informing counseling on return-to-rugby risk.
195. Deng X, Yao Z, Li X, et al. A Quantitative Morphological Analysis of Shoulder Labrum Based on Resliced 3-Dimensional MRI FRACTURE (Fast Field Echo Resembling A CT Using Restricted Echo-Spacing). Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261453289
In a level 4 case series of 58 patients without labral lesions, the authors quantitatively measured glenoid labral morphology (labral height, footprint width, labral width, slope angle) at each clockface position using resliced 3D FRACTURE-sequence MRI, validated against 3D proton density sequences. Measurements showed good interobserver consistency and defined position-specific labral dimensions. These normative data can guide anchor placement during glenoid labral repair.
199. Cuozzo F, Marsilio E, De Giovanni R, et al. Posterior shoulder instability: a therapeutic algorithm. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100888
The authors present a review and therapeutic algorithm for managing posterior shoulder instability, synthesizing current evidence on arthroscopic and open techniques, bony procedures, and indications. The algorithm stratifies treatment by instability etiology, bone loss, and patient factors. It provides clinicians with a structured, evidence-based framework for individualized management of posterior shoulder instability.
Perioperative Risk and Complications (16)¶
10. Catanzaro C, Guareschi M, Ninness H, et al. Infection risk following total shoulder arthroplasty in patients with diabetic foot ulcers. Shoulder & Elbow 2026. doi:10.1177/17585732261493522
Using the PearlDiver Mariner database (2010-2023), 56,482 diabetic patients undergoing primary total shoulder arthroplasty were stratified by diabetic foot ulcer status to assess infection outcomes. Diabetic foot ulcer patients (4.3% of cohort) had significantly higher rates of sepsis, periprosthetic joint infection, and deep infection at 90 days and 1 year, with DFU independently associated with these complications. Diabetic foot ulcers should be considered a marker of elevated infection risk when counseling and managing diabetic patients before shoulder arthroplasty.
31. Parmar RP, Mian M, Holle AM, et al. Myocardial Infarction Within 6 Months Before Arthroscopic Rotator Cuff Repair Is Associated With Significantly Increased Risk of Postoperative Myocardial Infarction. Arthroscopy 2026. doi:10.1002/arj.70607
Using the PearlDiver Mariner database (2010-2022), this propensity-matched analysis compared 2886 patients with prior myocardial infarction undergoing arthroscopic rotator cuff repair against 10,613 controls without prior MI. Prior MI increased the odds of postoperative MI (OR 3.48), with risk peaking when surgery occurred within 6 months of the infarct (OR 7.55). The clinical implication is that elective rotator cuff repair should be delayed at least 6 months after MI when feasible, with careful cardiac risk stratification in these patients.
43. Vakharia AM, Fortier LM, Moyal AJ, et al. Alcohol Use Disorder Is Associated With Higher Rates of Adverse Events, Readmissions, and Costs of Care Within 90 Days of Arthroscopic Rotator Cuff Repair. Arthroscopy 2026. doi:10.1002/arj.70578
Using a private insurance database with 1:5 matched cohorts, this study compared 90-day outcomes after arthroscopic rotator cuff repair in patients with and without alcohol use disorder. AUD patients had higher rates of medical complications, readmissions, and greater episode-of-care costs. These findings highlight AUD as a modifiable risk factor warranting preoperative optimization and counseling before rotator cuff surgery.
53. Choudhury A, Slusarczyk S, Mathson L, et al. The impact of glucagon-like peptide-1 (GLP-1) receptor agonists on postoperative outcomes following rotator cuff repair. Shoulder & Elbow 2026. doi:10.1177/17585732261486333
A retrospective TriNetX cohort of 5,876 adults with type II diabetes undergoing rotator cuff repair compared preoperative GLP-1 receptor agonist users versus non-users, with propensity-weighted regression to adjust for confounding. Unadjusted analyses showed higher odds of respiratory complications, urinary tract infection, and postoperative stiffness in GLP-1 users, though these associations were attenuated after weighting. Perioperative GLP-1 exposure warrants attention to respiratory risk and stiffness counseling, but residual confounding limits causal inference.
55. Ninness H, Woodland J, Rogalski BL, et al. Perioperative proton pump inhibitors use and postoperative surgical complications following primary total shoulder arthroplasty. Shoulder & Elbow 2026. doi:10.1177/17585732261483539
A propensity-matched retrospective TriNetX cohort compared surgical complications at three years between patients receiving perioperative proton pump inhibitors (7 days preoperative to 2 days postoperative) and matched controls undergoing primary total shoulder arthroplasty. PPI exposure was associated with increased rates of aseptic loosening, dislocation, revision, and overall complications. Surgeons should weigh these associations when prescribing perioperative PPIs, recognizing the retrospective design cannot establish causation.
60. Mena L, Checchia C, Malavolta EA. Duration of Smoking Cessation Needed to Achieve Retear Rates Comparable to Those of Nonsmokers After Arthroscopic Rotator Cuff Repair: Letter to the Editor. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261453028
This letter to the editor responds to a study identifying 3 years of smoking cessation as the threshold for retear rates comparable to nonsmokers after arthroscopic rotator cuff repair. The authors caution that the study examined patients who had already quit rather than the effect of counseling patients to quit, highlighting the need to distinguish causal inference from prognostic association when advising whether to delay surgery for cessation.
61. Chang H, Chun Y, Kim S, et al. Duration of Smoking Cessation Needed to Achieve Retear Rates Comparable to Those of Nonsmokers After Arthroscopic Rotator Cuff Repair: Response. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261453029
The authors respond to critique of their retrospective cohort study, clarifying that it compared retear rates among nonsmokers, former, and current smokers to identify the cessation interval at which outcomes approximate nonsmokers, not to estimate the intention-to-treat effect of a cessation intervention at surgical indication. They defend the target trial framework discussion while acknowledging the distinction between causal and prognostic interpretations.
83. Moore ML, Holle AM, Rankin WH, et al. Comparative Postoperative Outcomes After Rotator Cuff Repair in Tobacco and Nontobacco Nicotine Users. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261470573
Using PearlDiver data with propensity matching, this cohort compared 90-day complications and 2-year revisions after arthroscopic rotator cuff repair among nontobacco nicotine users, tobacco users, and nonusers. Tobacco users had increased infections, pneumonia, AKI, ED visits, readmissions, and revisions, whereas nontobacco nicotine users showed only mildly higher lysis-of-adhesions rates and otherwise outcomes similar to nonusers. Clinical implication: nontobacco nicotine products appear substantially less detrimental to rotator cuff repair healing than tobacco smoking.
101. Nguyen CN, Drake JH, Mounajjed MM, et al. Clinical utility of 16S ribosomal ribonucleic acid gene polymerase chain reaction versus tissue culture in shoulder periprosthetic joint infections. JSES International 2026. doi:10.1016/j.jseint.2026.101766
This study compared broad-range 16S rRNA gene PCR with sequencing against periprosthetic tissue culture for diagnosing shoulder periprosthetic joint infection in revision shoulder arthroplasty. The results define the clinical utility of 16S PCR as an adjunct to culture, particularly for detecting indolent organisms in challenging infection diagnoses.
102. Coombs J, Morriss N, Loyd K, et al. Perioperative outcomes following tranexamic acid use in arthroscopic rotator cuff repair. JSES International 2026. doi:10.1016/j.jseint.2026.101769
This study compared post-operative outcomes of arthroscopic rotator cuff repair performed with versus without perioperative tranexamic acid, hypothesizing fewer complications, less pain, and reduced opioid prescriptions with TXA. The findings clarify whether routine TXA use offers clinically meaningful perioperative benefits in rotator cuff surgery.
119. Zhu AR, Chen GQ, Zhu AR, et al. Impact of pre-operative dementia or cognitive impairment on outcomes after elective primary total shoulder arthroplasty. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100043
Using the NSQIP database, 219 elective primary total shoulder arthroplasty patients with pre-operative dementia or cognitive impairment were propensity-matched 5:1 to controls to compare 30-day outcomes. Dementia patients had longer length of stay, more frequent non-home discharge, and higher 30-day readmission rates. These findings support incorporating cognitive status into pre-operative planning, discharge disposition decisions, and risk counseling for TSA patients.
122. Marter JA, Smith KC, Entessari M, et al. Predictors for failed same-day discharge after total shoulder arthroplasty. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100044
This retrospective study of 808 primary reverse and anatomic total shoulder arthroplasties identified risk factors for failed same-day discharge, defined as hospitalization beyond 24 hours postoperatively. Logistic regression was used to evaluate demographic, comorbidity, laboratory, and perioperative pain-control predictors. The findings are intended to guide patient selection for outpatient versus inpatient postoperative care settings, reducing unnecessary costs from prolonged length of stay.
133. Nguyen CN, Drake JH, Mounajjed MM, et al. Diagnostic Accuracy of Arthroscopic Pre-Revision Tissue Biopsy in Shoulder Arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.023
A retrospective single-center review of 23 patients who underwent arthroscopic pre-revision tissue biopsy before shoulder arthroplasty revision calculated sensitivity, specificity, PPV, and NPV for periprosthetic joint infection using intraoperative cultures graded by 2018 ICM criteria as the gold standard; 11 patients (47.8%) met PJI criteria. The study evaluated whether arthroscopic biopsy can improve organism-level diagnosis prior to revision, given the poor performance of serum markers and aspiration in shoulder PJI. Results guide the pre-revision workup of suspected shoulder PJI and revision decision-making.
135. Torrez C, van de Wall BJ, Rippen E, et al. Single-Shot Versus Continuous Interscalene Blockade in Primary Shoulder Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.026
A systematic review and meta-analysis of seven studies (2,639 patients; 1,182 single-shot interscalene blocks, 1,457 continuous interscalene catheters) compared pain at 24 hours, opioid consumption, length of stay, complications, and costs after anatomic and reverse shoulder arthroplasty, with subgroup analysis by local anaesthetic agent. No significant global difference was found in 24-hour pain scores or opioid consumption between techniques, though continuous catheters provided lower pain with standard local anesthetics. Findings inform anaesthetic choice by balancing modest analgesic benefit against catheter-related complications and complexity.
160. Khoo KJ, Dasari SP, Chin EK, et al. Is the Presence, Increased Number, or Certain Category of Patient-Reported Allergies Associated with a Poor Outcome after Total Shoulder Arthroplasty?. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.028
This retrospective study of anatomic total shoulder arthroplasty patients with minimum 2-year follow-up investigated whether patient-reported allergies (presence, number, or category) were associated with worse outcomes, including SST scores, percentage of maximal possible improvement, and revision rate. Regression analyses assessed allergy categories such as antibiotics, pain medications, other medications, food, and materials. The results clarify whether allergy history should factor into preoperative risk stratification and outcome expectations for shoulder arthroplasty patients.
182. Castano AA, Holle AM, Renfree SP, et al. Preoperative Sepsis Is Associated With Increased 90-Day and 2-Year Complications Following Total Shoulder Arthroplasty: A Time-Stratified and Organism-Specific Analysis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.006
Using the PearlDiver claims database, 3,742 patients with sepsis within two years before shoulder arthroplasty were propensity matched to 11,044 controls and stratified by timing and causative organism of sepsis. Preoperative sepsis was strongly associated with postoperative sepsis at 90 days (OR 3.89) and with increased complications at both 90 days and 2 years. Clinically, recent sepsis, particularly within months of surgery, should be considered a significant risk factor when planning and counseling for shoulder arthroplasty.
Other articles this month¶
2. Hurley ET, Myers H, Dickens JF. Rehabilitation and Return to Sport After Anterior Shoulder Stabilization. Arthroscopy 2026. doi:10.1002/arj.70682
This review presents a phased, timeline-based rehabilitation protocol following anterior shoulder stabilisation (including remplissage), spanning protection with sling and staged motion (0-6 weeks) through strengthening, functional testing, and graded return to sport (4-6 months and beyond). Key findings emphasize early protection of internal rotation and conservative external rotation progression specific to remplissage, while avoiding high-risk loading activities until later phases. Clinically, it provides a structured framework to standardize rehabilitation and safely guide athletes' return to sport after stabilisation surgery.
3. Zhang J, Zhou C, Hao S, et al. Isotension Versus Low-Tension Fixation in Arthroscopic Biceps Tenodesis: A Comparative Study of Clinical Outcomes. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261486095
This retrospective cohort study compared clinical outcomes of isotension versus low-tension fixation in arthroscopic long head of the biceps tendon (LHBT) tenodesis, using shear wave elastography to measure tendon elastic modulus pre- and postoperatively. The authors hypothesized isotension fixation (tenodesis in situ before proximal resection) would yield superior outcomes versus low-tension fixation (resection first, then tenodesis of the residual stump). The clinical implication is guidance on optimal tensioning strategy for tendon-to-bone fixation in biceps tenodesis.
9. Keatisuwan S, Rattanavarinchai J, Sisayanarane T, et al. Magnetic resonance imaging-based cortical thickness as a predictor of osteoporosis in rotator cuff tears. Shoulder & Elbow 2026. doi:10.1177/17585732261491314
In a retrospective study of 130 women who underwent shoulder MRI and DXA within 6 months, proximal humeral cortical bone thickness was measured on coronal T1-weighted images to screen for osteoporosis in rotator cuff tear patients. Cortical thickness measures were significantly lower in osteoporotic patients, with CBTavg of 4.5 mm achieving 100% sensitivity and 86% specificity for femur DXA-defined osteoporosis (AUC 0.955). Standard shoulder MRI could serve as an opportunistic osteoporosis screening tool in this population, though findings apply only to women.
14. Tazawa R, Kenmoku T, Matsumoto M, et al. Scapular upward rotation during intraoperative functional zero-position assessment in relation to postoperative outcomes and elevated alignment after reverse total shoulder arthroplasty. International Orthopaedics 2026. doi:10.1007/s00264-026-07048-y
In 28 shoulders with cuff tear arthropathy treated with reverse total shoulder arthroplasty, the scapular upward rotation angle required to achieve the intraoperative fluoroscopically-confirmed functional zero-position was measured and related to postoperative outcomes. The study evaluated whether intraoperative scapular motion correlates with postoperative function and elevated (superior-shifted) prosthesis alignment. Intraoperative scapular upward rotation may serve as an intraoperative indicator relevant to postoperative function and alignment after rTSA.
16. Ferraro S, Pautasso A, Lanzetti RM, et al. Surgical treatment of complex scapular fractures: a single centre prospective observational study. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-026-07247-8
This prospective observational study of 12 patients surgically treated for complex scapular fractures (displaced fractures with articular extension or floating shoulder) between 2016 and 2022 assessed functional outcomes (Quick-DASH, Constant-Murley, SST), imaging outcomes, complications, and operative timing. The study also examined under-reported factors such as duration of surgery and time from injury to definitive fixation. It provides real-world outcome data supporting surgical management of selected complex scapular fractures.
17. Ranieri R, Calamita AG, Delle Rose G, et al. Salvage reverse shoulder arthroplasty after failed plate fixation of proximal humeral fractures: Clinical outcomes, complications, and prognostic factors. Shoulder & Elbow 2026. doi:10.1177/17585732261488974
This retrospective study of 29 patients who underwent reverse shoulder arthroplasty as salvage after failed plate fixation of proximal humeral fractures (mean follow-up 4.6 years) found significant improvements in clinical scores and range of motion, except external rotation, with a mean adjusted Constant score of 64%, SSV of 56, and ASES of 65. Complications occurred in 34% of patients, with 10% requiring reoperation and 7% requiring revision. Clinically, RSA is a viable salvage option for failed proximal humeral plating, but surgeons and patients should counsel on the substantial complication risk and limited external rotation recovery.
18. Funao H, Ideura K, Isogai N, et al. Upper-extremity disability in cervical myelopathy: insights from the Disabilities of the Arm, Shoulder, and Hand questionnaire. International Orthopaedics 2026. doi:10.1007/s00264-026-07043-3
This study evaluated the clinical utility of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire in cervical myelopathy, examining discordance between the Japanese Orthopaedic Association (JOA) score and DASH-based disability. The authors sought to identify factors associated with discordant outcomes, recognizing that neurological scores and patient-reported upper-extremity disability do not always align. The findings support incorporating the DASH into cervical myelopathy assessment to capture functional limitations missed by conventional neurological scoring, with implications for more comprehensive postoperative evaluation.
20. Cole PA, Xu JL, Huaco AA, et al. Extra-Articular Malunions and Nonunions of the Scapular Body and Neck. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00294
This retrospective case series from a Level-1 trauma center reported outcomes of surgical reconstruction, including osteotomy, for 45 patients with symptomatic extra-articular malunion or nonunion of scapular body and neck fractures treated by a single surgeon over two decades. Functional measures (DASH), range of motion, strength, and reoperation rates were assessed before and after correction of medial-lateral displacement and angular deformity. The findings support surgical reconstruction as an effective option for restoring function in patients with painful scapular malunions and nonunions.
25. Girardi KG, Ali IS, Lord KT, et al. Knot‐Dependent Constructs Show Narrowly Better Ultimate Failure Loads Than Knotless Constructs in Proximal Biceps Tenodesis: A Systematic Review and Meta‐analysis. Arthroscopy 2026. doi:10.1002/arj.70596
This systematic review and meta-analysis pooled 12 cadaveric biomechanical studies (245 specimens) of proximal biceps tenodesis constructs published since 2019, comparing all-suture versus other constructs, knot-dependent versus knotless fixation, inlay versus onlay techniques, and single- versus double-anchor configurations. Ultimate failure loads ranged widely from 79 N (interference screw) to 588 N (all-suture Caspari-Weber technique), with knot-dependent constructs showing only narrowly better ultimate failure loads than knotless constructs. Clinically, the findings suggest fixation strength differences between techniques are modest, so construct choice can be guided by factors other than biomechanical load-to-failure alone.
29. Kim YT, Yoo HJ, Oh SY, et al. Postoperative Supraspinatus Muscle Volume Restoration Is Associated With Tendon Healing and Strength Recovery After Rotator Cuff Repair: Deep‐Learning‐Based Volumetric Analysis of the Entire Muscle With Clinical Correlation. Arthroscopy 2026. doi:10.1002/arj.70531
This retrospective study of 102 rotator cuff repair patients used a deep-learning segmentation model on full-coverage preoperative and 1-year postoperative MRIs to quantify supraspinatus muscle volume change, with mean follow-up of 38.9 months. Patients whose muscle volume increased (n=70) had lower retear rates (14.3% vs 37.5%), better Constant scores, and greater abduction and internal rotation strength than those with volume loss. The findings indicate that postoperative muscle volume restoration is linked to tendon healing and strength recovery, supporting volumetric MRI surveillance as a prognostic and outcome tool.
30. Long WE, Shah D, Eskandari S, et al. Definitions of Return to Play After Shoulder Surgery in Competitive Athletes Are Nonspecific and Unstandardized: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70576
This systematic review of 130 studies encompassing 6983 competitive athletes characterized how return to play after shoulder surgery is defined, classifying definitions as complete, partial, or minimal. Only 27.7% of studies used complete definitions (referencing both preinjury competitive level and an objective participation threshold), 51.5% were partial, and 20.8% were minimal, with successful RTP explicitly defined in just 15.4% of studies and single-sport studies more often using complete definitions. The findings highlight a need for standardised RTP definitions and reporting criteria in shoulder surgery research to enable meaningful comparison across studies.
33. Lopiz Y. From reduction to replacement: a reconstructibility-based framework for chronic locked shoulder dislocations. International Orthopaedics 2026. doi:10.1007/s00264-026-07031-7
This narrative review proposes a unified, surgery-oriented framework for chronic locked glenohumeral dislocations structured around four sequential steps, REDUCE, ASSESS, RESTORE, and REPLACE, based on joint reconstructibility rather than traditional defect-size thresholds alone. It integrates literature on reduction techniques, joint-preserving reconstruction, and arthroplasty for both anterior and posterior dislocations. Clinically, the framework offers surgeons a stepwise decision-making algorithm to guide the choice between joint-preserving reconstruction and arthroplasty in these uncommon injuries.
34. Boekel P, Piggott RP, Conyard C, et al. Clinical and radiographic outcomes of reverse shoulder arthroplasty performed with 40 mm polyethylene glenospheres vs. 36 mm cobalt chrome glenospheres at minimum 2-years follow-up. Shoulder & Elbow 2026. doi:10.1177/17585732261489263
This retrospective multicenter study compared 199 patients undergoing reverse shoulder arthroplasty with either a 40 mm highly cross-linked polyethylene glenosphere or a 36 mm cobalt-chrome glenosphere on the Lima SMR platform, with minimum 2-year follow-up. Clinical outcomes (Oxford Shoulder Score), notching rates, and revision rates were equivalent between groups, though the cobalt-chrome group showed more glenoid radiolucency. The findings support the polyethylene glenosphere as a safe alternative intended to reduce polyethylene debris when the humeral liner contacts the scapula.
40. Garra S, Krasovitsky N, Howard MS. Osteochondritis dissecans of the glenoid: A case report and review of the literature. Shoulder & Elbow 2026. doi:10.1177/17585732261481796
This case report and literature review describes a rare ICRS grade III osteochondritis dissecans-like glenoid lesion with a large unstable chondral flap in a 16-year-old competitive female softball player who failed conservative management, detailing the arthroscopic cartilage-preserving surgical approach. Glenoid OCD is exceptionally uncommon, with literature limited to isolated case reports, mostly in male overhead athletes. The report raises awareness that glenoid OCD-spectrum lesions can occur in adolescent female overhead athletes and outlines surgical management when lesions are unstable and nonoperative treatment fails.
41. Kang HW, Italia K, Sane RM, et al. Clinical and radiological outcomes following complete release of the long head of triceps in reverse shoulder arthroplasty. Shoulder & Elbow 2026. doi:10.1177/17585732261487441
In 80 patients undergoing primary reverse shoulder arthroplasty with complete long head of triceps release, 2-year triceps strength was comparable to preoperative levels (6.3 vs 6.2 kg), with significant improvements in range of motion, VAS, ASES, and Constant scores. Notching occurred in 15% of patients. These findings suggest complete triceps release can be performed without triceps strength compromise, supporting its use to prevent inferior impingement in RSA.
44. Long WE, Eskandari S, Sharma AK, et al. Shoulder Surgery Studies in Contact and Collision Athletes Prioritize Patient‐Reported Outcomes but Infrequently Report Athlete‐Specific Measures: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70478
This systematic review of 65 studies (3596 patients) evaluated outcome reporting in shoulder surgery studies of competitive contact and collision athletes. While 74% reported patient-reported outcome measures, only 20% used athlete-specific instruments, and strength, satisfaction, and range of motion were infrequently reported. The authors conclude that athlete-relevant outcome measures, particularly return-to-sport-specific tools, should be incorporated into future studies of this population.
51. Rossi MJ. Introducing Albert Lin, M.D., as Associate Editor. Arthroscopy 2026. doi:10.1002/arj.70590
This editorial announces the appointment of Dr. Albert Lin, Harvard-trained shoulder and elbow and sports medicine subspecialist, as Associate Editor of Arthroscopy. It outlines his training background, including fellowship experience in Lyon, France, and at UPMC. The piece is an announcement with no research findings or direct clinical implications.
54. Zhou M, Li X, Zhang J, et al. The Lark-Loop Technique for Onlay Biceps Tenodesis: A Biomechanical, Histological, and Radiological Study in a Rabbit Model. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261469680
In a controlled rabbit model of cortical surface biceps tenodesis, 75 animals were randomised to Lasso-Loop, Lark-Loop, or Krackow suture techniques and evaluated biomechanically, histologically, and radiologically at 4, 8, and 12 weeks. The study compared initial fixation strength and healing among the three constructs. Results inform selection of tenodesis suture technique, with the novel Lark-Loop intended to overcome insufficient initial mechanical strength of traditional cortical surface fixation.
57. Su F, Fiandeiro M, LaMonaca J, et al. Prevalence, risk factors, and outcomes of patients with coracoid-based pain after reverse total shoulder arthroplasty. Shoulder & Elbow 2026. doi:10.1177/17585732261484885
In a 10-year case-control study of reverse total shoulder arthroplasty, coracoid-based pain occurred in 1.0% of patients, typically arising ~10 months postoperatively, and resolved completely in about half with nonoperative treatment. Osteoporosis, decreased subcoracoid distance, greater anterior glenosphere overhang, and less calcar distalization were independent risk factors, suggesting these modifiable implant and patient factors deserve attention during preoperative planning.
58. Duralde XA, Heramb CA, Blanda JN. Arthroscopic Suprapectoral Biceps Tenodesis Using a Standard Suture Anchor Is Safe and Effective. Arthroscopy, Sports Medicine, and Rehabilitation 2026. doi:10.1002/ars2.70078
A retrospective series of 80 patients at minimum 2-year follow-up evaluated arthroscopic suprapectoral biceps tenodesis performed with a standard absorbable double-loaded suture anchor. The technique proved safe and effective, with 91% maintaining normal biceps contour, improved ASES and pain scores, and low complication/revision rates, supporting its use without specialised implants.
62. Daher M, Issa C, Parmar T, et al. Bone graft augmentation reduces complications in osteosynthesis of proximal humerus fractures: A meta-analysis of randomized controlled trials. Shoulder & Elbow 2026. doi:10.1177/17585732261484932
A meta-analysis of five RCTs (350 patients) found that bone graft augmentation of proximal humerus fracture osteosynthesis reduced overall complications by ~79% (OR 0.21). Biologic grafts additionally shortened healing time and reduced pain, whereas synthetic grafts offered no such benefit, supporting biologic graft use especially in osteoporotic bone.
64. Geng Y, Wang G, Zhang Y. Early Repair of Traumatic Massive Rotator Cuff Tears Improves Functional Outcomes Compared With Delayed Repair. Arthroscopy 2026. doi:10.1002/arj.70476
In a retrospective cohort of traumatic massive rotator cuff tears, arthroscopic repair within 3 weeks of injury yielded significantly better 2-year ASES scores and tendon integrity than delayed repair, with timing independently associated with outcomes on regression analysis. These results support early surgical intervention for traumatic massive tears rather than delayed repair.
67. Tanimura S, Tokunaga T, Goshogawa H, et al. Enthesis-related progenitors recruited from the subacromial bursa contribute to rotator cuff healing in rats. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.007
In a rat rotator cuff repair model using wild-type and ScxGFP transgenic rats, the authors tested whether subacromial bursa resection affected recruitment of Scx+/Sox9+ enthesis-related progenitors and tendon-to-bone healing quality. Findings indicated that PDGFRα+ mesenchymal progenitors resident in the subacromial bursa give rise to healing-associated progenitor cells, and bursal resection impaired progenitor recruitment and healing maturation. This suggests the bursa is a biologically valuable progenitor reservoir that should be preserved rather than routinely excised during rotator cuff surgery.
68. Hatae F, Itoigawa Y, Tsurukami H, et al. Autologous biceps tendon grafts enhance attachment strength in rotator cuff repair. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.008
The abstract text provided for this article duplicates the Japan Shoulder Society abstract on subacromial bursa-derived enthesis progenitors rather than content specific to autologous biceps tendon grafting. Based on the title, the study evaluated biceps tendon autograft augmentation of rotator cuff repair, with reported enhancement of tendon-to-bone attachment strength. If confirmed, biceps autograft augmentation may be a useful strategy for reinforcing repairs, particularly in compromised tendon tissue.
69. Yoshimura Y, Morikawa D, Itoigawa Y, et al. Scapula morphologic analysis using magnetic resonance imaging in unstable painful shoulder and anterior shoulder instability. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.009
The abstract text supplied for this article repeats the Japan Shoulder Society bursa progenitor abstract rather than the scapular morphology study itself. The available fragment of the actual study indicates MRI-based measurement of 14 glenoid, acromion, and coracoid parameters in unstable painful shoulder versus anterior instability versus controls. Reported differences in glenoid width and depth suggest osseous morphology may help distinguish painful instability from other unstable presentations, with potential implications for surgical planning.
70. Uekama K, Taniguchi N. Critical role of the joint capsule in the progression of cuff tear arthropathy. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.010
The abstract text provided for this article is a mismatched fragment from the scapular morphology study, so details of the cuff tear arthropathy capsule investigation are unavailable. Based on the title, the study examined the joint capsule's contribution to progression of rotator cuff tear arthropathy. This line of work implies the capsule may be a modifiable target for slowing arthropathy progression.
71. Matsumoto M, Kenmoku T, Inoue K, et al. Impact of aging and estrogen deficiency on extracellular matrix composition in rotator cuff tendons. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.011
The abstract text supplied for this article duplicates the scapular morphology abstract rather than content on aging and estrogen deficiency in rotator cuff tendon extracellular matrix. Based on the title, the study investigated how aging and estrogen deficiency alter tendon matrix composition. Such findings would support a mechanistic link between hormonal status and tendon degeneration, potentially informing prevention or treatment strategies in postmenopausal patients.
72. Takigami S, Yamaura K, Inui A, et al. Effects of angiotensin II receptor antagonists on oxidative stress in rotator cuff cells. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.012
The abstract text provided for this article is a mismatched fragment from the scapular morphology study, so specifics of the angiotensin II receptor antagonist experiment are unavailable. Based on the title, the study tested whether ARB agents reduce oxidative stress in rotator cuff cells. If confirmed, commonly used antihypertensives could be repurposed as a low-risk adjunct to mitigate tendon degeneration.
74. Morikawa D, Itoigawa Y, Uehara H, et al. Impact of subacromial bursa reimplantation on arthroscopic rotator cuff repair for small to large tears: A randomized controlled trial. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.014
This randomised controlled trial evaluated whether reimplanting the subacromial bursa during arthroscopic rotator cuff repair improves healing in small-to-large tears. The abstract text provided is truncated and appears to be a mismatched record describing an in vitro losartan study rather than the bursa trial. As reported, no reliable clinical findings can be extracted; the trial's premise suggests bursa preservation may enhance biologic healing environment.
75. Koda H, Kai Y, Kida N, et al. Investigation of elevation strength-to-muscle mass ratio in dwelling older adults with asymptomatic rotator cuff tears. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.015
The abstract supplied for this study on elevation strength-to-muscle mass ratios in community-dwelling older adults with asymptomatic rotator cuff tears is truncated and duplicates the losartan in vitro abstract. No valid methods or results specific to this title can be extracted. Clinically, the study concept addresses whether strength relative to muscle mass differs in asymptomatic tear patients, informing nonoperative management decisions.
76. Funakoshi T, Takahashi T, Miyamoto A, et al. Anterior glenohumeral capsular ligament reconstruction for baseball players with traumatic SHOULDER dislocation on the throwing side. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.016
This study compared elevation strength-to-muscle mass ratios among 433 shoulders in 303 asymptomatic community-dwelling older adults, grouped by ultrasound tear pattern: no tear, supraspinatus/infraspinatus tears, and tears including subscapularis. Muscle strength was measured by functional elevation testing and mass by bioelectrical impedance, with groups compared by ANOVA. The findings inform how tear extent relates to strength independent of muscle mass, potentially guiding surveillance and treatment thresholds in asymptomatic degenerative tears.
77. Okuhara K, Miyoshi N, Fujisawa T, et al. Long-term outcomes of cuff integrity on magnetic resonance imaging following rotator cuff repair and reconstruction: A more than 10-year follow-up. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.017
This study reported more than 10-year MRI follow-up of cuff integrity after rotator cuff repair and reconstruction. The abstract text provided is truncated and appears mismatched, describing the strength-to-mass ratio study of asymptomatic older adults rather than long-term imaging outcomes. No reliable findings can be extracted; the study's premise addresses durability of structural healing beyond a decade, relevant to long-term recurrence risk counseling.
78. Kotagiri Y, Hata Y, Ishigaki N, et al. Characteristics of long-term outcomes of re-tear cases following rotator cuff repair. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.018
This study characterized long-term outcomes of patients who sustained re-tears after rotator cuff repair. The abstract text provided is truncated and mismatched, duplicating the strength-to-mass ratio abstract rather than describing re-tear case outcomes. No valid findings can be extracted; the study concept aims to define the natural history and functional trajectory of failed repairs to guide revision versus conservative management.
79. Niwa T, Matsumura N, Yoshida Y, et al. Three-dimensional analysis of the shoulder in frozen and healthy shoulders in the hand-behind-back position. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.019
Comparing 39 shoulders with re-tear (Sugaya types 4-5) and 138 with intact repairs (types 1-3) at 10 years post-repair, the re-tear group showed significantly lower manual muscle strength in flexion, abduction, and external rotation, lower functional scores, and limited horizontal extension and C7 thumb distance. Preoperative supraspinatus fatty infiltration was more advanced in the re-tear group. These results support preoperative fatty infiltration as a prognostic marker and emphasize achieving durable healing to preserve long-term strength and function.
80. Hashimoto E, Ochiai N, Terakawa F, et al. Optimal three-dimensional evaluation of glenoid and humeral lateralization after reverse shoulder arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.020
This study proposed an optimal three-dimensional method for evaluating glenoid and humeral lateralization after reverse shoulder arthroplasty. The abstract text provided is truncated and mismatched, duplicating the 10-year re-tear outcomes abstract rather than describing the radiographic methodology. No reliable findings can be extracted; the study concept addresses standardised 3D measurement to improve postoperative assessment of prosthesis positioning and lateralization.
81. Takayama K, Yamada S. Global kyphosis of the spine influences clinical outcomes and deterioration of internal rotation following reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.021
This study compared 10-year outcomes after rotator cuff repair between 39 shoulders with re-tear (Sugaya types 4-5) and 138 without re-tear (types 1-3). At 10 years, the re-tear group showed significantly lower muscle strength (flexion, abduction, external rotation), worse shoulder function scores, and more advanced supraspinatus fatty infiltration. Clinical implication: re-tear after repair portends long-term functional decline, reinforcing the importance of achieving durable tendon healing.
82. Kawada A, Ishikawa M. Association between preoperative HbA1c levels and long-term outcomes following shoulder arthroplasty: A multi-institutional real-world data analysis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.022
In 100 reverse total shoulder arthroplasty patients, those with global kyphosis (C7 plumb line anterior to the femoral head; n=35) had significantly worse flexion, abduction, external rotation, and internal rotation, and smaller postoperative improvements, than patients without kyphosis. Of 30 patients with internal rotation deterioration, 26 had global kyphosis, which was identified as a predictive factor on logistic regression. Clinical implication: assessing spinal sagittal alignment may help identify rTSA patients at risk for inferior motion recovery, particularly internal rotation.
85. Erdi Malkoç F, Afacan MY, Karadeniz OC, et al. Exploratory anchor-derived six-month improvement thresholds for sleep quality and pain after reverse total shoulder arthroplasty. JSES International 2026. doi:10.1016/j.jseint.2026.101748
In 61 primary reverse total shoulder arthroplasty patients, exploratory ROC analyses using the global rating of change anchor derived 6-month improvement thresholds for sleep quality (PSQI) and pain (VAS). Both PSQI and VAS improved significantly at 6 months, and anchor validity was supported by Spearman correlations with ordinal GRC responses. Clinical implication: these anchor-based thresholds offer interpretable benchmarks for judging clinically meaningful sleep and pain improvement after rTSA.
87. Barthel C, Schneller T, Brune D, et al. Radiographic outcomes of a standardized versus conventional reduction technique in proximal humerus fractures: a matched cohort study. JSES International 2026. doi:10.1016/j.jseint.2026.101750
This single-center retrospective matched-pair cohort compared a standardised stepwise reduction technique using temporary transhumeral K-wire retention against conventional non-standardised fixation for displaced proximal humerus fractures. The study assessed whether the standardised approach yields better anatomical reduction and medial calcar reconstruction radiographically, though the excerpt does not report final outcome data. Clinical implication: standardizing reduction technique could improve reproducibility of radiographic quality in these technically demanding fractures.
88. O'Brien JB, Gurnani N, Johnson TM, et al. Rate and timing of return to sport following reverse total shoulder arthroplasty: a retrospective study of an active Australian cohort. JSES International 2026. doi:10.1016/j.jseint.2026.101751
This retrospective single-surgeon Australian study evaluated 12-month return-to-sport rate, timing, and performance level in physically active patients undergoing reverse total shoulder arthroplasty for osteoarthritis or rotator cuff arthropathy, alongside pain and satisfaction. Multivariable regression explored patient and surgical factors associated with outcomes, but the excerpt does not report the specific results. Clinical implication: the data inform counseling of increasingly younger, active rTSA candidates about realistic sport participation expectations.
92. Moosmann AM, Marin A, Vial P, et al. Is the St. Gallen Algorithm for proximal humerus fractures associated with improved outcomes?. JSES International 2026. doi:10.1016/j.jseint.2026.101755
This retrospective external validation study applied the 2019 St. Gallen Algorithm to patients with isolated proximal humerus fractures treated between 2010 and 2020, comparing failure rates and Subjective Shoulder Value scores between those managed per the algorithm and those not. Adherence to the SGA and predictors of treatment failure were analyzed across the cohort. The results clarify whether the algorithm improves outcomes and reduces secondary surgery, guiding its use in fracture management decisions.
93. Yamashita D, Oishi T, Nozaki T, et al. Magnetic resonance imaging–based quantitative definition of pathologic long head of the biceps tendon sheath effusion and its association with intra-articular shoulder pathology. JSES International 2026. doi:10.1016/j.jseint.2026.101756
In 261 shoulder MRI examinations, the authors quantified long head of the biceps tendon sheath effusion area on axial T2*-weighted images to establish a quantitative, observer-based threshold for pathologic effusion. Pathologic LHB effusion thresholds were then correlated with intra-articular shoulder pathology. This provides a standardised MRI criterion that can flag associated glenohumeral disease when biceps sheath effusion is seen.
94. Tseng W, Chen S, Lai T, et al. High-dose extracorporeal shockwave therapy restores shoulder motion in adhesive capsulitis after a single session. JSES International 2026. doi:10.1016/j.jseint.2026.101757
This dose-response study evaluated extracorporeal shockwave therapy at varying dosages for adhesive capsulitis, including a high-dose single-session protocol. A single high-dose ESWT session restored shoulder motion in adhesive capsulitis. If confirmed, single-session high-dose ESWT could offer a convenient, time-efficient alternative to repeated-session regimens in clinical practice.
95. Simon MJ, Moola FO, Coghlan J, et al. A worldwide cross-sectional survey seeks the current global practice patterns on perioperative management in elective shoulder replacement surgery. JSES International 2026. doi:10.1016/j.jseint.2026.101758
A worldwide cross-sectional survey of shoulder arthroplasty surgeons documented global practice patterns for perioperative management of elective shoulder replacement, covering areas such as anaesthesia, thromboprophylaxis, antibiotics, and glucose/medication management. Substantial international variation in perioperative protocols was identified. The findings highlight the lack of consensus and can inform development of standardised, evidence-based perioperative guidelines.
96. Cozzolino A, Gatto A, Di Pietto F, et al. Is it relevant to distinguish scapulothoracic abnormal motion (STAM) type in professional overhead athletes?. JSES International 2026. doi:10.1016/j.jseint.2026.101759
This cross-sectional study compared the prevalence of scapulothoracic abnormal motion (STAM) types 1 and 2 in the dominant and non-dominant shoulders of professional overhead athletes versus controls, and examined associations with sport type, glenohumeral internal rotation deficit, and hyperlaxity. STAM types 1 and 2 appeared common and sport-related, suggesting they may represent adaptive changes rather than distinct pathology. This challenges the routine clinical significance of classifying these STAM types in asymptomatic overhead athletes.
97. Hawryluk CJ, Rothrauff BB, Whicker EA, et al. Clinical outcomes following surgical fixation of proximal humerus fractures in skiers and snowboarders. JSES International 2026. doi:10.1016/j.jseint.2026.101761
This study evaluated clinical outcomes and return to sport after surgical fixation of proximal humerus fractures sustained while skiing or snowboarding, examining the effects of age, sex, sport, Neer classification, and fixation type (ORIF vs. closed reduction percutaneous pinning). The findings inform counseling of winter-sport athletes regarding expected recovery and return-to-sport timelines after proximal humerus fracture fixation.
98. Antoni M, Ciais G, Billaud A, et al. Is horizontal stabilization necessary in chronic acromioclavicular reconstructions?. JSES International 2026. doi:10.1016/j.jseint.2026.101762
This study compared chronic acromioclavicular dislocation reconstructions performed with coracoclavicular ligament reconstruction alone versus with added horizontal AC stabilisation to determine whether horizontal stabilisation improves outcomes. The results clarify whether horizontal AC stabilisation is a necessary component of chronic AC reconstruction, guiding surgical technique selection.
99. Brooks JM, Myers NL, Floyd SB, et al. Assessing the properties of an encounter-based “process of recovery” measure of patient benefit following rotator cuff repair. JSES International 2026. doi:10.1016/j.jseint.2026.101763
This study assessed the measurement properties of an encounter-based 'process of recovery' instrument designed to capture patient benefit after rotator cuff repair. Validating this measure supports its use in tracking recovery and evaluating treatment value across care encounters in rotator cuff surgery.
103. Tazawa R, Kenmoku T, Nakawaki M, et al. Intraoperative functional zero-position is associated with superior outcomes after reverse total shoulder arthroplasty for cuff tear arthropathy: a retrospective comparative study. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100033
This retrospective study of 45 shoulders with cuff tear arthropathy undergoing reverse total shoulder arthroplasty tested whether intraoperative achievement of the functional zero-position under fluoroscopy was associated with post-operative outcomes. Shoulders achieving the position showed superior elevation outcomes over ≥2-year follow-up, supporting its use as an intraoperative benchmark for balanced implant positioning.
105. El Abiad R, Maalouf Y, Daher M, et al. The association between scapular orientation and spinopelvic parameters. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100032
This retrospective study measured scapular orientation (internal rotation, protraction, upward rotation) and spinopelvic parameters on PET scans from adults without spinal deformity or upper extremity pathology, grouping patients by scapular internal rotation. The authors found correlations between spinopelvic alignment and scapular positioning, extending prior work that had only linked scapular orientation to thoracic kyphosis. The findings suggest spinopelvic parameters should be considered alongside spinal measures when planning reverse total shoulder arthroplasty.
106. Alfaro DO, Zhuang Z, Davis A, et al. Trends in opioid prescribing after shoulder arthroplasty in an integrated health system: an analysis across racial and ethnic groups. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100031
This retrospective cohort study examined opioid prescriptions filled after shoulder arthroplasty from 2016 to 2021 within a closed integrated health system undergoing system-wide opioid reduction initiatives, quantifying morphine milligram equivalents per day by race/ethnicity. Opioid dispensing declined over the study period, and the multivariable analysis assessed whether these reductions differed across racial and ethnic groups relative to non-Hispanic White patients. The study addresses whether system-level opioid stewardship efforts are implemented equitably across patient populations.
107. Adio AA, Bouras A, Gonzalez-Morgado D, et al. Economic advantage of outpatient shoulder arthroplasty: a Markov model analysis. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100029
A Markov cost-utility model compared outpatient versus inpatient total shoulder arthroplasty from a U.S. payer perspective over 20 years, with probabilistic sensitivity analyses varying readmission and revision risks. Outpatient TSA was the dominant strategy, costing $5,027 less per patient ($23,375 vs. $28,402) while yielding a modest QALY gain (0.009), and remained cost-effective across sensitivity analyses. These results support outpatient TSA as the economically preferable approach, strengthening the case for its continued expansion.
109. Van Oost L, Demey P, Loobuyck H, et al. Effect of prior breast cancer treatment on outcomes of reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100035
This retrospective cohort compared 15 women with prior ipsilateral breast cancer treatment (mastectomy, lymph node dissection, and/or radiotherapy) undergoing reverse total shoulder arthroplasty for cuff tear arthropathy against 50 female controls, with minimum 2-year follow-up. Patient-reported outcomes (Oxford Shoulder Score, Constant Murley score) and satisfaction were similar between groups, but the breast cancer cohort had reduced abduction and forward flexion and numerically more complications, including borderline higher revision rates. Prior breast cancer treatment does not compromise subjective rTSA outcomes but may limit motion recovery and warrants counseling about elevated complication risk.
111. Hesseling B, Perry SI, Hoelen MA, et al. The Dutch patient-based Constant Murley score cannot be used interchangeably with the clinician-based Constant Murley score in shoulder arthroplasty patients. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100034
This Dutch multicenter study translated the patient-based Constant Murley score (p-CMS) into Dutch and administered both it and the clinician-based CMS (c-CMS) to 139 shoulder arthroplasty patients preoperatively and 6 months postoperatively to assess interchangeability and test-retest reproducibility. The 95% limits of agreement between versions (-20.4 to 22.6) and for test-retest of each version exceeded the minimal clinically important difference for shoulder arthroplasty. The Dutch p-CMS cannot be used interchangeably with the c-CMS, so scores from the two versions should not be substituted for one another in practice or research.
112. Giannakis P, Johnson MA, Covin SE, et al. Does upper limb dominance influence outcomes in adults undergoing primary anatomic or reverse total shoulder arthroplasty? A systematic review. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100023
This systematic review of 30 studies (7,916 shoulders) examined the effect of operated limb dominance on outcomes after primary anatomic and reverse total shoulder arthroplasty. Findings were mixed and limited: some studies showed greater forward elevation and internal rotation in the dominant arm after aTSA, no consistent association with patient-reported outcomes was found, and dominant-side rTSA was linked in some studies to greater dissatisfaction, loss of independence, radiolucent lines, and acromial stress fractures. Overall, limb dominance appears to have an inconsistent, modest influence on arthroplasty outcomes and should not be a major determinant of surgical decision-making.
113. Dutta A, Chatindiara I, Buckley N, et al. Clinical and radiographic outcomes of the SMR TT system – a novel convertible all-polyethylene glenoid with hybrid fixation in anatomic total shoulder arthroplasty: minimum 5-year follow-up. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100022
A retrospective review of 42 anatomic total shoulder replacements using the SMR TT hybrid convertible all-polyethylene glenoid with minimum 5-year follow-up assessed clinical scores, range of motion, and radiographic loosening. The study reports medium-term clinical and radiographic outcomes supporting durable fixation of this novel glenoid design. Its convertibility offers surgeons a reliable option when later revision to reverse arthroplasty may be needed.
114. Barret H, Diaw E, Barlow J, et al. Distal clavicle autograft: a relatively simple solution for glenoid bone loss at the time of revision reverse arthroplasty. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100025
Twenty consecutive revision reverse shoulder arthroplasties with glenoid bone loss were augmented with ipsilateral distal clavicle autograft, with outcomes focused on glenoid baseplate survival. The technique provided a relatively simple autograft solution for managing central and combined glenoid defects at revision surgery. This supports distal clavicle harvest as a practical alternative to structural allograft or metal augmentation in revision rTSA.
116. Khan AA, Hussain ZB, Lew RM, et al. Outpatient revision shoulder arthroplasty can Be safe and effective: a matched analysis. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100037
Revision shoulder arthroplasties performed as outpatient procedures were matched 1:1 to inpatient revisions by components exchanged, age, and gender to compare complications and outcomes. The matched analysis demonstrated that outpatient revision shoulder arthroplasty can be safe and effective in appropriately selected patients. This supports expanding same-day discharge criteria to include revision cases, potentially reducing costs and healthcare utilisation.
117. Obana KK, Chen JY, Weiss DL, et al. Outcomes of reverse total shoulder arthroplasty in patients ≤65 years old. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100041
A retrospective cohort of 103 patients aged 65 years or younger who underwent reverse total shoulder arthroplasty, the largest such cohort reported, was reviewed for complications and clinical outcomes. Most patients were discharged same-day or home, with outcomes supporting the expanding use of rTSA in younger patients. These findings help address concerns about implant longevity and function, informing shared decision-making when rTSA is considered in patients ≤65 years.
123. Yanagi E, Hirakawa Y, Manaka T, et al. Radiographic comparison of humeral and glenoid lateralization and distalization between onlay and inlay reverse total shoulder arthroplasty designs in Japanese shoulders. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100045
In 139 Japanese shoulders, the authors compared postoperative lateralization and distalization between an onlay (Aequalis Ascend Flex, 145°) and an inlay (Tornier Perform, 135° with 10° insert) reverse total shoulder arthroplasty design, both achieving a 145° effective neck-shaft angle with a 36-mm glenosphere. Radiographic measures included the lateralization shoulder angle, modified distalization shoulder angle, and Schippers indices, correlated with range of motion and clinical scores. The study addresses the scarcity of implant-design comparison data using these parameters in smaller Asian populations.
124. Movassaghi A, Williams C, Bhatti H, et al. Sex-associated differences in deltoid and rotator cuff muscle elongation after reverse shoulder arthroplasty. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100047
This retrospective analysis of 507 CT-based preoperative plans for reverse total shoulder arthroplasty using the INHANCE system measured percent elongation of the deltoid, infraspinatus, teres minor, and subscapularis between native and planned states in males versus females. The authors assessed whether sex-based differences in muscle elongation and implant selection persist after controlling for anatomic and implant-related variables. The results inform how patient sex may influence implant configuration choices aimed at optimising postoperative function and stability.
127. Christy KB, Saad MA, Arroyo RA, et al. Functional and radiographic outcomes of allograft reconstruction for contained glenoid defects in revision reverse total shoulder arthroplasty: a case series. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100054
This retrospective case series evaluated short-term clinical and radiographic outcomes of femoral head allograft reconstruction for contained central glenoid defects during revision reverse total shoulder arthroplasty, with minimum 2-year follow-up. The allograft was shaped from a cement mold of the defect, impacted into the defect, and secured with a long-post baseplate; outcomes included beta angle and Nerot-Sirveaux classification. The study provides evidence on a technique for which prior outcome data were limited.
129. Pageau A, Pervez Y, Wolfe A, et al. Inset glenoid component stability and bone removal by implantation depth. Journal of Shoulder and Elbow Arthroplasty 2026. doi:10.1016/j.jsea.2026.100038
Finite element models of seven osteoarthritic scapulae were used to virtually implant a circular inset glenoid component at four depths (25%, 100% inlay) and compare micromotion under joint loading, bone removal, and underlying bone density. The study sought to identify an inset depth that minimizes component micromotion while preserving glenoid bone stock. Results inform surgical technique for inset glenoid implantation in total shoulder arthroplasty, where optimising depth may reduce aseptic loosening risk from the rocking-horse phenomenon.
130. Chua SKK, Balasubramaniam S, Cole PA, et al. Integrated surgical management of forequarter lateral implosion injury: Technical considerations and early outcomes. Injury 2026. doi:10.1016/j.injury.2026.113292
Two cases of forequarter lateral implosion injury, concomitant ipsilateral clavicle, scapula, and rib fractures from high-energy trauma, were managed with concurrent single-setting surgical fixation using CT 3D reconstructions, patient-specific 3D printed models, multidisciplinary incision planning, muscle-sparing approaches, and staged fixation. The authors present a reproducible integrated surgical strategy for this underrecognized injury complex. Early outcomes support simultaneous osseous stabilisation of the chest wall and shoulder girdle to restore structural integrity when combined injuries would otherwise compromise each other's fixation.
132. Calem DB, Mendiratta D, Mehta P, et al. Geographic Distribution of Shoulder Arthroplasty in the United States: A Rural–Urban Analysis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.022
Medicare data from 2013-2024 were used to identify orthopaedic surgeons performing shoulder arthroplasty and classify them by rural-urban commuting area (urban, large town, small town, rural), with temporal trends analyzed via Kendall's tau and procedures-per-surgeon assessed using Mann-Kendall testing with Sen's slope. The study characterized the national geographic distribution of shoulder arthroplasty surgeons across settlement types and its relationship to procedural volume. Results bear on access to shoulder arthroplasty care, particularly for rural populations, as the procedure rapidly grows.
134. Saffi M, Fleet CT, Iio R, et al. Allograft Strut Fixation to Humeral Bone: A Biomechanical Comparison of Suture-Tape Cerclage, Wire Cerclage, and Screws. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.024
Eight cadaveric humeral diaphyseal specimens with onlay cortical allograft struts were tested biomechanically across three fixation methods, suture-tape cerclage, wire cerclage, and lag screws, measuring compressive force and strut-shaft contact area under static loading and displacement under cyclic shear loading to 150 N. The study compared the fixation strength of these commonly used strut attachment techniques in the setting of humeral bone loss, periprosthetic fracture, and revision arthroplasty. Results guide surgeons in selecting strut fixation methods for shoulder arthroplasty reconstruction.
136. Gonzalez-Morgado D, Lohre R, Hachem A, et al. Facioscapulohumeral Muscular Dystrophy: A Comprehensive Guide for Shoulder Surgeons. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.027
This review provides a clinically focused overview of facioscapulohumeral muscular dystrophy for shoulder surgeons, covering presentation (scapular winging, progressive periscapular degeneration), diagnostic evaluation to distinguish it from peripheral nerve disorders, and physical examination findings relevant to surgical planning such as deltoid integrity and response to manual scapular stabilisation. Scapulothoracic arthrodesis is highlighted as the principal surgical option for selected patients with severe winging, active elevation below 90°, and preserved deltoid function. The guide supports earlier diagnosis and appropriate patient selection, technique, rehabilitation, and complication counseling.
139. Prasetia R, Handoko HK, Izdihar I, et al. Implantless Transosseus Bankart Repair: Technical Note. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100872
The authors present a technical note describing an implantless transosseous Bankart repair for anterior shoulder instability. The technique avoids suture anchor implants by using transosseous tunnels for labral fixation. This may reduce implant-related complications and costs in appropriate instability patients.
140. Inagaki K, Ochiai N, Sasaki Y, et al. Clavicular Tunnel Position Is Associated with Reduction Loss After Arthroscopic Coracoclavicular Ligament Reconstruction: A CT-Based Analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100873
This CT-based analysis examined the relationship between clavicular tunnel position and reduction loss after arthroscopic coracoclavicular ligament reconstruction for acromioclavicular joint injuries. Tunnel position was significantly associated with postoperative reduction loss. Surgeons should carefully plan clavicular tunnel placement to minimise loss of reduction.
142. Miyasaka Y, Sekiguchi T, Takahashi N, et al. The Usefulness of Newly Developed Ultrasonographic Measurement Method for Predicting Postoperative Stiffness after Arthroscopic Rotator Cuff Repair. JSES International 2026. doi:10.1016/j.jseint.2026.101789
This study evaluated a newly developed ultrasonographic measurement method for predicting postoperative stiffness after arthroscopic rotator cuff repair. The ultrasound-based measure showed utility in identifying patients at risk for postoperative stiffness. It may allow early targeted rehabilitation interventions for at-risk patients.
144. Adan FO, Boeder ML, Puckett HD, et al. Time-Driven Activity-Based Costing Comparison of Intramedullary Nails Versus Locking Plates for Proximal Humerus Fractures: What is the Primary Cost Driver?. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100876
This study used time-driven activity-based costing to compare intramedullary nails versus locking plates for proximal humerus fractures and identify the primary cost driver. The analysis determined which fixation approach is more costly and what drives the expense. Results can guide cost-conscious implant selection in managing these fractures.
145. Ciavarro T, Elmaraghy A, Carroll PJ. Corticosteroid Dose Reporting in Atraumatic Osteonecrosis of the Humeral Head: A Scoping Review. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100877
This scoping review examined how corticosteroid exposure is reported in studies of atraumatic osteonecrosis of the humeral head. The authors found that corticosteroid dose, duration, and route are inconsistently documented across the literature, limiting the ability to establish dose-response relationships. Clinically, standardised corticosteroid reporting is needed to better counsel patients and identify true at-risk exposure thresholds.
146. Dillon MR, Mastroianni MA, Frappa N, et al. Pitch-Tracking Risk Factors and Warning Signs for Shoulder Capsulolabral Injuries in Major League Baseball Pitchers. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261431839
This case-control study used MLB Statcast pitch-tracking data (161,979 pitches) to identify preinjury kinematic risk factors for arthroscopic capsulolabral repair in 27 pitchers matched to 54 uninjured controls. Kinematic deviations were detectable in the seasons preceding injury, supporting the hypothesis that preinjury warning signs exist in pitch-level data. These findings suggest Statcast metrics could be used for population-level injury surveillance and targeted workload or mechanics interventions in pitchers.
148. Stupnicki S, Zakryś M, Jabłoński J, et al. Unobvious diagnosis: subcoracoid impingement. Current knowledge about this condition. EFORT Open Reviews 2026. doi:10.1530/eor-2025-0239
This narrative review summarized the current knowledge on subcoracoid impingement, an often-missed cause of anterior shoulder pain caused by coracoid, lesser tuberosity conflict that threatens the subscapularis tendon. Diagnosis relies on coracohumeral distance assessment with ultrasound, MRI, or arthroscopy, with symptoms provoked by flexion, adduction, and internal rotation. Conservative management is first-line, but bursectomy with mild coracoplasty, plus subscapularis repair when needed, is a safe and effective option for refractory cases.
149. Vanlommel J, Vingerhoets T, Vandenabeele P, et al. Early Mobilization After Reverse Total Shoulder Arthroplasty Is Not Associated With Increased Risk of Acromial and Scapular Stress Fractures: A Retrospective Cohort Study. JSES International 2026. doi:10.1016/j.jseint.2026.101787
This retrospective cohort study evaluated whether early mobilization after reverse total shoulder arthroplasty increases the risk of acromial and scapular stress fractures. Early mobilization was not associated with an increased fracture risk. These findings support accelerated rehabilitation protocols without heightened concern for periprosthetic stress fractures.
150. Nourissat G, Manceron A, Antoni M, et al. Deltoid and subscapularis muscle length variation during axial rotation in reverse total shoulder arthroplasty: an exploratory cadaveric study. JSES International 2026. doi:10.1016/j.jseint.2026.101788
This exploratory cadaveric study measured deltoid and subscapularis muscle length changes during axial rotation after reverse total shoulder arthroplasty implantation. The findings characterize how rotational positioning alters muscle excursion around the prosthesis. The results may guide implant positioning and rehabilitation strategies to optimise muscle tension and function in reverse shoulder arthroplasty.
151. Sakhat G, Ezzeddine H, Badra M, et al. Hidden Culprit of Suprascapular Neuropathy: Independent Suprascapular Notch Entrapment Coexisting with Spinoglenoid Notch Cyst - A Case Report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100879
This case report described suprascapular neuropathy caused by independent suprascapular notch entrapment coexisting with a spinoglenoid notch cyst. The case highlights that dual compression sites can be overlooked when imaging identifies only one lesion. Clinicians should evaluate the entire course of the suprascapular nerve to ensure both entrapment points are addressed and avoid persistent postoperative deficits.
152. Nishino K, Okamura N, Sekine H, et al. The Effect of Activating the Scapular Muscles During Warm-up on Shoulder Function and Baseball Pitching Performance in Male Adult Baseball Players: An Approach Using Electric Muscle Stimulation. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261479170
This controlled laboratory study tested whether electric muscle stimulation, assisted activation of the lower trapezius and infraspinatus during warm-up improves shoulder function, pitching mechanics, and performance in 15 adult male pitchers compared with usual warm-up alone. Scapular muscle activation during warm-up was hypothesized to increase shoulder mobility and enhance pitching mechanics. The findings may inform evidence-based warm-up protocols aimed at performance optimization and throwing injury prevention.
153. Jiang Z, Xiang Y, Lei C, et al. A Structured Three-Step Reduction Strategy for Locked Posterior Fracture-Dislocation of the Proximal Humerus Through a Standard Deltopectoral Approach: A Retrospective Case Series. Injury 2026. doi:10.1016/j.injury.2026.113679
This retrospective case series evaluated a structured three-step reduction strategy for locked posterior fracture-dislocations of the proximal humerus performed through a standard deltopectoral approach. The technique achieved reduction without requiring a posterior or extended approach, supporting its use as a reproducible surgical option. Clinically, it offers surgeons a systematic method to avoid the morbidity of more extensile exposures in this rare injury.
154. Zumstein MA, Werthel JD, Cirigliano G, et al. Posterior Acromial Bone Block (PABB) As a Modification of The Scapinelli Procedure to Correct Posterior Shoulder Instability. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100878
The authors describe the posterior acromial bone block (PABB) procedure, a modification of the Scapinelli technique using autologous acromial bone to address posterior shoulder instability. The technique report details surgical steps and early clinical experience demonstrating correction of posterior instability. It provides an alternative bony augmentation option for surgeons managing recurrent posterior instability, particularly with glenoid bone loss.
155. Adio A, Boufadel P, Ilyas MH, et al. Epidemiology of Sports- and Recreation-Related Shoulder and Elbow Injuries in Older Adults Presenting to Emergency Departments in the United States between 2010 and 2024. Injury 2026. doi:10.1016/j.injury.2026.113636
Using US emergency department data from 2010 to 2024, this study characterized the epidemiology of sports- and recreation-related shoulder and elbow injuries in older adults. Injury patterns, rates, and trends over time were quantified for this growing active elderly population. The findings inform clinicians and policymakers about the rising burden of these injuries and the need for targeted prevention and resource allocation.
157. Mariaux S, Chelli M, Abadie P, et al. Clinical Outcomes of Rotator Cuff Tear Repair in Patients ≤45 Years of Age: A Retrospective Analysis of 108 Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261476548
This multicenter retrospective case series of 108 patients aged ≤45 years evaluated outcomes after arthroscopic repair of full-thickness rotator cuff tears with follow-up at 12, 24, and 120 months. Repair significantly improved pain, strength, range of motion, and Constant scores, confirming good results in young patients. The findings support arthroscopic repair as an effective option in this population with high functional expectations.
158. Choi Y, Lee S, Shin S. Recovery Trajectory of Range of Motion and Its Association With Patient Factors During Early Postoperative Stiffness After Arthroscopic Rotator Cuff Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261477946
In a retrospective cohort of 352 patients after arthroscopic full-thickness rotator cuff repair, 46.9% met criteria for stiffness at 3 months, and multivariate regression identified factors predicting persistent stiffness at 6 months. Early stiffness was associated with worse functional scores and higher pain, and the ROM recovery trajectory was characterized alongside patient-reported rehabilitation barriers. Recognizing at-risk patients early may guide counseling and targeted rehabilitation to prevent persistent postoperative stiffness.
159. Chen V, Beretov J, Bilog AM, et al. Shear-Wave Elastography for Assessing the Histological Characteristics of Torn Rotator Cuff Tendons. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.032
This study correlated preoperative shear-wave elastography (SWE) stiffness measurements of the supraspinatus tendon with intraoperative histological findings (Bonar score, glycosaminoglycan content) in 22 torn rotator cuff tendons. SWE values were associated with specific histological characteristics of the torn tendon tissue. The findings support SWE as a noninvasive surrogate for tendon degeneration, potentially aiding preoperative assessment of tendon quality and healing potential.
161. Hung VT, Kucharik MP, Konapala A, et al. Reverse Shoulder Arthroplasty with a Glenoid-Sided Lateralized Prosthesis and Concomitant Latissimus Dorsi Transfer Is Associated with Early Proximal Humeral Osseous Erosion Without Superior Functional Outcomes. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.08.031
In a propensity score-matched comparison of reverse shoulder arthroplasty with a glenoid-sided lateralized prosthesis performed with versus without concomitant latissimus dorsi transfer for external rotation deficit, the combined procedure was associated with early proximal humeral osseous erosion and did not deliver superior functional outcomes. Adding a latissimus dorsi transfer to lateralized rTSA should be weighed carefully, as it may add radiographic risk without clear functional benefit.
162. Khilnani TK, Megerian MF, Xu T, et al. Defining A Successful Total Shoulder Arthroplasty: A Systematic Review of Clinically Relevant Outcome Metrics. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.001
This systematic review of 39 studies (19,674 patients) examined which patient-reported outcome measures and clinically meaningful thresholds (MCID, PASS, SCB) are used to define success after total shoulder arthroplasty. It found heterogeneous use of PROMs and threshold-derivation methods, highlighting the need for standardised, consensus-based definitions of a successful TSA.
163. Koda H, Kai Y, Kida N, et al. Investigation of elevation strength relative to upper-limb muscle mass in dwelling older adults with asymptomatic rotator cuff tears. JSES International 2026. doi:10.1016/j.jseint.2026.101795
This study measured shoulder elevation strength normalised to upper-limb muscle mass in community-dwelling older adults with asymptomatic rotator cuff tears. The findings characterize how asymptomatic cuff tears affect strength relative to muscle mass, informing early detection of functional decline in older adults before symptoms develop.
166. van Hessem L, Smeitink N, Nijsink H, et al. Improved range-of-motion following correction osteotomy for varus malunited proximal humerus fractures with three-dimensional planned cutting guides A case series. JSES International 2026. doi:10.1016/j.jseint.2026.101799
This case series evaluated corrective osteotomy using three-dimensional planned cutting guides for varus-malunited proximal humerus fractures. Patients showed improved range of motion, suggesting that 3D-guided osteotomy is a viable joint-preserving option for this deformity.
167. Datry V, Gagnepain E, Guillot M, et al. Medial clavicle resection for acute traumatic posterior sternoclavicular dislocation: Experience from Grenoble Alpes University Hospital. Injury 2026. doi:10.1016/j.injury.2026.113662
A single-center case series from Grenoble Alpes University Hospital described medial clavicle resection for acute traumatic posterior sternoclavicular dislocation. The experience provides evidence on the safety and outcomes of resection as a management option when stable reduction or fixation is not achievable.
170. Osawa S, Mitani M, Fujibayashi I, et al. Clinical Outcomes of Glenoid Fractures Following Manipulation Under Anesthesia for Frozen Shoulder. JSES International 2026. doi:10.1016/j.jseint.2026.101796
This study reported clinical outcomes of glenoid fractures that occurred following manipulation under anaesthesia (MUA) for frozen shoulder. The key finding was that these iatrogenic fractures, when identified and managed, resulted in clinical outcomes that were documented in this cohort. Clinically, this highlights glenoid fracture as a recognised complication of MUA for adhesive capsulitis and informs counseling and post-MUA imaging decisions.
171. Kim H, Song HS. The unresolved question of optimal distalization and lateralization in reverse total shoulder arthroplasty. Clinics in Shoulder and Elbow 2026. doi:10.5397/cise.2026.00724
This commentary discusses a study by Griff et al. analyzing whether distalization and lateralization of the humeral implant after reverse total shoulder arthroplasty influence ASES scores. The key finding was that neither distalization nor lateralization significantly affected the ASES score, consistent with prior work by Boutsiadis et al. Clinically, this suggests that the optimal degree of distalization and lateralization in reverse shoulder arthroplasty remains unresolved and should not be rigidly tied to patient-reported outcomes alone.
173. Lim B, Lim G, Zhang J. Coracoid process morphometry in Asians: a systematic review of computed tomography-based studies. Clinics in Shoulder and Elbow 2026. doi:10.5397/cise.2026.00549
This systematic review synthesized CT-based studies of coracoid process morphometry in Asian populations, pooling dimensional estimates from 14 studies comprising 1,581 coracoid processes. The key finding was pooled mean measurements including total coracoid length of 39.82 mm, tip-to-flexion point distance of 23.31 mm, and mid-coracoid thickness of 11.28 mm, with smaller dimensions in females. Clinically, these population-specific reference values can guide preoperative planning and graft sizing in coracoid transfer procedures such as Latarjet.
174. Gumina S, Cantore M, Rionero M, et al. Preservation of the long head of the biceps tendon is a viable option in rotator cuff repair: a retrospective comparative study using Biceps Inflammation Section Integrity classification. Clinics in Shoulder and Elbow 2026. doi:10.5397/cise.2025.01319
This retrospective comparative study compared outcomes of rotator cuff repair with long head of the biceps tendon (LHBT) preservation via debridement and radiofrequency ablation versus tenotomy (±tenodesis) in patients with similar degrees of LHBT degeneration using the BISI classification. The key finding was that preserving the LHBT in appropriately selected patients (BISI score <5) yielded viable clinical results. Clinically, this supports a more selective, preservation-oriented approach to the biceps tendon during rotator cuff surgery rather than routine sacrifice.
176. Kang LS, Mavrommatis S, Ina JG, et al. Game-Level Temporal Patterns Identify Optimal Preinjury Windows for Shoulder and Elbow Injuries in Major League Baseball Pitchers. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261477532
This case-control study used machine learning (XGBoost) on game-level workload and mechanical data from MLB pitchers (2017-2025) to identify optimal preinjury windows for shoulder and elbow injuries. The key finding was that discrete preinjury windows (7-49 days) could be identified via changepoint analysis of model AUC, with feature importance revealing baseline risk and short-term variability patterns. Clinically, this suggests injury prevention monitoring in professional pitchers should focus on these specific short-term windows rather than season-level metrics.
177. Chen S, Yang Y, Chen J, et al. Clinical Outcomes of Arthroscopic Treatment for Shoulder Joint Tuberculosis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.002
Eighteen patients with shoulder tuberculosis underwent arthroscopic debridement and synovectomy after at least 3 weeks of antitubercular therapy, with outcomes tracked via VAS, UCLA, ASES, and Constant-Murley scores plus inflammatory markers. All surgeries were completed without complications, and the study supports arthroscopy as both a diagnostic and therapeutic approach for this rare disease. Clinically, this suggests combining early antitubercular therapy with arthroscopic treatment can effectively manage shoulder tuberculosis, though larger series are needed given its rarity.
178. Rowse JC, Faulkner H, Hermans D, et al. Return to riding after open reduction internal fixation of acute clavicle fractures in professional horse jockeys. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.003
A retrospective review of a prospectively maintained database examined professional horse jockeys who underwent open reduction internal fixation of acute clavicle fractures between 2008 and 2024, using a limited-incision plating technique. Outcomes included DASH scores, time to return to riding, range of motion, and radiographic union. The findings aim to provide evidence-based guidance for postoperative recovery timelines in this high-demand athletic population, where such data were previously lacking.
180. Morriss NJ, Castle P, Pezzulo JD, et al. Whole-Body Compensation Supports Early Functional Hygiene Recovery Despite Persistent Internal Rotation Deficits After Reverse Shoulder Arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.005
Thirty-five patients undergoing reverse shoulder arthroplasty were evaluated with 3D motion capture and dynamic EMG during a hand-behind-back task preoperatively and at 3 and 6 months postoperatively. Although internal rotation range of motion remained persistently reduced at both postoperative timepoints, task efficiency improved through whole-body and axial skeletal compensation. Clinically, functional hygiene recovery after rTSA depends more on compensatory trunk and axial motion than on restored glenohumeral internal rotation, informing rehabilitation expectations.
184. Chirattikalwong S, Phornphutkul C. Comparison of Different Coracoclavicular Stabilization Techniques in Acute Acromioclavicular Injury With Augmented Acromioclavicular Ligament Repair: A Whole-Body Cadaveric Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261481000
In a whole-body cadaveric model, eight shoulders underwent three coracoclavicular stabilisation techniques, CC loop, single clavicular tunnel, and double clavicular tunnel, each combined with double-row AC ligament repair, with scapular and clavicular kinematics measured via inertial sensors during passive arm motion. The study compared which technique most closely restored physiologic motion under intact, injured, and repaired conditions. Results guide surgeons in selecting CC stabilisation constructs when augmenting acute AC joint repair.
185. Lam AD, Parikh N, Valenzuela M, et al. More Tech-Savvy Than You Think: Digital Proficiency Among Total Joint Arthroplasty Patients. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.09.033
A prospective survey of 201 total joint arthroplasty patients (mean age 70) using the Mobile Device Proficiency Questionnaire found that daily smartphone use was nearly universal in both younger (<65) and older (≥65) patients, with similar self-reported ease navigating menus, typing, and emailing. Clinically, this challenges assumptions that elderly arthroplasty patients cannot engage with digital tools, supporting smartphone-based patient-reported outcome collection and perioperative data platforms across age groups.
186. Levins JG, Yamaguchi JT, Whitson AJ, et al. Early Postoperative Predictors of Two-Year Satisfaction after Ream and Run Arthroplasty. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.007
Among 375 ream-and-run arthroplasty patients from a longitudinal shoulder database, investigators examined whether responses to Simple Shoulder Test questions on comfort at rest (SST-1) and sleep (SST-2) at 3 and 6 months predicted satisfaction at 2 years. Early postoperative rest and sleep comfort served as prognostic markers for eventual satisfaction, giving surgeons a basis for evidence-based expectation counseling during the difficult early rehabilitation period in young, active patients.
187. Abouelsoud M, Wahab MMA, Kamal HM, et al. Locked plate fixation versus non-operative management for three and four-part proximal humeral fractures in elderly; a randomized controlled trial. Injury 2026. doi:10.1016/j.injury.2026.113686
This randomised controlled trial compared locked plate fixation with non-operative management for three- and four-part proximal humeral fractures in elderly patients. The trial addresses an ongoing controversy in geriatric fracture care by testing whether surgical fixation improves outcomes over conservative treatment; findings inform treatment selection for this common injury in the elderly.
189. Ekdahl M, Domínguez C, Pinedo M, et al. Suture-Button coracoclavicular fixation for acromioclavicular joint dislocation following Latarjet surgery: Report of three cases. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100886
This report describes three cases of acromioclavicular joint dislocation occurring after Latarjet surgery, managed with suture-button coracoclavicular fixation. The cases demonstrate a feasible fixation strategy for this unusual injury pattern, where prior coracoid transfer alters local anatomy and complicates standard AC joint reconstruction options.
193. Simcox TG, DelliCarpini G, Chen C, et al. Mechanical Investigation of the Distal Acromial Tip Fusion for Reverse Shoulder Arthroplasty. JSES International 2026. doi:10.1016/j.jseint.2026.101800
In a cadaveric biomechanical study, the authors evaluated the mechanical properties of distal acromial tip fusion performed in conjunction with reverse shoulder arthroplasty. The fusion construct demonstrated adequate mechanical stability, supporting its feasibility. This suggests distal acromial tip fusion may be a viable adjunct to reverse shoulder arthroplasty when acromial integrity or deltoid tension requires augmentation.
194. Güven M, Kömür B, Shafiei A, et al. Minimally invasive excision of a ventrolateral scapular osteochondroma using a patient-specific cutting guide produced with a home-based 3D printer. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100883
The authors report a surgical technique case in which a ventrolateral scapular osteochondroma was excised minimally invasively using a patient-specific cutting guide fabricated on a home-based desktop 3D printer. The guide allowed accurate, less invasive resection with good clinical results. The report highlights that low-cost, in-house 3D printing can make patient-specific instrumentation accessible without commercial vendors.
197. Kudaravalli S. Interpreting Tendon Rupture Risk and Trends in Surgical Repair With Testosterone Therapy: Letter to the Editor. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261466188
In this letter to the editor, the author responds to a retrospective study linking testosterone replacement therapy to higher tendon rupture rates and altered rotator cuff repair patterns. The letter raises methodological points requiring clarification, such as confounding, dosing, and indication bias. It underscores the need for cautious interpretation of observational data before attributing causality between testosterone therapy and tendon injury.
200. Valencia M, Santana F, Ulloa AM, et al. Glenoid Defects In Revision Reverse Total Shoulder Arthroplasty:Are Current Classification Systems Appropriate?. JSES International 2026. doi:10.1016/j.jseint.2026.101804
The authors evaluated whether current glenoid defect classification systems adequately characterize bone loss encountered in revision reverse total shoulder arthroplasty. Their analysis found limitations in existing classifications for capturing the complexity and variability of defects seen in the revision setting. This suggests revised or novel classification schemes may be needed to standardize reporting and guide reconstructive planning in revision reverse arthroplasty.