Shoulder replacements lasted, but function faded: what 'success' means at ten years

The edition in brief

A single-institution cohort of 791 anatomic total shoulder arthroplasties found implant survival of 96.1% at 10 years and 93.7% at 15, with younger age and Walch B glenoids linked to revision. Patient-reported function gradually declined, though about 70% still reached an acceptable symptom state and 80% a minimal important improvement at 10 years. A Chinese single-centre trial randomised 128 patients to robot-assisted minimally invasive or open TLIF: the robotic arm had slightly better disability scores at two weeks, more accurate screws and less blood loss, but longer surgery and no difference by three months or in fusion. In 70 adults having knee arthroscopy with a femoral nerve block, opioid-free anaesthesia with dexmedetomidine and esketamine was non-inferior for recovery quality and halved nausea, but brought earlier pain and more rescue opioid. A meta-analysis of 11 trials suggests structured exercise programmes may reduce fear of movement after knee replacement, with low-certainty evidence and very high heterogeneity. A Bone & Joint Journal annotation updates periprosthetic joint infection prevention a decade after major guidelines.