Reverse replacements now outnumber anatomic in US registry
The AAOS Shoulder & Elbow Registry 2026 report found 52.7% of 39,251 shoulder replacements were reverse and 35.1% anatomic, with reverse use rising with age. Average ASES scores rose from 40 before surgery to 76.4 at one year.
What this could change in a conversation with your surgeon: If you're offered a reverse, you're in the majority. If you're younger with a healthy cuff, it's still worth asking whether anatomic fits you.
Sources: AAOS fact sheet
US registry: routine bone shaving during cuff repair keeps falling
The AAOS Shoulder & Elbow Registry 2026 report found subacromial decompression was performed in 39.5% of arthroscopic rotator cuff repairs, continuing a decline.
What this could change in a conversation with your surgeon: If acromioplasty is planned, ask why. Current guidance doesn't suggest it routinely for small to medium tears.
Sources: AAOS fact sheet
SI-BONE device cleared for fusion in weaker bone
SI-BONE received 510(k) clearance for its iFuse Granite Onyx system, intended for patients with compromised bone and its first such product for use outside the pelvis.
What this could change in a conversation with your surgeon: Weak bone is a common reason fusions struggle, so ask how your bone density affects the plan. A 510(k) clearance doesn't show this device works better than other options.
Sources: Becker's Spine
ACL repair failed more often than reconstruction at 5 years
A matched study of 71 pairs of patients found ACL repairs failed in 15.5% by five years, compared with 4.2% for reconstruction. Ten of the 11 repair failures were in patients under 40.
What this could change in a conversation with your surgeon: ACL repair is being marketed as a less invasive option. For younger people in pivoting sports, reconstruction still has the better track record.
Sources: Healio
Study raises questions about one expandable cage
A retrospective study of 168 minimally invasive TLIF patients found cage collapse in 20.5% with one Medtronic expandable cage versus 1.8% with a comparison cage. The authors said the nonrandomized design can't prove the cage caused it.
What this could change in a conversation with your surgeon: Early, nonrandomized findings, but a reasonable thing to ask about if an expandable cage is planned.
Sources: Becker's Spine
Review: repairing a medial root tear beats trimming at 5+ years
A systematic review of 12 studies with more than five years of follow-up found that repairing a medial meniscus root tear was associated with better outcomes than partial meniscectomy.
What this could change in a conversation with your surgeon: If you have a root tear, ask whether repair is an option. The included studies were mostly lower-quality, so the evidence is still building.
Sources: Orthop J Sports Med, doi:10.1177/23259671261453326
New expandable lumbar cages cleared
Life Spine's VersaLift and Xenix Medical's Lux expandable lumbar interbody systems received 510(k) clearance for minimally invasive fusion approaches.
What this could change in a conversation with your surgeon: Expandable cages aim to restore disc height through smaller incisions. Long-term comparisons with standard cages are limited.
Sources: Medical Economics · HospiMedica
Kids' ACL surgery caused only small changes in leg alignment
A prospective multicenter study of 211 growing children found only small changes in leg alignment after growth-plate-sparing and transphyseal ACL reconstruction, with no growth problems needing treatment.
What this could change in a conversation with your surgeon: Parents worry about surgery on growing knees. This supports current techniques, while showing why follow-up X-rays still matter.
Sources: Healio
Low-volume shoulder surgeons had more complications
A meta-analysis of 332,542 patients found surgeons doing fewer than five shoulder replacements a year had higher complication and revision odds (3.7% vs 2.6% complications). A second drop in risk appeared above about 25 to 28 cases a year.
What this could change in a conversation with your surgeon: It's reasonable to ask how many your surgeon does.
Sources: Hoag press release · Ryortho analysis
Small trial: adding LET improved knee scores at one year
In 41 athletes under 40 with high-grade knee looseness, adding a lateral extra-articular tenodesis to ACL reconstruction gave better knee scores and less laxity at 12 months than reconstruction alone.
What this could change in a conversation with your surgeon: It adds to larger studies supporting LET in high-risk patients, but this trial was small and short.
Sources: ReachMD summary
Updated ROSA Shoulder robot cleared
Zimmer Biomet received 510(k) clearance for an updated ROSA Shoulder system that assists with anatomic and reverse shoulder replacement.
What this could change in a conversation with your surgeon: Robotic shoulder surgery is spreading. Clearance doesn't show patients do better with it, and outcome data are still early, so ask what difference it would make for you.
Sources: MassDevice
Complex meniscus tears can often be repaired
Researchers reviewed 171 patients whose complex meniscus tears were repaired. 13.5% needed more surgery, and previous surgery on the same knee was the only factor linked with failure.
What this could change in a conversation with your surgeon: Tears once routinely trimmed may be repairable. Ask whether repair is possible before agreeing to remove tissue.
Sources: Healio
UK knee surgeons respond: trimming still has a role for some
The British Association for Surgery of the Knee said the FIDELITY trial tested a specific group, and that selected patients with mechanical symptoms who have completed physiotherapy may still benefit from arthroscopy.
What this could change in a conversation with your surgeon: Experts agree trimming shouldn't be routine for wear-related tears. They still debate whether it helps a smaller group.
Sources: BASK letter (PDF)
10-year trial: trimming a worn meniscus didn't help, and may have harmed
The FIDELITY trial randomized 146 adults with degenerative tears to partial meniscectomy or sham surgery. At 10 years, the meniscectomy group did no better. Arthritis progressed in 81% versus 70%, and 12% versus 4% went on to knee replacement or osteotomy.
What this could change in a conversation with your surgeon: This is the strongest long-term evidence yet. If your tear is from wear, ask about structured therapy before surgery.
Sources: NEJM, doi:10.1056/NEJMc2516079 · University of Helsinki · Physician's Weekly
Partial tears: faster early recovery with an implant-only approach
A randomized trial in high-grade partial-thickness tears compared a bioinductive implant alone with taking down and repairing the tendon. Early recovery was faster with the implant, and tendon healing at 12 months was similar (90% vs 85%).
What this could change in a conversation with your surgeon: For some partial tears, a smaller operation may get you back to daily life sooner. Long-term outcomes were similar.
Sources: Smith+Nephew summary of Wang A, et al. Orthop J Sports Med 2026
Zimmer Biomet Identity Shoulder System cleared
The Identity system covers anatomic, reverse, revision and fracture procedures with a single set of instruments.
What this could change in a conversation with your surgeon: A system that can switch between anatomic and reverse gives the surgeon options during the operation. Clearance doesn't show it gets better results than older systems, so ask why your surgeon prefers the system they use.
Sources: Ryortho
ACL reconstruction over 50: high satisfaction, low failure
A study presented at the 2026 AAOS meeting followed 155 patients with a mean age of 56 for about six years after reconstruction and found high satisfaction and low failure rates. The authors note their patients were carefully selected and active.
What this could change in a conversation with your surgeon: Age alone shouldn't rule out surgery for an active older adult with an unstable knee.
Sources: AAOS Now
A non-fusion option approved for some slipped vertebrae
The FDA approved the LimiFlex Dynamic Sagittal Tether for lumbar stenosis with grade I degenerative spondylolisthesis after decompression. In its pivotal trial, two-year results were non-inferior to instrumented fusion.
What this could change in a conversation with your surgeon: For a narrow group of patients, stabilization without fusion is now an option. Ask whether you'd qualify.
Sources: Company announcement
Infuse bone graft approved for TLIF
The FDA approved Medtronic's Infuse Bone Graft for one- or two-level transforaminal lumbar interbody fusion (TLIF), used with a cleared cage and screw-and-rod system.
What this could change in a conversation with your surgeon: If a growth-factor graft is proposed, ask why it suits you and what the specific risks are.
Sources: FDA summary (PDF)
Trial: technique that adds marrow stimulation lowered retears
In a trial of 126 patients, a repair technique combining the repair with small holes in the bone (to release healing cells) had a lower retear rate than standard single-row repair, with similar function.
What this could change in a conversation with your surgeon: Surgeons are trying several low-cost ways to improve healing. Ask what your surgeon does to help the tendon heal.
Sources: J Shoulder Elbow Surg, doi:10.1016/j.jse.2025.05.030
Review: augmenting a cuff repair cuts retears but not early pain scores
A systematic review found structural augmentation lowered retear rates, especially with allograft, but did not improve short-term patient-reported outcomes.
What this could change in a conversation with your surgeon: A healed tendon matters long term, but don't expect an augment to make the first months feel different.
Sources: Am J Sports Med (abstract)
FDA clears updated labeling for the BEAR implant
The FDA cleared updated labeling for Miach's BEAR implant. The company says pooled six-year data from its BEAR I and II studies showed lower rates of arthritis on X-ray than hamstring-graft reconstruction in patients 14 and older.
What this could change in a conversation with your surgeon: Arthritis after ACL injury is common. The data come from two company-sponsored studies with relatively small numbers, so ask your surgeon how it applies to you.
Sources: FDA record K251214 · News summary
Two-year trial data on the REGENETEN implant
Smith+Nephew announced two-year results from a randomized trial: 12.3% retears with the REGENETEN implant added to repair versus 35.1% with standard repair.
What this could change in a conversation with your surgeon: Lower retear rates are promising. These are company-announced results, so ask whether your tear type matches the study.
Sources: MassDevice
AAOS updates its rotator cuff guideline
The updated guideline has 21 recommendations. It supports bioinductive implants during repair, upgrades evidence for dermal allograft, doesn't support porcine grafts, and found similar results with early or delayed sling removal for small to medium tears.
What this could change in a conversation with your surgeon: This is what many US surgeons will follow. It's useful to know when you discuss options.
Sources: AAOS press release · ODT summary
BEAR implant cleared for partial tears and younger patients
The FDA cleared an expanded indication for the BEAR implant, adding partial ACL tears and expanding use in children and adolescents.
What this could change in a conversation with your surgeon: More people may be offered ACL restoration as an alternative to reconstruction, so it's worth understanding the trade-offs.
Sources: MassDevice
Industry and company news
Business, product and professional-society developments.
Stryker's Mako Shoulder enters full US release
Stryker began full market release of Mako Shoulder, combining Tornier Perform reverse implants, Blueprint planning and its robotic arm for primary reverse replacement.
What this could change in a conversation with your surgeon: Robotics improves how closely the implant matches the plan in bench studies. Whether that improves results for patients is not yet known.
Sources: MassDevice
Spine market: two companies dominate
ORTHOWORLD estimates Medtronic and Globus Medical account for nearly 43% of global spine sales, with fast-growing ATEC next tier and Stryker's implants now sold by VB Spine.
What this could change in a conversation with your surgeon: The company matters less than the surgeon and the indication, but it explains why your hospital may favor certain brands.
Sources: ORTHOWORLD
Exactech's shoulder line moves to Advita Ortho
Advita Ortho launched with Exactech's former assets, including the Equinoxe shoulder, after Exactech's restructuring. The FDA issued Advita a warning letter in December 2025 related to manufacturing specifications for the Equinoxe Reverse.
What this could change in a conversation with your surgeon: If you have or are offered an Equinoxe shoulder, it's reasonable to ask your surgeon about the company's status and any follow-up.
Sources: ORTHOWORLD · BioWorld
