This issue of Orthopaedics and Trauma deals with problems affecting the shoulder but also demonstrates some of the substantial advances that have been made in dealing with pathology of this joint since the last Shoulder symposium, published 4 years ago, in June 2018 (volume 32:3). Most notably, the place of reverse shoulder replacement is being clarified as we come to understand its indications better but also develop our expertise in dealing with the unique problems it can bring. Registries have shown us that the main reason for failure of anatomic shoulder replacement is rotator cuff failure; consequently our assessment of the cuff has become much more critical before we embark on surgery, and the drift towards choosing reverse options continues. Some of the earlier problems with initial fixation, loosening and bone loss in reverse arthroplasty have been addressed by combinations of operative techniques, implant design and engineering solutions to assist successful revision.
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