Today's shoulder and elbow edition examines six recent studies spanning surgical decision-making across the age spectrum and pathologic severity. We cover a landmark randomized trial showing reverse shoulder arthroplasty superiority over nonoperative treatment for displaced proximal humerus fractures in older patients, concerning registry data on higher early revision rates with short humeral stems, the natural history of muscle changes in nonoperatively managed rotator cuff tears, successful outcomes of reverse arthroplasty in patients ninety and older, lack of benefit from tranexamic acid in arthroscopic rotator cuff repair, and the clinical utility of measuring superior humeral head migration as a marker of rotator cuff disease severity.