{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:33:47Z","timestamp":1788845627107,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To provide an ESSKA\u2010ESA formal Consensus to help general practitioners in their daily clinical decisions regarding the diagnosis and treatment of traumatic anterior shoulder instability (TASI) according to age and timing after injury. Part 1 is dedicated to the history\u2010taking, physical examination and imaging studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were categorised into three age groups: adolescents (&lt;20 years), young adults (20\u201340 years) and older adults (&gt;40 years). Two clinical scenarios were addressed: first\u2010time and recurrent dislocations. A formal consensus process was followed, including a steering group (15 experts from 9 countries), a rating group (18 experts from 18 countries) and a reader group (28 experts from 13 countries). The steering group formulated 35 clinical questions, 12 of which related to Part 1. Each question was answered with a statement and grade of recommendation (A\u2013D), based on literature and expert opinion. The rating group reviewed and refined the statements, followed by validation from the reader group for cultural adaptability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus was reached with high agreement: median (range) 9 (8\u20139). One question received a grade A recommendation, nine were B, and two were C. Most debated topics included imaging to guide treatment decisions in first\u2010time dislocations, assessment of glenoid bone loss, and soft tissue quality. Each age group presents unique diagnostic considerations: younger patients have higher recurrence risk and activity levels; older patients more often present with associated soft\u2010tissue injuries. While physical exam findings were consistent across ages, associated injuries gain importance with age. The distinction between first\u2010time and recurrent dislocations significantly impacts imaging needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ESSKA\u2010ESA Consensus highlights that age and timing (first\u2010time versus recurrent) influence the decision\u2010making when managing TASI. All parameters related to history taking, physical exam and imaging studies should be considered according to the patient's age and the number of dislocation episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70336","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T10:12:07Z","timestamp":1771409527000},"page":"1545-1555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Age\u2010 and time\u2010specific management of traumatic anterior shoulder instability: The 2024 ESSKA\u2010ESA formal consensus. Part 1: History taking, physical exam and imaging studies"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8979-8404","authenticated-orcid":false,"given":"Eduard","family":"Alentorn\u2010Geli","sequence":"first","affiliation":[{"name":"Barcelona Sports Trauma Institute Barcelona Spain"},{"name":"Trauma Unit, Unidad de Cirug\u00eda de Hombro, Rodilla y Traumatolog\u00eda deportiva Centro M\u00e9dico Teknon, Grupo Quir\u00f3nsalud Barcelona Spain"},{"name":"Sport\u2010IT Instituto de Traumatolog\u00eda, Unidad de Medicina y Traumatolog\u00eda Deportiva Hospital El Pilar, Grupo Quir\u00f3nsalud Barcelona Spain"},{"name":"ViuSalut, Medicina Integrativa Barcelona Spain"},{"name":"Zona Wellness, The Aquatics Medical Center, Club Nataci\u00f3 Atl\u00e8tic\u2010Barceloneta (CNAB) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Catarina","family":"\u00c2ngelo","sequence":"additional","affiliation":[{"name":"Hospital SAMS I Mais Sindicato Lisbon Portugal"},{"name":"Joaquim Chaves Sa\u00fade I Cl\u00ednica Cir\u00fargica, Praia de Carcavelos  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Brilakis Orthopaedics Athens Greece"},{"name":"Orthopaedic Department of Modern Arthroscopic and Robotic Surgery Athens Medical Group Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berte","family":"B\u00f8e","sequence":"additional","affiliation":[{"name":"Division of Orhopaedic Surgery, Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Ru\u00edz\u2010Iban","sequence":"additional","affiliation":[{"name":"Unidad de Hombro y Codo Hospital Universitario Ram\u00f3n y Cajal Madrid Espa\u00f1a"},{"name":"Departamento de Cirug\u00eda, Facultad de Medicina, Universidad de Alcal\u00e1 Ciencias Sanitarias y Medicosociales, Alcal\u00e1 de Henares Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Dyrna","sequence":"additional","affiliation":[{"name":"Gelenkzentrum\u2010Leipzig Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-8762","authenticated-orcid":false,"given":"Maristella Francesca","family":"Saccomanno","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Fondazione Policlinico Universitario A. Gemelli, IRCSS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucca","family":"Lacheta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Housset","sequence":"additional","affiliation":[{"name":"Clinique des Maussins Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horea","family":"Benea","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy UMF \u201cIuliu Hatieganu\u201d Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helder","family":"Fonte","sequence":"additional","affiliation":[{"name":"Hospital das For\u00e7as Armadas \u2013 P\u00f3lo Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achilleas","family":"Boutsiadis","sequence":"additional","affiliation":[{"name":"Bioclinic of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frantzeska","family":"Zampeli","sequence":"additional","affiliation":[{"name":"Hand, Upper Limb &amp; Microsurgery Department KAT Attica General Hospital Kifisia Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Milano","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy"},{"name":"Department of Bone and Joint Surgery Spedali Civili Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Beaufils","sequence":"additional","affiliation":[{"name":"ESSKA consensus projects advisor Centre M\u00e9dical Fondation Norbert Metz  Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ladislav","family":"Kovacic","sequence":"additional","affiliation":[{"name":"Arbormea \u2013 Artro Center Ljubljana Slovenija Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-022-09796-x"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.06.022"},{"issue":"2","key":"e_1_2_13_4_1","first-page":"145","article-title":"How to identify and calculate glenoid bone deficit","volume":"90","author":"Baudi P","year":"2005","journal-title":"Chir Organi Mov"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-023-00664-2"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12390"},{"issue":"23","key":"e_1_2_13_7_1","first-page":"141","article-title":"Polyarticular hypermobility and its consequences in rowers and swimmers: a preliminary report","volume":"3","author":"Gebska M","year":"2016","journal-title":"Trends Sport Sci"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-022-09773-4"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518791555"},{"key":"e_1_2_13_10_1","unstructured":"Haute Autorit\u00e9 de Sante.2022. 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