{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:08:07Z","timestamp":1790698087077,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"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":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To highlight why the current arthroscopy\u2010centred paradigm may be insufficient for rotator cuff disease and to propose a surgeon\u2010led transition towards office\u2010based, ultrasound\u2010guided \u2018micro\u2019 interventions. The central question is whether earlier, less invasive image\u2010guided procedures can preserve tissue biology and improve value while maintaining patient safety. This commentary synthesises five decades of arthroscopic shoulder surgery principles with contemporary rotator cuff care pathways and the rapid expansion of musculoskeletal ultrasound outside the operating room. Emerging enabling technologies, including navigation, dedicated micro\u2010instruments, and standardised procedural workflows, are considered to outline a plausible near\u2010term shift in first\u2010line procedural care. Arthroscopy has transformed shoulder surgery, yet its foundational approach has changed little: fluid distension for visualisation, tissue ablation to create a view, and dependence on costly operating\u2010room infrastructure. In rotator cuff disease, clinical practice often tolerates prolonged delay, during which imaging, injections, and adjunctive therapies repeatedly consume resources while tendon and muscle degeneration progress. This delay can culminate in complex salvage procedures once reparative biology is compromised. In parallel, ultrasound has become ubiquitous and increasingly capable of supporting interventional solutions beyond diagnosis and injections. As barriers to adoption decrease, first\u2010line procedures may move upstream, potentially shifting the scope of practice away from surgeons unless they actively shape standards and evidence. The appropriate response is not territorialism but leadership. Shoulder surgeons should treat ultrasound literacy as foundational, adopt a deliberate micro\u2010interventional mindset, develop and validate safety\u2010first workflows, and generate comparative evidence that patients and health systems require. If surgeons lead this transition, earlier intervention may preserve biology and value; if not, the next paradigm will be defined elsewhere.<\/jats:p>","DOI":"10.1002\/ksa.70405","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:02:36Z","timestamp":1776171756000},"page":"3470-3473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Own the turf or lose it: Ultrasound\u2010guided procedures and the future of shoulder repair"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2797-8936","authenticated-orcid":false,"given":"Alexandre","family":"L\u00e4dermann","sequence":"first","affiliation":[{"name":"Division of Orthopaedics and Trauma Surgery H\u00f4pital de La Tour Meyrin Switzerland"},{"name":"Division of Orthopaedics and Trauma Surgery, Department of Surgery Geneva University Hospitals Geneva Switzerland"},{"name":"Faculty of Medicine University of Geneva Geneva Switzerland"},{"name":"FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System) Meyrin Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Vukanic","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics Wythenshawe Hospital, Manchester University NHS Foundation Trust Manchester UK"}],"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 ASST Spedali Civili Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-016-3231-2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-024-00492-3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.10.029"},{"key":"e_1_2_7_5_1","first-page":"88","article-title":"[Rapid chondrolysis after arthroscopic external meniscectomy. 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