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A number of prognostic factors for recurrent instability have been proposed, including younger age, male sex, contact sports, and glenoid bone loss. Predictive tools and scores have been developed to assist in risk stratifying this patient population; however, no universally agreed upon, clinically validated algorithm exists. More recently, there has been emerging evidence favoring early surgical stabilization, as it has been shown to result in better overall outcomes compared with patients undergoing surgery following episodes of recurrent instability. With each subsequent dislocation or subluxation event, there is increased glenoid bone loss (and development of inverted\u2010pear glenoid), a greater prevalence of engaging (i.e., off\u2010track) Hill\u2010Sachs lesions, more extensive labral tears, a greater risk of rotator cuff involvement (in the older patient), and increased plastic and\/or permanent deformation, elongation, and compromise of the antero\u2010inferior glenohumeral joint capsule and associated inferior glenohumeral ligament complex. Moreover, there is now sufficient evidence to suggest that recurrence comes at a cost, as it is a major risk factor for poor outcomes following arthroscopic stabilization. However, one risk is overtreatment, potentially exposing those individuals who would not have had another instability event due to an unnecessary procedure. We should continue to use the available evidence within the literature to help risk\u2010stratify patients and develop an individualized treatment plan through a shared decision\u2010making process with the patient.<\/jats:p>","DOI":"10.1016\/j.arthro.2021.05.052","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T03:12:46Z","timestamp":1627873966000},"page":"2440-2443","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["<i>Editorial Commentary:<\/i>\n                    Management of First\u2010Time Anterior Shoulder Instability Requires Risk Stratification and Surgery for Many, But Not All"],"prefix":"10.1002","volume":"37","author":[{"given":"Ujash","family":"Sheth","sequence":"first","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,1]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513510391"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509357610"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0998-3"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00070"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.01327"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-001-1070-2"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0749-8063(89)90174-6"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2016.07.054"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2014.07.013"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2018-000447"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.05.039"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.08.011"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.89B11.18962"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.10.037"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2020.9284"},{"key":"e_1_2_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.12.185"},{"key":"e_1_2_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos\u20102020\u2010000584"},{"key":"e_1_2_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.03.047"},{"key":"e_1_2_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510371607"},{"key":"e_1_2_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507300262"},{"key":"e_1_2_2_22_2","doi-asserted-by":"crossref","unstructured":"Burkhart SS De Beer JF. 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