Dillon MT, Prentice HA, Burfeind WE, et al. - The present study was conducted to describe the annual revision burden from a large integrated healthcare system and identify patient and operative factors that may predispose patients to revision failure, necessitating further surgery. Researchers obtained an annual revision burden as a proportion of the overall shoulder arthroplasties performed from 2005 to 2017. The relationship between the specified factors and re-revision risk was assessed by using Multivariable Cox proportional hazards regression. It was shown that the annual revision shoulder arthroplasty volume increased over the study period. The outcomes revealed that patient factors, including BMI and diabetes, were correlated with higher re-revision risks for hemiarthroplasty and reverse total shoulder arthroplasty (RTSA) primaries, respectively. The data indicated that RTSA revised for instability had a higher risk of re-revision in comparison with other indications. The outcomes suggest that TSA and hemiarthroplasty requiring aseptic revision may be best treated with RTSA as opposed to another TSA or hemiarthroplasty. Future trials are required to clarify these findings and distinguish how the mechanism of failure may affect the procedure selection in the revision setting.