Duethman NC, Bernard CD, Leland D, et al. - This study was carried out to define the success rate of initial non-operative treatment for traumatic anterior shoulder instability in a defined US geographic population, describe factors that predict conversion to surgery after initial non-operative management, and present the long-term outcomes of non-operative treatment following index traumatic anterior instability event. Researchers applied the Rochester Epidemiology Project database to distinguish patients –14 - 39 years of age treated for anterior shoulder instability between 1994 and 2016. They assessed patient demographics, comorbidities, injury characteristics, and imaging. A total of 379 patients were included with an average follow-up of 10.2 years (range 0.53 to 25.00). The results indicated that the majority of individuals less than 40 years old with shoulder instability who are initially treated non-operatively for 6 months are definitively treated without surgery. After 6 months of conservative treatment, 35% of these individuals experienced recurrent dislocation and 20% ultimately had undergone surgical treatment. It was shown that the majority of individuals that convert to surgical treatment had surgery within 12.5 years of their first instability event. After initial non-operative management, patients who experienced multiple instability events before or after consultation were more likely to convert to surgery.