This chapter contains a history of how surgeons think and act when best evidence collides with basic surgical principles and common practice. At the turn of the millennium, a new implant technology, locking plates, became a panacea in treating shoulder fractures. Promising laboratory tests and a strong biomechanical rationale helped this new technology become the implant of choice. Enthusiasm only grew, despite a lack of high-quality clinical evidence and the emergence of high complication rates. The first randomized trial appeared after a decade. Four randomized trials have reported no superiority of surgery but high complication and reoperation rates. As a result, multiple modifications of the implant and procedure have been proposed to lower the failure rate. Restoring the anatomy and establishing stable fixation, although a valuable principle in other fractures, does not seem to be beneficial in older people with shoulder fractures. A strong biomechanical rationale, successful marketing, and consensus within the orthopedic community cannot replace high-quality clinical trials. De-implementation can be a challenge, and the cost of delaying it can be substantial for patients, the healthcare system, and society.