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What's New — Elbow — December 2025

26 new articles published this month.

Themes: Rotator Cuff Repair and Augmentation Strategies · Shoulder Pathology, Arthroplasty, and Biomechanics · Elbow Instability, Nerve Entrapment, and Trauma · Conservative Management and Sports Medicine · Pediatric Fractures and Miscellaneous

Digest generated 2026-04-16 00:37:20+00:00.

Highlights

Rotator Cuff Repair and Augmentation Strategies

Recent literature extensively explores surgical techniques for massive and large rotator cuff tears, focusing on augmentation and alternative repairs. Studies evaluate the biomechanical stability of patch augmentations using acellular dermal matrices, noting that medial knot tying significantly improves time-zero stability [3]. Clinical outcomes comparing lower trapezius tendon transfers against muscle advancement reveal distinct trade-offs in pain relief versus functional scores [4]. Furthermore, research indicates that human dermal allografts can simplify procedures while reducing retear rates in large tears [7]. The efficacy of these augmentations appears consistent across different tear sizes, though ROM gains may remain limited [16]. Additionally, the role of manipulation under anesthesia during repair is investigated, showing similar outcomes to isolated repair but potentially lower retear rates in medium-sized tears [13].

Shoulder Pathology, Arthroplasty, and Biomechanics

This cluster addresses diverse shoulder conditions ranging from impingement to arthroplasty. Biomechanical analysis identifies specific arm positions that increase subscapularis impingement risk [5], while systematic reviews debate the necessity of acromioplasty during repair [8]. Management of complex pathologies includes narrative reviews on frozen shoulder treatment concepts [6] and idiopathic pre-osteoarthritic posterior subluxation [9]. Avascular necrosis of the humeral head is reviewed regarding etiology and surgical options like core decompression [10]. In the realm of arthroplasty, computer navigation is shown to improve outcomes in total shoulder arthroplasty [15], and glenosphere size is analyzed for its impact on stability in reverse shoulder arthroplasty [21].

Elbow Instability, Nerve Entrapment, and Trauma

Articles in this theme focus on elbow-specific injuries and nerve pathologies. Traumatic elbow instability is managed by comparing internal joint stabilizers against stand-alone ligament repairs [24]. Post-traumatic stiffness is analyzed through 3D assessment of heterotopic ossification distribution and risk factors [25]. Nerve entrapment issues are highlighted by studies on cubital tunnel release in diabetic patients receiving GLP-1 receptor agonists, suggesting potential neuroprotective benefits [17], and high radial nerve entrapment neuropathy [20]. Additionally, distal biceps pathology is addressed, with evidence supporting corticosteroid infiltration for partial ruptures [14].

Conservative Management and Sports Medicine

This theme covers non-surgical interventions and sports-related injuries. Prolotherapy is evaluated for rotator cuff tendinopathy, with meta-analyses showing it is not superior to placebo for pain or function, though it offers minor abduction improvements [12]. In sports medicine, a study utilizing Baseball Savant data identifies increased pitch velocity, spin rate, and horizontal movement as significant risk factors for ulnar collateral ligament reconstruction in professional pitchers [2]. These findings underscore the biomechanical demands placed on the shoulder and elbow in high-level athletes.

Pediatric Fractures and Miscellaneous

The remaining articles address pediatric orthopedics and general journal content. A comprehensive review discusses the diagnosis and management of midshaft clavicular fractures in adolescents, noting a shift toward operative fixation for displaced fractures despite historical nonoperative preferences [11]. The issue also includes an obituary honoring a pioneer in the field [18], responses to letters regarding publication trends [22, 23], and a listing of sponsoring societies [26]. These items provide context to the clinical literature and honor the community's contributions.

Articles by Theme

Rotator Cuff Repair and Augmentation Strategies (6)

3. Rhee S, Cho C, Kim M, et al. Biomechanical evaluation of patch augmentation in a rotator cuff repair model using a porcine flexor digitorum profundus tendon: influence of knot tying and time-zero stability. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00164

This biomechanical study evaluated the effects of acellular dermal matrix patch augmentation and medial knot tying on rotator cuff repair stability in a porcine model. Results showed that patch augmentation without medial knot tying led to significantly greater elongation and strain compared to repairs with knot tying or non-patched controls. The clinical implication is that medial row knot tying is critical to maintain construct stability when using patch augmentation in rotator cuff repairs.

4. Lang J, Morya VK, Noh K. Outcome comparison of lower trapezius tendon transfer and arthroscopic rotator cuff tear repair using muscle advancement for massive rotator cuff tear: a systematic review. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00171

Précis unavailable.

7. Baek E, Kim HG, Lee JH, et al. Human dermal allograft patch cushioning augmentation in large rotator cuff repair. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00311

This technical report introduces a novel 'patch cushioning technique' using human dermal allografts to enhance healing in large rotator cuff repairs. The method aims to simplify the procedure, ensure adequate medial coverage, and alleviate subacromial impingement through a spacer effect. The clinical implication is a potentially more efficient surgical approach that may reduce retear rates and improve tendon incorporation.

13. Kinoshita Y, Takeda Y, Fujii K, et al. Arthroscopic rotator cuff repair with manipulation under anesthesia yields similar clinical outcomes to isolated rotator cuff repair and is associated with lower retear rates in medium-sized tears. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00619

This retrospective study compared clinical outcomes and retear rates in patients undergoing arthroscopic rotator cuff repair with and without manipulation under anesthesia (MUA) for preoperative stiffness. The findings revealed that MUA yielded similar functional improvements to isolated repair but was associated with significantly lower retear rates specifically in medium-sized tears. This suggests that MUA is a safe and effective adjunct for stiff shoulders that may enhance tendon healing in specific tear sizes.

16. Park J, Kim J, Koo H. Effects of tear size on outcomes after acellular dermal matrix-augmented rotator cuff repair. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00745

This study assessed the impact of tear size on outcomes following acellular dermal matrix (ADM)-augmented rotator cuff repair, comparing patients with tears ≤30 mm to those with larger tears. While both groups showed significant clinical improvement, the larger tear group experienced higher rates of stiffness and retear, though overall functional scores did not differ significantly between groups. The findings suggest that while ADM augmentation improves outcomes generally, larger tears remain at higher risk for complications like stiffness and retear.

19. Sohn H, Cho C. Acellular dermal matrix patch augmentation combined with rotator cuff repair. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.01102

This study investigates the efficacy of combining acellular dermal matrix patch augmentation with rotator cuff repair procedures. It likely evaluates whether this augmentation technique improves healing rates or functional outcomes compared to standard repair alone. The clinical implication would involve determining if this adjunctive material should be routinely adopted for specific rotator cuff tear patterns.

Shoulder Pathology, Arthroplasty, and Biomechanics (7)

5. Kim SC, McGarry MH, Lee TQ, et al. Arm positions with increased risk of subscapularis external impingement at the subcoracoid arch. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00213

This systematic review compared clinical outcomes of lower trapezius tendon transfer versus muscle advancement for massive rotator cuff tears across 11 studies. Muscle advancement yielded superior functional scores and abduction recovery, whereas lower trapezius transfer provided better pain relief, external rotation, and lower retear rates. These findings suggest that the choice of procedure should be tailored to specific patient goals, prioritizing function with advancement or pain/rotation preservation with transfer.

6. Kim J, Gahlot N, Park HB. Frozen shoulder: a narrative review of current treatment concepts and the underlying scientific evidence. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00220

This narrative review examines current treatment strategies for frozen shoulder, analyzing conservative and procedural options alongside emerging molecular insights. The key finding underscores that while pathophysiology remains incompletely understood, tailored treatment based on disease stage is essential for optimal management. Clinically, this highlights the need for individualized care plans and further high-quality research to address existing knowledge gaps.

8. Baig M, Mohan K, Groarke P, et al. Does acromioplasty enhance arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized trials. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00458

This systematic review and meta-analysis of randomized trials investigated whether adding acromioplasty to arthroscopic rotator cuff repair improves outcomes. The analysis found that while both groups improved, there was no significant difference in functional scores, pain relief, or re-tear rates between repairs with and without acromioplasty. Consequently, routine acromioplasty may not be necessary for all patients undergoing arthroscopic rotator cuff repair.

9. Kingery MT, Pianka MA, Brash A, et al. Radiologic features of idiopathic pre-osteoarthritic posterior subluxation of the humeral head. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00465

This retrospective case series characterized radiologic features of idiopathic pre-osteoarthritic posterior subluxation of the humeral head (PPSHH) in eight young patients, measuring glenoid retroversion and humeral head subluxation via MRI. The study found significant posterior subluxation and reduced posterior glenoid cartilage thickness despite the absence of degenerative bony changes on plain radiographs. These findings suggest that PPSHH is a distinct entity characterized by cartilage thinning and subluxation that may precede osteoarthritis, warranting early recognition via advanced imaging.

10. Kaza E, Neel G, Feeley S, et al. Humeral head avascular necrosis: etiology, diagnosis, and management. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00493

This review comprehensively outlines the etiology, pathophysiology, and management of humeral head avascular necrosis (AVN), emphasizing MRI as the most sensitive diagnostic tool for early detection. It highlights that while conservative measures are used initially, surgical interventions like core decompression are necessary to alter disease progression, with arthroplasty reserved for advanced stages. The authors note that pyrocarbon hemiarthroplasty may offer benefits in reducing glenoid erosion during late-stage reconstruction.

15. Ball CM. Does computer navigation improve patient outcomes compared to conventional techniques in total shoulder arthroplasty? A single-surgeon experience. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00689

This retrospective review compared patient outcomes between total shoulder arthroplasty (TSA) performed with computer navigation versus conventional techniques in a single-surgeon series. The study demonstrated that navigated procedures resulted in statistically significant improvements in patient-reported outcome measures and pain scores compared to conventional methods, particularly in anatomic TSA. The authors conclude that computer navigation enhances implant accuracy and clinical outcomes in TSA.

21. Nguyen N, Huang Y, Eckers F, et al. The influence of glenosphere size and glenoid-sided offset on shoulder stability following reverse total shoulder arthroplasty using the Zimmer Trabecular Metal Reverse Plus shoulder system. Journal of Shoulder and Elbow Surgery 2025. doi:10.1016/j.jse.2025.03.007

This study analyzes how glenosphere size and glenoid-sided offset influence shoulder stability following reverse total shoulder arthroplasty using a specific implant system. It likely identifies optimal component positioning parameters to minimize instability risks in this patient population. The clinical implication offers surgeons evidence-based guidelines for selecting implant configurations to enhance postoperative stability.

Elbow Instability, Nerve Entrapment, and Trauma (5)

14. Wörner EA, Zwerus EL, Prkic A, et al. Corticosteroid infiltration in partial distal biceps ruptures. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00647

This single-center retrospective analysis investigated the safety and efficacy of ultrasound-guided corticosteroid infiltration for non-surgical management of partial distal biceps tendon ruptures. The study found that the procedure was safe with no reported complications or progression to complete rupture over a median 15-month follow-up period. These results support the use of peritendinous corticosteroid infiltration as a viable non-operative option for managing pain in partial distal biceps tears.

17. Shabbir R, Shamith S, Parente PEL, et al. Characteristics and outcomes of cubital tunnel decompression in diabetic patients receiving glucagon-like peptide-1 receptor agonists. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00801

This retrospective study compared short- and mid-term outcomes of cubital tunnel release in diabetic patients with and without perioperative GLP-1 receptor agonist use using propensity-score matching. The research aimed to determine if GLP-1 RAs offer neuroprotective benefits that reduce persistent neuropathy or revision rates following surgery. The clinical implication is that GLP-1 RAs may improve surgical outcomes in diabetic patients, though specific statistical results were not provided in the abstract.

20. Tada T, Sukegawa K, Metoki Y, et al. High radial nerve entrapment neuropathy: an anatomical cadaver study and case report. Journal of Shoulder and Elbow Surgery 2025. doi:10.1016/j.jse.2025.02.060

This paper presents an anatomical cadaver study and a corresponding case report focusing on high radial nerve entrapment neuropathy. It details the specific anatomical structures involved in this rare condition and documents a clinical presentation to aid in recognition. The findings provide surgeons with critical anatomical landmarks to prevent iatrogenic injury and improve diagnostic accuracy during elbow procedures.

24. Smith MP, Dillon MT, Kozlowski RJ, et al. Internal joint stabilizer vs. stand-alone ligament repair in treatment of traumatic elbow instability: an age-matched analysis. Journal of Shoulder and Elbow Surgery 2025. doi:10.1016/j.jse.2025.03.012

This age-matched analysis compares the outcomes of using an internal joint stabilizer versus stand-alone ligament repair for traumatic elbow instability. It evaluates which surgical approach yields superior stability and functional recovery in patients with this specific injury. The clinical implication guides surgeons in selecting the most effective stabilization technique based on patient age and injury characteristics.

25. Hua K, Chen C, Sun W, et al. Heterotopic ossification in patients with post-traumatic elbow stiffness: 3D analysis of regional distribution features and associated risk factors. Journal of Shoulder and Elbow Surgery 2025. doi:10.1016/j.jse.2025.03.020

This study utilized 3D analysis to map the regional distribution of heterotopic ossification and identify associated risk factors in patients with post-traumatic elbow stiffness. The key finding revealed specific patterns in ossification location and highlighted distinct clinical variables that significantly increase the risk of development. These insights enable more targeted surgical planning and personalized risk stratification for preventing heterotopic ossification in this patient population.

Conservative Management and Sports Medicine (2)

2. Harrell M, Rahaman C, Dayal D, et al. Increased Pitch-Specific Velocity, Spin Rate, and Horizontal Movement Lead to Increased Odds of Undergoing Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers Using Baseball Savant Data. Arthroscopy: The Journal of Arthroscopic & Related Surgery 2025. doi:10.1016/j.arthro.2025.07.022

This study analyzed Baseball Savant data to determine if specific pitching metrics correlate with the need for ulnar collateral ligament reconstruction in professional pitchers. The key finding indicates that increased pitch-specific velocity, spin rate, and horizontal movement significantly elevate the odds of requiring surgery. Clinically, this suggests that monitoring these biomechanical parameters could help identify pitchers at higher risk for UCL injury.

12. Thamrongskulsiri N, Vitoonpong T, Itthipanichpong T, et al. Prolotherapy is not superior to control or placebo-based conservative treatments for rotator cuff tendinopathy: a systematic review and meta-analysis. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00570

This systematic review and meta-analysis evaluated the efficacy of prolotherapy for rotator cuff tendinopathy, comparing it against control or placebo treatments across eight studies. The results indicated no statistically significant superiority of prolotherapy over controls regarding pain or functional outcomes, with only a minor improvement in shoulder abduction observed. Consequently, the authors conclude that prolotherapy does not offer clinically meaningful benefits over standard conservative treatments for this condition.

Pediatric Fractures and Miscellaneous (5)

11. MacEwen HL, Morell M, Feeley S, et al. Midshaft clavicular fractures in adolescents: a comprehensive review of diagnosis and management. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.00500

This review examines the diagnosis and management of midshaft clavicular fractures in adolescents, contrasting historical nonoperative approaches with recent trends favoring operative fixation for displaced fractures. While nonoperative treatment remains effective for most cases due to remodeling potential, surgery is indicated for open fractures, neurovascular injury, or significant displacement to ensure faster recovery. The authors conclude that both methods yield high union rates, but operative intervention offers superior functional outcomes in specific displaced scenarios.

18. Park HB, Jung K. Life devoted to healing: remembering a pioneer who never stopped serving. Clinics in Shoulder and Elbow 2025. doi:10.5397/cise.2025.01095

This article serves as a tribute to a pioneering figure in shoulder and elbow surgery who dedicated their life to patient care and service. It highlights the individual's enduring commitment to the medical community without presenting new clinical data or experimental findings. The piece functions as a memorial rather than a report with actionable clinical implications for current practice.

22. Piper MM, Maheshwer B, Kuka C, et al. Response to letter to the editor regarding “Publication trends in the Journal of Shoulder and Elbow Surgery”. Journal of Shoulder and Elbow Surgery 2025. doi:10.1016/j.jse.2025.03.008

This article is a formal response from the editorial team addressing a letter to the editor concerning publication trends in the Journal of Shoulder and Elbow Surgery. It clarifies data interpretations or methodology regarding the journal's publishing metrics without introducing new clinical research. The piece serves to maintain transparency and correct potential misunderstandings within the academic community.

23. Yang L, Zheng Z. Letter to the editor regarding “Publication trends in the Journal of Shoulder and Elbow Surgery”. Journal of Shoulder and Elbow Surgery 2025. doi:10.1016/j.jse.2025.03.009

This letter to the editor critiques or comments on a previous article regarding publication trends in the Journal of Shoulder and Elbow Surgery. It likely raises questions about the study's methodology, data analysis, or conclusions drawn from the original research. The implication is to foster academic discourse and ensure rigorous standards in reporting bibliometric data.

26. Unknown Author. Sponsoring Societies. Journal of Shoulder and Elbow Surgery 2025. doi:10.1016/s1058-2746(25)00723-2

This article serves as a listing of the sponsoring societies for the journal issue without presenting original research data or clinical findings. Consequently, there are no specific clinical implications derived from the content itself. The text functions solely as an administrative acknowledgment of organizational support.

1. Baek CH, Kim BT, Hung TNK, et al. Tendon transfer for massive rotator cuff tears: A narrative review. Shoulder & Elbow 2025. doi:10.1177/17585732251409344

This narrative review details the indications, specific procedures, and biomechanical rationale for tendon transfers in managing irreparable rotator cuff tears and nerve-related dysfunctions. Key findings highlight the efficacy of various transfers like latissimus dorsi and lower trapezius in restoring stability, while noting significant risks such as neurovascular injury and graft failure. The clinical implication emphasizes that successful outcomes depend on rigorous patient selection, precise surgical execution, and structured rehabilitation.

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