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What's New — Elbow — August 2026

6 new articles published this month.

Themes: Radial Head Arthroplasty Outcomes · Capitellar OCD in Athletes · Revision Surgery and Infection · Distal Biceps Tendinopathy Debate · Throwing Athletes Injury Risk

Digest generated 2026-09-04 19:48:36+00:00.

Highlights

Radial Head Arthroplasty Outcomes

Two studies address radial head replacement in different contexts. In acute elbow trauma, press-fit anatomic designs (Anatomic Radial Head System and Align) showed comparable radiological and clinical outcomes, informing implant selection [5]. When these implants fail, management is controversial: removal without re-implantation, with or without soft-tissue interposition, was evaluated over an average 7-year follow-up, documenting outcomes, complications, and proximal radioulnar impingement pain in 37 elbows [4]. Together these papers help surgeons weigh revision options, new prosthesis versus removal, against long-term risks such as radiocapitellar pain and impingement.

Capitellar OCD in Athletes

Osteochondral autograft transplantation (OAT) for capitellar osteochondritis dissecans in adolescent athletes was examined to identify preoperative predictors of suboptimal results. Proximal migration of the radial head emerged as an independent predictor of poorer outcomes, alongside candidate severity markers such as lesion size and lateral wall disruption, with outcomes assessed by elbow range of motion and Timmerman-Andrews scores at minimum two-year follow-up [1]. This radiographic sign may guide case selection and preoperative counseling, highlighting which athletes are at risk of persistent symptoms despite cartilage restoration surgery.

Revision Surgery and Infection

Preoperative biopsies to exclude infection in presumed aseptic revision shoulder and elbow arthroplasty remain debated. In 81 consecutive revision cases, biopsies in 40 patients yielded seven positive results treated with oral antibiotics, yet intraoperative cultures at revision showed cleared infection in only four and new infection in six previously negative cases, questioning the reliability and value of routine pre-revision sampling [2]. The findings inform whether biopsy-driven antibiotic strategies reduce periprosthetic infection risk or add cost and delay without clear benefit.

Distal Biceps Tendinopathy Debate

A letter to the editor challenges a study on early postoperative complications after partial distal biceps tendon repair, arguing that such publications normalize surgery for what is often tendinopathy rather than a true partial tear. The authors emphasize that distal biceps enthesopathies nearly always resolve nonoperatively, citing Mayo Clinic data showing good clinical and functional results with conservative management, and note the evidence base for surgery rests largely on case series [3]. This exchange underscores the need for caution in operative decision-making for partial distal biceps lesions.

Throwing Athletes Injury Risk

A cross-sectional study of 67 female collegiate baseball and softball players assessed self-reported symptoms and ultrasound-detected structural abnormalities of the shoulder and elbow. Elbow pain or discomfort was reported by roughly a third of softball players, with higher symptom rates among baseball players, and early sport participation was examined as a risk factor using Firth penalized logistic regression [6]. The data fill a gap regarding overhead-throwing injuries in female athletes and may guide screening and prevention programs at the collegiate level.

Articles by Theme

Radial Head Arthroplasty Outcomes (2)

4. Hart CM, Weir TB, O’Driscoll CM, et al. Outcomes of Implant Removal After Failed Radial Head Arthroplasty:An Average 7-Year Follow-up Study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.022

This registry-based study evaluated outcomes after removal of failed radial head arthroplasty implants without reimplantation, including 25 elbows with an average 7-year follow-up. The study assessed motion, complications, reoperations, and symptomatic proximal radioulnar impingement after implant removal. The results inform the relative indications for revision implantation versus simple removal with or without interposition when radial head implants fail.

5. Heredia JD, Ruiz Ibán MA, Espejo Reina MJ, et al. RADIOLOGICAL AND CLINICAL OUTCOMES OF TWO DESIGNS (ANATOMIC RADIAL HEAD SYSTEM® AND ALIGN®) OF PRESS-FIT ANATOMIC RADIAL HEAD ARTHROPLASTY FOR ACUTE ELBOW TRAUMA. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.028

This study compared radiological and clinical outcomes of two press-fit anatomic radial head arthroplasty designs (Anatomic Radial Head System and Align) used for acute elbow trauma. Outcomes included clinical scores, radiographic assessment, and complications between the two implant systems. The findings help guide implant selection in radial head replacement for trauma.

Capitellar OCD in Athletes (1)

1. Kamijo H, Takahashi N, Matsuki K, et al. Preoperative Proximal Migration of the Radial Head as an Independent Predictor of Suboptimal Outcomes After Osteochondral Autograft Transplantation for Capitellar Osteochondritis Dissecans: A Retrospective Cohort Study. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261469691

This retrospective cohort study of adolescent athletes undergoing osteochondral autograft transplantation for capitellar OCD evaluated clinical outcomes and preoperative risk factors for suboptimal results (Timmerman-Andrews score <160). Preoperative proximal migration of the radial head on radiographs emerged as an independent predictor of suboptimal outcomes, alongside lesion severity measures. Clinically, radial head migration should be assessed preoperatively to identify patients at risk and guide surgical decision-making and counseling.

Revision Surgery and Infection (1)

2. Howard M, Thomas W, Evans J, et al. Pre-operative biopsies in the revision setting – helpful or harmful?. Shoulder & Elbow 2026. doi:10.1177/17585732261474495

This single-center study examined whether pre-operative biopsies are useful in presumed aseptic revision shoulder and elbow procedures by comparing outcomes in 81 patients with and without pre-revision biopsies. Pre-revision biopsy showed low sensitivity (54%), with some infections cleared after treatment but new infections also emerging, while 13 of 41 non-biopsied patients had unexpected positive cultures at revision. The findings suggest routine pre-revision biopsies may be of limited value, and positive intraoperative cultures can be managed successfully with oral antibiotics.

Distal Biceps Tendinopathy Debate (1)

3. Reichel LM, Ring D. Re: Early Postoperative Complications Following Partial Distal Biceps Tendon Surgical Repair. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.03.017

This is a letter to the editor critiquing a study on early postoperative complications after partial distal biceps tendon surgical repair. The authors argue that the study's methodology and publication risk normalizing surgery for distal biceps tendinopathy, a condition that is largely self-limiting and for which surgery is optional, citing evidence that nonoperative management yields good results. The clinical implication is caution against extrapolating surgical case series to support operative treatment of enthesopathies and tendinopathies.

Throwing Athletes Injury Risk (1)

6. Tsukahara Y, Jyoto E, Sato R. Risk of Shoulder/Elbow Injuries and Imaging Abnormalities in Female Collegiate Baseball and Softball Players. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.07.026

This cross-sectional study of 67 female collegiate baseball and softball players used questionnaires and diagnostic ultrasound to assess shoulder and elbow injury prevalence and structural abnormalities. Symptoms were common (shoulder pain in 36% of softball and 64% of baseball players), and abnormal shoulder ultrasound findings were highly prevalent (79-100%), with early sport participation examined as a associated factor. The results highlight a high burden of subclinical and symptomatic pathology in female overhead-throwing athletes, supporting screening and injury-prevention efforts.

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