What's New — Elbow — October 2026¶

39 new articles published this month.

Themes: Throwing Athlete Elbow · Trauma and Fracture Management · Arthroplasty and Implant Outcomes · Nerve and Tendon Disorders · Instability and Biomechanics · Research Methods and Miscellany

Digest generated 2026-11-04 16:05:25+00:00.

Highlights¶

Throwing Athlete Elbow¶

This month's digest features a strong focus on the overhead athlete's elbow, spanning diagnosis, risk factors, and return-to-play. A comprehensive review outlines a systematic physical examination protocol for throwing elbow pathology [1]. Workload and biomechanical studies examine how pitch counts, velocity, stride length, and the new MLB pitch clock relate to arm injury risk [4, 18, 34], while correspondence debates valgus torque as a risk factor in young pitchers [9]. Preseason ultrasound of the medial ulnar collateral ligament was evaluated for predicting subsequent injury in professional pitchers [27], and cadaveric work clarified that distal UCL tears produce both valgus and internal-rotation instability [23]. After UCL reconstruction, active spin rates are preserved across pitch types despite reduced workload [28]. Finally, COVID-19 activity restrictions in Japan offered a natural experiment on repetitive-throwing exposure and capitellar osteochondritis dissecans prevalence in preadolescent players [19].

Trauma and Fracture Management¶

Traumatic elbow conditions received substantial attention, from fracture fixation to dislocations and Monteggia variants. A multicenter study characterized infectious, mechanical, and functional failure patterns leading to revision after distal humerus fracture fixation [15], complemented by CT-based guidance for safe medial column screw placement in elderly transcondylar fractures [16] and analysis of coronal shear fractures with medial trochlear involvement [39]. The medial collapse sign was identified as a predictor of cubitus varus after paediatric supracondylar fixation [30], and floating elbow injuries were compared with supracondylar fractures in children [5]. Monteggia injuries featured prominently, including recurrent radial head instability treated with temporary radioulnar transfixation and biceps chemodenervation [2], biomechanical benefits of radial head arthroplasty in Monteggia-like lesions [3], residual radiocapitellar instability after paediatric Monteggia fractures [13], and primary total elbow arthroplasty for a posterior Monteggia fracture-dislocation [26]. Simple posteromedial dislocation failure pathways [38] and the saline load test for anteromedial arthrotomy [37] round out the theme.

Arthroplasty and Implant Outcomes¶

Total elbow arthroplasty research this month emphasized complication risk stratification and challenging indications. A matched cohort study found that combined anxiety and depression significantly increased 90-day wound complications, anemia, emergency visits, and readmission after total elbow arthroplasty [10], while social determinants of health were associated with 2-year implant-related complications and healthcare utilisation [11]. Population-based data demonstrated that radial head arthroplasty for radial head fracture carries a lower reoperation rate than open reduction internal fixation [25]. For difficult salvage scenarios, preliminary experience with a contemporary implant instrumentation technique for total elbow arthroplasty in elbow ankylosis was reported [31], alongside a case of primary total elbow arthroplasty with ulnar fixation for a Jupiter type IID posterior Monteggia fracture-dislocation [26]. Outcomes and complications of the rarely performed elbow arthrodesis as a last-resort salvage procedure were also documented [24].

Nerve and Tendon Disorders¶

Nerve compression and tendon pathology around the elbow were addressed with both surgical series and biologic therapy trials. Early PROMIS outcomes after cubital tunnel release showed improvement whether or not anterior transposition was performed, clarifying early recovery trajectories between techniques [6]. An explainable machine-learning model identified preoperative clinical and electrodiagnostic predictors of outcome after anterior subcutaneous ulnar nerve transposition for idiopathic cubital tunnel syndrome, enabling individualized prognosis [32]. For lateral epicondylitis, a randomised controlled trial compared leukocyte-rich versus leukocyte-poor platelet-rich plasma against saline injection under an identical rehabilitation protocol, measuring isokinetic and isometric upper limb strength over 12 months [17]. Nerve-related surgical safety also appeared in arthroscopic technique innovation, with ultrasound-assisted elbow arthroscopy described to prevent iatrogenic nerve injury during synovectomy [7].

Instability and Biomechanics¶

Biomechanical and clinical investigations advanced understanding of elbow instability beyond the throwing population. Partial triceps tendon transfer to the supinator crest was biomechanically validated as a dynamic stabilisation salvage option for posterolateral rotatory instability when conventional ligament reconstruction fails [12]. Cadaveric work using Thiel-embalmed specimens quantified the distinct valgus and internal-rotation instability patterns produced by sequential distal ulnar collateral ligament release [23]. Directional failure pathways in simple posteromedial elbow dislocation were described, with the anterolateral escape route identified as a structural threshold for spontaneous redislocation [38]. The saline load test proved effective for identifying small anteromedial arthrotomies, relevant to traumatic elbow stability assessment [37]. Additionally, morphological analysis linked increased proximal ulna dorsal angulation to primary elbow osteoarthritis, suggesting a potential mechanical contributor to degenerative disease [36].

Research Methods and Miscellany¶

A cluster of studies addressed research methodology, epidemiology, and miscellaneous elbow topics. A systematic review and meta-analysis examined loss to follow-up rates in randomised controlled trials on elbow pathology and factors associated with attrition bias [21]. A methodological critique highlighted pitfalls of large datasets such as TriNetX and COSMOS for shoulder and elbow research [33]. Normative ASES and Simple Shoulder Test scores in an asymptomatic United States population provide reference values useful for interpreting elbow and upper extremity outcomes [29]. Epidemiological analyses covered the growing emergency department burden of Brazilian jiu-jitsu injuries [20] and comparative musculoskeletal injury trends in pickleball versus tennis [35]. A narrative review catalogued French innovations that became gold standards in upper limb surgery, including the GUEPAR total elbow and bipolar radial head arthroplasty [14], and nerve transfer outcomes for upper brachial plexus injury restoring elbow flexion were reported [8].

Articles by Theme¶

Throwing Athlete Elbow (9)¶

1. Eskew JR, Soth BT, Alawa J, et al. A Comprehensive Review of the Physical Examination of the Elbow in the Throwing Athlete. Arthroscopy Techniques 2026. doi:10.1002/atn2.70313

The authors present a technical note outlining a systematic physical examination protocol for the elbow in overhead throwing athletes, covering conditions such as ulnar collateral ligament injury, valgus extension overload, medial epicondylitis, ulnar neuritis, and radiocapitellar pathology. The protocol emphasizes combining a structured examination with advanced imaging for accurate diagnosis. Clinically, this offers a practical framework to standardize evaluation and improve diagnostic accuracy of elbow pain in throwers.

4. Salamh P, Plisky P, Beiting J, et al. Association of Changes in Game Pitch Count, Pitching Velocity, and Arm Injuries in Collegiate Pitchers. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261489882

Collegiate baseball pitchers were prospectively followed over one summer season, with Bayesian joint models used to assess associations between changes in game pitch count and fastball velocity and arm injuries, accounting for competing risks of release or retirement. The study examined whether fluctuations in pitching workload and velocity predict shoulder and elbow injury. The results inform workload monitoring strategies aimed at reducing arm injuries in collegiate pitchers.

9. Qin K, Xu Y, Liang W. Regarding “Increased Elbow Valgus Torque During Pitching Is Not a Risk Factor for Medial Elbow Injuries in Young Baseball Pitchers: A Prospective Cohort Study”. Arthroscopy 2026. doi:10.1002/arj.70643

This is a letter to the editor commenting on a prospective cohort study of elbow valgus torque and medial elbow injuries in young baseball pitchers. The authors argue that the observed age association likely reflects skeletal maturity and maturational vulnerability rather than chronological age, recommending that future models incorporate peak height velocity, growth velocity, and bone or apophyseal age. Clinically, this suggests youth pitching injury risk stratification should be maturity-based rather than age-based.

18. Manzi J, Dowling B, Xu W, et al. A Biomechanical Analysis and Comparison of Prior Injury History in Professional Baseball Pitchers on the Basis of Stride Length. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261480486

This cross-sectional study used 3D motion capture on 326 professional pitchers throwing fastballs to compare prior injury history between short- and long-stride groups. Contrary to the hypothesis, stride length groups did not differ meaningfully in overall prior injury burden, and the anticipated protective association of longer strides with medial elbow injury was not clearly demonstrated. Findings suggest stride length alone should not guide injury-risk profiling or pitching-mechanics interventions in professional pitchers.

19. Takamatsu N, Matsuura T, Iwase J, et al. Impact of the COVID-19 Pandemic on Prevalence of Capitellar Osteochondritis Dissecans in Preadolescent Baseball Players in Japan. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261487858

This retrospective cross-sectional study compared ultrasonography-based elbow screening results in 5006 Japanese preadolescent baseball players before, during, and after COVID-19 activity restrictions to assess capitellar osteochondritis dissecans (OCD) prevalence. Reduced baseball activity during the pandemic was associated with a lower prevalence of capitellar OCD, supporting repetitive throwing microtrauma as a key driver of the disease. The results reinforce the importance of limiting throwing volume in youth baseball prevention programs.

23. Matsuzawa K, Edama M, Sakamoto K, et al. Differences in valgus and internal-rotation instability after sequential distal ulnar collateral ligament release: a cadaveric study using Thiel-embalmed cadavers. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.10.002

In this cadaveric study, 12 Thiel-embalmed elbows underwent sequential distal ulnar collateral ligament release (intact, 5 mm, and 10 mm), with valgus instability measured via medial joint space and internal rotation instability via posteromedial joint space using ultrasonography. Progressive distal UCL release produced both valgus and internal rotation instability, with internal rotation instability becoming increasingly evident as the tear progressed. This supports assessing rotatory instability in distal UCL injuries and may explain poorer conservative outcomes in overhead athletes with distal tears.

27. Bendrick TR, Helgeson EE, Schaefer JJ, et al. Association of Preseason Medial Ulnar Collateral Ligament Ultrasound Findings With Subsequent Elbow Injury in Professional Baseball Pitchers. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261490299

In this retrospective cohort of Minor League Baseball pitchers followed over three seasons, standardised preseason ultrasound was used to measure medial ulnar collateral ligament (MUCL) morphology and ulnohumeral joint widening with valgus stress, which were then tested for association with subsequent throwing-arm elbow injury. The study evaluated whether these baseline ultrasound measures predict future elbow injury. The findings inform whether preseason MUCL ultrasound can be used for risk stratification and targeted prevention or workload modification in professional pitchers.

28. Kress DJ, Garrett CS, Lee J, et al. Preserved Active Spin and Reduced Workload After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers: A Propensity-Matched Analysis of 8 Pitch Types. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261490996

This propensity-matched cohort study used Major League pitch-tracking data (2020-2024) to compare active spin rate, the movement-producing component of spin, across 8 pitch types in 456 professional pitchers before and after ulnar collateral ligament reconstruction (UCLR). Active spin was preserved after UCLR across the pitching arsenal, not just for fastballs. These results reassure pitchers and team medical staff that pitch movement quality, not merely total spin rate, is maintained after UCLR and return to play.

34. Langford T, Stump K, Kelleher S, et al. Comparing Injury Rate and Injury Type in MLB Pitchers Before and After Pitch Clock Implementation: A 10-Year Analysis. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261490739

Using 10 years of public MLB data (2015-2025, excluding 2020), the authors compared pitcher injury rates before and after 2023 pitch clock implementation via interrupted time-series with a counterfactual projection and difference-in-differences analysis using position players as controls. Pitcher injury rates rose post-implementation beyond the projected counterfactual, with shifts in injured-list utilisation and injury type distribution relative to position players. The findings suggest reduced interpitch recovery may contribute to pitcher injury, informing workload monitoring and rule-making in professional baseball.

Trauma and Fracture Management (11)¶

2. Yuan JT, Cohen-Tanugi S. Temporary Proximal Radioulnar Joint Transfixation and Biceps Chemodenervation for Recurrent Anterior Radial Head Instability After Monteggia-Variant Injury: A Case Report. HAND 2026. doi:10.1177/15589447261496342

This case report describes a 68-year-old man with recurrent anterior radial head instability after fixation of a Monteggia-variant injury, attributed to loss of anterior soft tissue restraint and biceps-driven translation of the proximal radius. Revision management used temporary Kirschner wire transfixation of the proximal and distal radioulnar joints combined with botulinum toxin injection of the biceps, with pins removed at 3 weeks. The report suggests that temporary radioulnar transfixation with biceps chemodenervation is a viable salvage strategy for this rare and challenging instability pattern.

3. Weber MM, Hockmann JP, Rosenkranz TA, et al. Radial head arthroplasty restores axial construct stiffness in a Monteggia-like injury model: a biomechanical study. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06515-w

In this cadaveric biomechanical study, eight fresh-frozen elbow specimens were tested under axial loading in a simulated Monteggia-like injury to compare native state, radial head resection, and radial head arthroplasty. Radial head resection reduced construct stiffness, while arthroplasty restored axial stiffness toward native levels. The findings support preserving or reconstructing radial head integrity to protect ulnar fixation and may inform primary surgical decision-making in complex proximal ulna-radial head injuries.

5. Liu B, Ren P, Su Y. Comparison of surgically treated floating elbow injuries and supracondylar humeral fractures in children. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06427-9

This retrospective cohort compared 27 children with floating elbow injuries and 86 with supracondylar humeral fractures treated surgically, analyzing injury mechanisms, neurovascular injury, complications including acute compartment syndrome, and Mayo Elbow Performance Score outcomes. Floating elbows differed significantly from supracondylar fractures in mechanism, fracture type, and preoperative nerve injury. The findings highlight that floating elbow represents a higher-energy injury pattern requiring heightened vigilance for neurovascular compromise and compartment syndrome.

13. Polat M, Akgün H, Çat G, et al. Residual instability of the radiocapitellar joint after treatment of acute pediatric Monteggia fractures: A single-center experience. Injury 2026. doi:10.1016/j.injury.2026.113506

This single-center retrospective study evaluated 39 children treated for acute Monteggia fracture-dislocations with minimum 2-year follow-up, assessing clinical (MEPS) and radiographic outcomes including radial head displacement index and carrying angle. ROC analysis identified cutoff values for initial ulnar angulation associated with treatment success and residual radiocapitellar instability. The findings help surgeons identify which paediatric Monteggia fractures are at risk for residual radiocapitellar joint instability and may guide the need for closer follow-up or additional stabilisation.

15. Elze M, Ellwein A, Bülow H, et al. Failure Patterns Leading to Revision After Distal Humerus Fracture Fixation: A Multicenter Study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.012

This multicenter retrospective cohort study of 491 adults undergoing revision surgery after distal humerus fracture fixation across 11 centers characterized mechanism-specific failure patterns leading to revision. Multinomial logistic regression identified determinants of infectious, mechanical, and functional revision pathways. The results refine risk stratification and may guide targeted prevention strategies for the most common failure mechanisms after operative fixation of distal humerus fractures.

16. Totoki Y, Yanagisawa Y, Ikumi A, et al. A Safe Medial Column Screw Strategy for Transcondylar Humerus Fractures in the Elderly: CT-Based Analysis of Screw Diameter and Insertion Trajectory. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.010

This CT-based morphometric analysis of 92 humeri defined safe screw diameters and insertion trajectories for medial column screw fixation of transcondylar distal humerus fractures in elderly patients. The mean maximal virtual cylinder diameter was 6.4 mm, was larger in males, and 96.2% of humeri from patients aged 65 or older accommodated at least a 5.0-mm screw. These data provide an anatomically grounded guide for safe single-screw medial column fixation without a medial plate in elderly patients.

26. Higashi T, Takahara S, Takayama H, et al. Primary total elbow arthroplasty with ulna fixation for a Jupiter type IID posterior Monteggia fracture-dislocation: A case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100897

This case report describes primary linked total elbow arthroplasty combined with ulnar fixation for a Jupiter type IID posterior Monteggia fracture-dislocation, an injury pattern typically managed with fracture fixation alone. The authors detail the surgical technique and report the outcome of this approach in a single patient. The report suggests that in selected, severely comminuted or unreconstructible Monteggia fracture-dislocations, particularly in older or low-demand patients, primary total elbow arthroplasty with ulnar fixation may be a viable reconstructive option.

30. Ikeda S, Okada S, Shiode R. The medial collapse sign is associated with cubitus varus after pediatric supracondylar humeral fracture fixation: a retrospective cohort study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.10.010

In this retrospective cohort of 52 paediatric supracondylar humeral fractures treated with reduction and cross pinning, the authors tested whether the medial collapse sign on immediate postoperative radiographs predicts final cubitus varus (defined as ≥5° side-to-side carrying-angle difference). The medial collapse sign was strongly and independently associated with cubitus varus (OR 155.4). This readily identifiable postoperative radiographic sign can alert surgeons to inadequate medial column reduction, prompting early consideration of revision fixation before deformity becomes established.

37. Gleason B, DiNicola G, Sobol K, et al. Saline Load Test is Effective in Identifying Small Anteromedial Arthrotomy of the Elbow. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100913

This study evaluated the diagnostic performance of the saline load test for detecting small anteromedial elbow arthrotomies, a clinically occult injury at risk of missed diagnosis. The test effectively identified small anteromedial arthrotomies, supporting its use in the evaluation of potential elbow joint violations. Clinicians evaluating periarticular elbow wounds can rely on the saline load test to help exclude arthrotomy and guide operative versus nonoperative management.

38. Lee J, Lee G, Nho J, et al. Directional Failure Pathways in Simple Posteromedial Elbow Dislocation: The Anterolateral Escape Route as a Structural Threshold for Spontaneous Redislocation. JSES International 2026. doi:10.1016/j.jseint.2026.101814

This study characterized directional capsuloligamentous failure patterns in simple posteromedial elbow dislocations, identifying an 'anterolateral escape route' of soft-tissue disruption. The extent of anterolateral structural injury appeared to act as a structural threshold beyond which elbows spontaneously redislocate after reduction. Recognizing this failure pathway can guide clinicians in assessing instability after posteromedial dislocation and in deciding when surgical stabilisation is warranted to prevent recurrent dislocation.

39. Ishihara N, Saeki M, Fujihara Y, et al. Fracture Characteristics in Coronal Shear Fractures of the Distal Humerus: Clinical Significance of Medial Trochlear Involvement. Injury 2026. doi:10.1016/j.injury.2026.113855

This study analyzed coronal shear fractures of the distal humerus to define fracture characteristics and the clinical significance of medial trochlear involvement. Medial trochlear involvement was associated with distinct fracture patterns and impacted classification and management considerations for these rare injuries. Accurate preoperative recognition of trochlear extension can guide surgical planning, fixation strategy, and counseling about outcomes in coronal shear fractures.

Arthroplasty and Implant Outcomes (6)¶

10. Smadi Z, Fiandeiro M, Pereira DE, et al. Anxiety and depression are associated with increased complication risk after total elbow arthroplasty: A matched cohort study. Shoulder & Elbow 2026. doi:10.1177/17585732261495067

This retrospective matched cohort study compared 90-day and 2-year outcomes of total elbow arthroplasty in 2106 patients with anxiety and/or depression versus matched controls. Patients with combined anxiety and depression had significantly higher rates of wound complications, anemia, ED visits, and readmission at 90 days, plus increased mechanical loosening and dislocation at 2 years. The findings support heightened perioperative surveillance and risk counseling for TEA patients with comorbid psychiatric disease.

11. Gordon AM, Said M, Nian PP, et al. Social Determinants of Health Are Associated With 2-Year Implant Complications Following Total Elbow Arthroplasty. HAND 2026. doi:10.1177/15589447261489335

This retrospective matched cohort study used a national insurance claims database (2010-2021) to compare 342 primary total elbow arthroplasty patients with documented social determinants of health (SDOH) exposures against 1683 matched controls. SDOH exposure was associated with higher odds of 2-year implant-related complications, as well as differences in discharge disposition and 90-day healthcare utilisation. The results highlight SDOH as a modifiable risk marker warranting attention in TEA planning and follow-up.

24. Clark SC, Diaw EF, Nieboer MJ, et al. Outcomes and Complications of Elbow Arthrodesis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.10.005

This single-institution retrospective review evaluated 13 patients (mean age 42 years) who underwent elbow arthrodesis between 2000 and 2024, mostly for posttraumatic arthritis, using chart review plus patient-reported pain, SANE, MEPS, satisfaction, and reoperation data. Arthrodesis provided acceptable pain relief and functional outcomes with a defined complication profile in this small cohort. The procedure remains a reasonable salvage option for elbows unsuitable for reconstruction or arthroplasty, though complication rates warrant careful patient counseling.

25. Carroll PJ, Chang N, Pequeno P, et al. Radial Head Arthroplasty for Radial Head Fracture Is Associated with a Lower Rate of Reoperation Than Open Reduction Internal Fixation: A Population-Based Cohort Study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.10.006

Using linked provincial databases, this Ontario population-based cohort followed 3,159 adults who underwent surgery (ORIF, radial head arthroplasty, or excision) for radial head fractures over 18 years and compared reoperation rates between ORIF and arthroplasty. Radial head arthroplasty was associated with a lower rate of reoperation than ORIF. Clinically, these data support considering arthroplasty in fracture patterns where it is indicated, while informing shared decision-making and patient counseling about revision risk.

26. Higashi T, Takahara S, Takayama H, et al. Primary total elbow arthroplasty with ulna fixation for a Jupiter type IID posterior Monteggia fracture-dislocation: A case report. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100897

This case report describes primary linked total elbow arthroplasty combined with ulnar fixation for a Jupiter type IID posterior Monteggia fracture-dislocation, an injury pattern typically managed with fracture fixation alone. The authors detail the surgical technique and report the outcome of this approach in a single patient. The report suggests that in selected, severely comminuted or unreconstructible Monteggia fracture-dislocations, particularly in older or low-demand patients, primary total elbow arthroplasty with ulnar fixation may be a viable reconstructive option.

31. Barret H, Tanenbaum JE, Nieboer MJ, et al. Total Elbow Arthroplasty for Elbow Ankylosis: Preliminary Experience With an Instrumentation Technique to Reestablish the Articulation Using a Contemporary Implant. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100904

This preliminary report presents an instrumentation technique for total elbow arthroplasty using a contemporary implant in patients with elbow ankylosis, where the normal articulation and bony landmarks are lost. The authors describe their surgical approach to reestablish the joint line and articulation and share their early experience with this challenging population. The technique offers guidance for surgeons managing ankylosed elbows with arthroplasty, though longer follow-up is needed to confirm implant survival and functional outcomes.

Nerve and Tendon Disorders (4)¶

6. Rinfret D, Wong J, Ramirez G, et al. Early PROMIS Outcomes After Cubital Tunnel Release With and Without Anterior Transposition. HAND 2026. doi:10.1177/15589447261487693

In this retrospective review of 210 adults undergoing cubital tunnel release (147 in situ decompression, 63 anterior transposition), PROMIS Upper Extremity, Physical Function, Pain Interference, and Depression scores were analyzed preoperatively and at 2 and 6 weeks using longitudinal mixed-effects regression. Both techniques produced early patient-reported improvement, with data characterizing differences in patient characteristics, electrodiagnostic severity, complications, and revisions between approaches. The results support individualized surgical selection, as both procedures yield comparable early outcomes.

7. Nakai M, Miyatake K, Fujisawa T, et al. Safe Ultrasonography‐Assisted Elbow Arthroscopy Technique. Arthroscopy Techniques 2026. doi:10.1002/atn2.70321

The authors describe a technical note for ultrasonography-assisted elbow arthroscopy in which ultrasound is used to visualize nerves in real time during portal creation and synovectomy. Given the technical demands of elbow arthroscopy and the risk of iatrogenic nerve injury, ultrasound guidance allows safer portal placement by confirming surrounding anatomy. This technique may reduce neurological complications in arthroscopic elbow synovectomy.

17. Wałecka J, Kaszyński J, Cisowski P, et al. Comparative Efficacy of Leukocyte-Rich and Leukocyte-Poor PRP for Lateral Epicondylitis on Isokinetic and Isometric Upper Limb Strength under an Identical Rehabilitation Protocol: A Randomized Controlled Trial. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.009

In a 12-month randomised controlled trial, 71 patients with lateral epicondylitis received leukocyte-poor PRP, leukocyte-rich PRP, or saline injections under an identical rehabilitation protocol, with isometric wrist extensor torque as the primary outcome. All groups, including saline, improved in strength over time, with no clear advantage of either PRP formulation over saline on primary or exploratory secondary strength measures. Clinically, these findings question the added value of PRP injections for restoring upper-limb strength in lateral epicondylitis when structured rehabilitation is provided.

32. Lim J, Kim M. An Explainable Prediction Model for Outcomes After Anterior Subcutaneous Ulnar Nerve Transposition in Idiopathic Cubital Tunnel Syndrome. The Journal of Hand Surgery 2026. doi:10.1016/j.jhsa.2026.08.013

In 119 patients undergoing anterior subcutaneous ulnar nerve transposition for idiopathic cubital tunnel syndrome, the authors compared conventional regression and six machine-learning algorithms using demographic, clinical, and electrodiagnostic predictors to forecast excellent/good versus fair/poor outcomes (Messina criteria), with internal validation via repeated nested cross-validation. An explainable prediction model was developed to individualize prognosis. This tool could help counsel patients preoperatively and guide the decision for surgery versus continued conservative management.

Instability and Biomechanics (5)¶

12. Pucher C, Lanzerath F, Kahmann SL, et al. Partial triceps tendon transfer for dynamic stabilization in posterolateral rotatory instability of the elbow: a biomechanical study. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06520-z

This biomechanical cadaveric study tested partial triceps tendon transfer to the supinator crest as a salvage dynamic stabilizer for posterolateral rotatory instability in nine fresh-frozen elbow specimens under cyclic external rotational loading. The transfer reduced external rotation relative to the LCLC-deficient unstable state even with the ligament detached, suggesting it can provide dynamic stability. This offers a potential salvage option when conventional ligament reconstruction fails, pending clinical validation.

23. Matsuzawa K, Edama M, Sakamoto K, et al. Differences in valgus and internal-rotation instability after sequential distal ulnar collateral ligament release: a cadaveric study using Thiel-embalmed cadavers. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.10.002

In this cadaveric study, 12 Thiel-embalmed elbows underwent sequential distal ulnar collateral ligament release (intact, 5 mm, and 10 mm), with valgus instability measured via medial joint space and internal rotation instability via posteromedial joint space using ultrasonography. Progressive distal UCL release produced both valgus and internal rotation instability, with internal rotation instability becoming increasingly evident as the tear progressed. This supports assessing rotatory instability in distal UCL injuries and may explain poorer conservative outcomes in overhead athletes with distal tears.

36. Florial E, van Riet R, Bozon O, et al. Morphological Association Between Proximal Ulna Dorsal Angulation and Elbow Radiographic Osteoarthritis: A Propensity-Score Matched Case-Control Multicenter Study. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104980

In this multicenter propensity-score-matched case-control study, proximal ulna dorsal angulation (PUDA) was compared between 61 elbows with primary elbow osteoarthritis and 108 radiographically normal controls. Mean PUDA was significantly higher in the OA group (7.1° vs 5.6°; mean difference 1.5°, 95% CI 0.7-2.3), and a PUDA ≥5.7° was more frequent among OA cases. The findings suggest ulnar morphology, particularly increased dorsal angulation, may be a structural risk factor for primary elbow OA, potentially informing screening and surgical alignment considerations.

37. Gleason B, DiNicola G, Sobol K, et al. Saline Load Test is Effective in Identifying Small Anteromedial Arthrotomy of the Elbow. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100913

This study evaluated the diagnostic performance of the saline load test for detecting small anteromedial elbow arthrotomies, a clinically occult injury at risk of missed diagnosis. The test effectively identified small anteromedial arthrotomies, supporting its use in the evaluation of potential elbow joint violations. Clinicians evaluating periarticular elbow wounds can rely on the saline load test to help exclude arthrotomy and guide operative versus nonoperative management.

38. Lee J, Lee G, Nho J, et al. Directional Failure Pathways in Simple Posteromedial Elbow Dislocation: The Anterolateral Escape Route as a Structural Threshold for Spontaneous Redislocation. JSES International 2026. doi:10.1016/j.jseint.2026.101814

This study characterized directional capsuloligamentous failure patterns in simple posteromedial elbow dislocations, identifying an 'anterolateral escape route' of soft-tissue disruption. The extent of anterolateral structural injury appeared to act as a structural threshold beyond which elbows spontaneously redislocate after reduction. Recognizing this failure pathway can guide clinicians in assessing instability after posteromedial dislocation and in deciding when surgical stabilisation is warranted to prevent recurrent dislocation.

Research Methods and Miscellany (7)¶

8. Cho ÁB, S. Neto AID, Cartolano R, et al. A Prospective Randomized Comparison of Median and Ulnar Fascicle Transfers to the Biceps Motor Branch in Upper Brachial Plexus Injury. HAND 2026. doi:10.1177/15589447261487493

In this prospective randomised trial, 33 patients with C5-C6 or C5-C7 upper brachial plexus injuries underwent either ulnar (n=18) or median (n=15) nerve fascicle transfer to the biceps motor branch. Elbow flexion against gravity was achieved in 78% of the ulnar transfer group versus 87% of the median transfer group, with no statistically significant difference between groups. Either donor nerve appears acceptable for restoring elbow flexion, allowing surgeons to base donor selection on intraoperative findings and individual factors.

14. Chammas P, Kermad Y, Coulet B, et al. French innovations in upper limb surgery that has become gold standards. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104805

This narrative review traces French innovations in upper limb surgery that achieved international gold-standard status, covering the Latarjet procedure, Grammont reverse shoulder arthroplasty, Walch glenoid classification, GUEPAR total elbow, bipolar radial head arthroplasty, and trapeziometacarpal arthroplasty. For each, the authors summarize the original description, technical evolution, and current evidence from systematic reviews and long-term cohorts. The review provides historical context and evidence appraisal supporting techniques in everyday global practice.

20. Gamadia M, Middleton CJ, Thatcher M, et al. Increasing Emergency Department Burden of Brazilian Jiu-Jitsu Injuries: A National 10-Year Analysis of Mechanisms and Severity Predictors, 2015-2024. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261486951

Using NEISS data from 2015-2024, this study analyzed 1448 Brazilian jiu-jitsu-related emergency department visits (approximately 58,170 weighted national cases) with an 11-category mechanism taxonomy and survey-weighted regression. Annual BJJ injury volume rose nearly five-fold, outpacing overall martial arts presentations, with specific mechanisms predicting nonroutine disposition. The findings highlight BJJ as a growing source of ED burden and can inform targeted injury-prevention and resource-planning efforts.

21. Güven Z, de Klerk HH, Versteeg T, et al. Loss to Follow-up in Randomized Controlled Trials on Elbow Pathology: A Systematic Review and Meta-Analysis. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.09.019

This systematic review and meta-analysis of 44 RCTs (3012 patients) on elbow pathology published between 2020 and 2025 quantified loss to follow-up and identified associated factors. The mean loss-to-follow-up rate was 12.1%, with reporting remaining inconsistent despite current guidelines. Elbow RCT results should be interpreted cautiously, and trialists should improve LTFU reporting and retention strategies to limit bias in treatment-effect estimates.

29. Zabiba A, Menendez ME. Normative American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) Scores in an Asymptomatic United States Population. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100905

This study established normative reference values for the American Shoulder and Elbow Surgeons (ASES) score and Simple Shoulder Test (SST) in a large asymptomatic United States population. Normative scores were generated to serve as benchmarks against which postoperative or patient-reported outcomes can be compared. Clinically, these reference values allow more meaningful interpretation of shoulder outcome scores and help define realistic post-treatment expectations for patients without shoulder pathology.

33. Kuhn JE. The Trouble with TriNetX, COSMOS, and other Large Data Sets for Shoulder and Elbow Research. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.10.022

This commentary critiques the use of large administrative databases (TriNetX, COSMOS) in shoulder and elbow research, highlighting methodological pitfalls such as coding inaccuracies, lack of clinical granularity, and inappropriate statistical reporting. The author recommends that studies using these databases specify the database, report meaningful effect estimates with 95% confidence intervals rather than p-values alone, and interpret findings cautiously. Clinicians should view database-derived conclusions as hypothesis-generating rather than definitive evidence for practice.

35. Kiehl D, Ibrado R, Axelrod A, et al. Comparative Trends of Musculoskeletal Injury in Pickleball and Tennis: An 11-Year Analysis of U.S. Emergency Department Visits. Injury 2026. doi:10.1016/j.injury.2026.113791

This study analyzed 11 years of U.S. emergency department data to compare musculoskeletal injury trends between pickleball and tennis, examining injury types, demographics, and temporal patterns as pickleball participation surged. Pickleball injuries increased markedly over the study period, with a distinct demographic and injury-type profile compared with tennis, reflecting its older participant base and different movement demands. The results support targeted injury-prevention strategies and clinician anticipation of rising pickleball-related musculoskeletal trauma.

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