Latest shoulder & elbow surgery research

New shoulder and elbow evidence from the weekly pipeline — rotator cuff, arthroplasty, instability — hottest first.

Journal of Orthopaedic Surgery and Research IF 2.8 Aug 22 2026 LoE II Full text read

Bone marrow stimulation in arthroscopic rotator cuff repair: a meta-analysis

This meta-analysis pooled 15 comparative studies (1552 patients) comparing arthroscopic rotator cuff repair (ARCR) with versus without bone marrow stimulation (BMS, e.g. microfracture or marrow venting of the greater tuberosity). Overall, adding BMS was associated with a lower retear rate (14% vs 18%, OR 0.69, 95% CI 0.51-0.92, p=0.01), an effect driven mainly by single-row repairs (16% vs 27%, p=0.0002), while the double-row subgroup showed a similar trend that was not statistically significant (11% vs 16%, p=0.07). Postoperative ASES and Constant-Murley scores and forward elevation were modestly better with BMS, but simple shoulder test, UCLA score, VAS pain, and rotation were unchanged between groups.

AI summary · from the full text

Why it mattersRetear after rotator cuff repair remains common, and this synthesis suggests a cheap, autologous biologic augmentation (marrow venting) may reduce retear risk, particularly when using single-row fixation, which is clinically relevant for surgeons deciding whether to add BMS during ARCR.

Meta-analysisShoulder & Elbown = 1,552DOI ↗

Presenting this at rounds? Start here

?Should surgeons preferentially add bone marrow stimulation when performing single-row rather than double-row rotator cuff repairs, given the differential retear benefit seen here?
?Given the marginal functional score differences (ASES +1.6, CMS +2.5 points) versus reported MCIDs, should BMS be adopted primarily to reduce retear risk rather than to improve patient-reported function?

Rigor × clinical importance

Rigor42Clinical59Editorial49

Limited39

Shoulder & Elbow IF 1.5 Jul 21 2026 LoE I Full text read

Restoring the anatomic tension relationship of the long head of the biceps during tenodesis: A prospective, randomized controlled trial

This RCT of 160 patients undergoing biceps tenodesis (mostly with concomitant rotator cuff or other shoulder procedures) compared a standard landmark-based tensioning technique to a patient-specific anatomic tensioning technique. At final follow-up (mean 19.6 months), ASES scores, VAS pain, forward flexion, and external rotation were statistically similar between groups (p=0.604, 0.308, 0.171, 0.726 respectively), though the intervention group had significantly higher ASES scores at 6 weeks (mean difference 9.1, 95% CI 0.1-18.0, p=.048) and, oddly, significantly lower ASES scores at 12 months (mean difference -16.8, 95% CI -33.1 to -0.5, p=.044).

AI summary · from the full text

Why it mattersBiceps tenodesis is common and lacks a standardized tensioning technique, so evidence on whether a more meticulous patient-specific method actually improves outcomes helps surgeons decide if the extra technical effort is worthwhile.

RCTShoulder & Elbown = 81DOI ↗

Presenting this at rounds? Start here

?The primary outcome (ASES at final follow-up) was not significant, yet a significant result appeared at 6 weeks and an unexplained significant worse result appeared at 12 months among six time points tested without correction for multiplicity: how much of this is chance given multiple comparisons?
?If you perform tenodesis routinely, does a possible early (6-week) functional advantage with patient-specific tensioning change your technique, given no advantage was seen at 3, 6, or 12 months, or at final follow-up?

Rigor × clinical importance

Rigor40Clinical45

Limited31