Robotic-Assisted Shoulder Replacement

Robotic-Assisted Shoulder Replacement

What is Robotic-Assisted Shoulder Replacement?

Robotic-assisted shoulder replacement is an advanced surgical technique that uses robotic technology to assist orthopedic surgeons in performing shoulder joint replacement with greater precision, accuracy, and consistency than conventional methods. In this procedure, a robotic system (such as Stryker's Mako and Zimmer-Biomet's Rosa) helps the surgeon plan and execute the replacement of damaged parts of the shoulder joint with artificial components (implants).

What Does a Robotic System Comprise in Robotic Shoulder Replacement?

A robotic system used in robotic-assisted shoulder replacement typically comprises several key components that work together to enhance surgical precision and safety:

• Preoperative Planning Software – Creates a detailed 3D model of the patient’s shoulder from CT scans, allowing precise surgical planning for implant size, alignment, and positioning.
• Robotic Arm or Navigation Unit – Assists the surgeon during the operation by guiding bone preparation and implant placement according to the preoperative plan, ensuring high accuracy.
• Tracking System – Uses sensors or cameras to track the patient’s anatomy and surgical instruments in real-time, maintaining precise orientation throughout the procedure.
• Surgeon Console or Control Interface – Allows the surgeon to monitor, adjust, and control the robotic system, maintaining full command over the surgery.
• Real-Time Feedback System – Provides continuous data and visual guidance, helping the surgeon make adjustments and avoid errors during the procedure.

What are the Indications for Robotic-Assisted Shoulder Replacement?

The common indications for robotic-assisted shoulder replacement include conditions that cause severe shoulder pain, stiffness, and loss of function due to joint damage. These include:

• Osteoarthritis: Degeneration of shoulder joint cartilage causing pain and restricted motion.
• Rheumatoid Arthritis: Chronic inflammation leading to joint destruction and deformity.
• Post-Traumatic Arthritis: Arthritis developing after a previous shoulder injury or fracture.
• Avascular Necrosis: Loss of blood supply to the humeral head causing bone collapse.
• Rotator Cuff Tear Arthropathy: Arthritis resulting from long-standing, irreparable rotator cuff tears.
• Failed Previous Shoulder Surgery: Revision cases where prior implants or procedures have failed.

What Happens During a Robotic-Assisted Shoulder Replacement?

In general, the procedure for robotic-assisted shoulder replacement will involve the following steps:

• Before surgery, a CT scan of the patient’s shoulder is taken to create a 3D model. Using this, the surgeon plans the ideal size, orientation, and alignment of the implants.
• The patient is placed under general anesthesia, and the shoulder area is sterilized and prepared for surgery.
• The surgeon makes a small incision to access the shoulder joint and carefully exposes the damaged bone and cartilage.
• The robotic system is positioned, and trackers are placed on the shoulder to map the anatomy and synchronize it with the 3D preoperative plan.
• Guided by the robotic arm or navigation system, the surgeon removes the damaged parts of the humeral head and glenoid with extreme precision, ensuring minimal bone loss.
• The artificial components (metal and plastic implants) are positioned according to the preoperative plan, with the robot confirming correct alignment and fit.
• Finally, the surgeon verifies joint movement and stability, then closes the incision with sutures or staples.

What Happens After a Robotic-Assisted Shoulder Replacement?

After a robotic-assisted shoulder replacement, patients are typically monitored in the recovery area until the effects of anesthesia wear off. The arm is placed in a sling to support and protect the new joint. Pain is typically managed with medications. Within the first day, patients usually begin gentle physical therapy exercises under supervision to restore movement and prevent stiffness. Most patients stay in the hospital for one to two days before going home. At home, they continue a structured rehabilitation program focusing on regaining shoulder strength, flexibility, and function over several weeks. Full recovery usually takes three to six months, during which regular follow-up visits are scheduled to monitor healing and implant position through imaging.

What are the Risks and Complications of a Robotic-Assisted Shoulder Replacement?

The risks and complications of a robotic-assisted shoulder replacement may include the following:

• Infection
• Bleeding or blood clots
• Nerve or blood vessel injury
• Joint stiffness or instability
• Implant loosening or wear over time
• Fracture around the implant
• Technical or robotic system errors (rare)
• Persistent pain or limited range of motion

What are the Benefits of a Robotic-Assisted Shoulder Replacement?

The benefits of a robotic-assisted shoulder replacement over conventional methods include the following:

• Greater precision and accuracy in implant positioning and alignment
• Personalized surgical planning based on the patient’s unique anatomy
• Improved joint stability and function due to optimal implant placement
• Reduced risk of complications such as implant loosening or uneven wear
• Less bone and soft tissue damage, leading to faster recovery
• Smaller incisions and minimal invasiveness
• Enhanced long-term outcomes and potentially longer implant lifespan
• Better visualization and control for the surgeon during the procedure