As digital tools reshape orthopedic surgery, understanding which technologies are ready for the operating room versus which remain experimental matters enormously for patients facing shoulder replacement. The gap between technological promise and clinical proof is rarely more visible than in shoulder arthroplasty — and a new review from Orthopadie draws that line with unusual clarity.
CT-based three-dimensional preoperative planning has achieved genuine clinical traction in shoulder arthroplasty, enabling surgeons to assess glenoid morphology, select implants, and virtually position components before the first incision. Patient-specific instrumentation (PSI) and computer-assisted navigation extend this planning into the operating room, aiming to reduce component malalignment. Virtual reality currently finds its strongest evidence base not in surgery itself but in surgical education and simulation training. Augmented reality and mixed reality — which overlay planning data onto the operative field or enable remote supervision — remain explicitly categorized as experimental for intraoperative use. Critically, robust evidence for long-term clinical benefit, reduced revision rates, or cost-effectiveness across these technologies remains scarce.
This assessment aligns with a broader pattern in surgical technology adoption: digital tools tend to outpace the randomized controlled trial infrastructure needed to validate them. Shoulder arthroplasty is particularly complex because glenoid component positioning is one of the strongest predictors of implant longevity, which makes precision technology theoretically compelling. Yet translating geometric accuracy into patient-reported outcomes and reduced revision rates is not automatic. The history of orthopedic innovation — including early robotic knee systems — shows that improved intraoperative precision does not always translate into superior long-term clinical results. For health-conscious adults monitoring this space, the key signal here is that 3D planning is now a reasonable expectation in shoulder arthroplasty centers, while AR and MR intraoperative applications should be viewed as research-stage rather than standard-of-care. The review's honest limitation assessment is itself a useful corrective to the marketing-heavy narrative that often surrounds surgical technology launches.