Surgeon using augmented reality during shoulder replacement surgery

Surgical Sight: How Augmented Reality is Changing Shoulder Replacements

Rhea Morgan in Health & Wellness December 2025 • 4 min read.

"New research explores using AR to guide surgeons during total shoulder arthroplasty, potentially improving accuracy and outcomes."

Total shoulder arthroplasty (TSA), or shoulder replacement surgery, is a common procedure to alleviate pain and restore mobility in individuals with severe shoulder joint damage. However, accurately implanting the glenoid component (the socket part of the artificial joint) remains a significant challenge for surgeons.

Imagine a technology that could provide surgeons with a real-time, X-ray-like vision during surgery, revealing hidden anatomical structures and guiding implant placement with pinpoint accuracy. This is the promise of augmented reality (AR) in the operating room, and recent research is bringing this vision closer to reality.

A study published in Orthopaedics & Traumatology: Surgery & Research explores the feasibility of using AR to assist surgeons in implanting the glenoid component during TSA. The researchers focused on creating a system that reconstructs a 3D model of the patient's 'premorbid' (original, healthy) glenoid and overlays it onto the surgeon's view during the procedure.

AR's 'Sixth Sense': Reconstructing the Ideal Glenoid

Surgeon using augmented reality during shoulder replacement surgery

The core innovation lies in the ability to create a virtual representation of the patient's shoulder before the onset of arthritis or injury. This 'premorbid' glenoid model acts as a blueprint for the surgeon, guiding them to restore the joint's original anatomy.

The process involves several key steps:

3D Reconstruction: Using pre-operative CT scans and advanced algorithms, a 3D model of the damaged glenoid is created.
Premorbid Glenoid Prediction: Regression equations are used to estimate the shape and position of the 'missing' portions of the glenoid, effectively reconstructing its original, healthy form.
Generic Glenoid Database: A library of healthy glenoid models is created through hierarchical analysis, allowing the selection of a generic glenoid that closely matches the patient's anatomy.
Morphing: The generic and reconstructed glenoid models are 'morphed' together to create a final, highly accurate representation of the patient's ideal glenoid.
AR Visualization: This 3D model is then overlaid onto the surgeon's view using smart glasses, providing real-time guidance during the implant placement.

Think of it like having a GPS for your surgery – the AR system provides a clear roadmap, even when the terrain (the damaged joint) is unfamiliar. This can lead to more accurate implant placement, reduced risk of complications, and ultimately, better outcomes for patients.

The Future is Clear: AR's Path to Precision Surgery

While this study demonstrates the feasibility of AR-assisted shoulder arthroplasty, the researchers acknowledge that further refinement is needed. Key limitations include the accuracy of the AR overlay and the need for more streamlined software integration.

However, the potential benefits are undeniable. AR has the power to transform surgical training, allowing surgeons to practice complex procedures in a safe, virtual environment. It can also personalize surgery, tailoring each procedure to the unique anatomy of the patient.

As AR technology continues to evolve, we can expect to see even more innovative applications in orthopedics and other surgical specialties. The future of surgery is clear – it's augmented.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.otsr.2018.08.021, Alternate LINK

Title: Views On A New Surgical Assistance Method For Implanting The Glenoid Component During Total Shoulder Arthroplasty. Part 2: From Three-Dimensional Reconstruction To Augmented Reality: Feasibility Study

Subject: Orthopedics and Sports Medicine

Journal: Orthopaedics & Traumatology: Surgery & Research

Publisher: Elsevier BV

Authors: Julien Berhouet, Mohamed Slimane, Maxime Facomprez, Min Jiang, Luc Favard

Published: 2019-04-01

Everything You Need To Know

What is Augmented Reality (AR) and how is it used in shoulder replacement surgery?

Augmented Reality (AR) in the context of shoulder replacement surgery, or Total Shoulder Arthroplasty (TSA), offers surgeons a 'surgical sixth sense.' It provides a real-time, X-ray-like vision, revealing hidden anatomical structures and guiding implant placement. Specifically, AR assists in accurately implanting the glenoid component, the socket part of the artificial joint, a significant challenge in TSA. AR technology uses pre-operative CT scans and advanced algorithms to create a 3D model of the patient's glenoid and overlays it onto the surgeon's view.

What is Total Shoulder Arthroplasty (TSA) and why is the accurate placement of the glenoid component important?

Total Shoulder Arthroplasty (TSA) is a surgical procedure designed to alleviate pain and restore mobility in individuals with severe shoulder joint damage. During a TSA, the damaged joint is replaced with an artificial joint. The accurate placement of the glenoid component, which is part of the artificial joint, is critical for the success of the surgery. Inaccurate placement can lead to complications and poorer outcomes. AR aims to improve the accuracy of glenoid component placement, potentially leading to better outcomes for patients undergoing TSA.

How is the 'premorbid' glenoid model created and what is its purpose?

The creation of a 'premorbid' glenoid model is a core innovation of the AR system. This involves several steps: 3D Reconstruction using pre-operative CT scans, Premorbid Glenoid Prediction using regression equations to estimate the shape of the original glenoid, Generic Glenoid Database of healthy glenoid models, Morphing the generic and reconstructed models to create a final accurate representation, and AR Visualization by overlaying the 3D model onto the surgeon's view using smart glasses. The 'premorbid' model serves as a blueprint for the surgeon, helping them restore the joint's original anatomy during TSA.

How does Augmented Reality (AR) provide guidance during a Total Shoulder Arthroplasty (TSA)?

AR systems use smart glasses to overlay a 3D model of the patient's ideal glenoid onto the surgeon's view during Total Shoulder Arthroplasty (TSA). The 3D model is created from pre-operative CT scans and uses various algorithms to create a virtual representation of the patient's shoulder before the onset of arthritis or injury. This real-time guidance helps the surgeon accurately place the glenoid component, the socket part of the artificial joint, leading to more precise implant placement and reduced complications.

What are the limitations and future directions of AR in shoulder replacement surgery?

While the study demonstrates the feasibility of AR-assisted Total Shoulder Arthroplasty (TSA), further refinement is needed. Key limitations include the accuracy of the AR overlay and the need for more streamlined software integration. Researchers are working on these improvements to enhance the precision and effectiveness of AR in TSA. The goal is to provide surgeons with even more accurate guidance, ultimately improving patient outcomes and the overall success of shoulder replacement surgeries.