How Shoulder Replacement Is Evolving with Better Implants and Patient-Specific Surgical Planning

Advances in medical technology and surgical techniques have made total shoulder replacement one of the most successful orthopedic surgical procedures performed today, with primary (anatomic) shoulder replacement being one of the most common shoulder replacement surgeries.

As Forté shoulder and elbow specialist Dr. Michael Bender explains, the procedure only continues to evolve with better implants and patient-specific surgical planning.

Anatomy of the Shoulder

The shoulder is a ball-and-socket joint with a ball (head) at the end of your upper arm bone that fits into a shoulder socket formed by your shoulder blade. A primary total shoulder replacement surgery involves removing the damaged portions on both sides of the joint and resurfacing them with similarly shaped metal and plastic implants.

Innovations Result in Better Implants

Historically, the implant for the ball side of the joint included a long stem (rod) that was inserted into your upper arm bone. Recent design innovation has led to a less-invasive option, known as a “stemless” implant, that is fixed to the bone with pins and cement.

The stemless design has several benefits, including:

• Preserving more of a patient’s bone.
• Reducing blood loss.
• Promoting a faster recovery with less pain after surgery.
• Enabling a more anatomically accurate placement.
• Ease of revision if future surgery needed

The majority of primary total replacement surgeries performed at Forté involve stemless implants.

“We can put a stemless implant exactly where it needs to be to match your anatomy,” says Bender. “It’s a more personalized shoulder replacement, which can reduce the risk of implant malpositioning which should lead to better range of motion, less stress on the rotator cuff and faster recovery.

Additionally, the plastic liner implanted on the socket side has evolved to have better wear properties, vitamin E impregnated to reduce free radicals that cause break down and better methods of fixation to the socket to limit loosening. It’s also more customizable than previous versions and can help correct bone deformities. This personalization has expanded the pool of patients eligible for primary total shoulder replacement surgery.

“You have a limited amount of bone on your socket for us to be able to correct,” says Bender. “In the past, we had to tell patients with certain bone deformities there was nothing we could do for them. The evolution of the augmented implants enables us to build back up the joint to correct it, and it makes the procedure a viable option for more patients with bone deformities.”

Advancements in Surgical Planning

Another advancement in primary total shoulder replacement is the development and utilization of patient-specific 3D surgical planning software. At Forté, a CT scan of your shoulder results in a virtual model of your joint that is used to simulate the surgery. During the simulation, surgeons can determine:

• Where cuts should be made for the least invasive procedure possible.
• The exact amount of damaged bone that needs to be removed from the joint.
• The optimal size and placement of your implants.

They can also generate a 3-D printed patient-specific guide to help them align the implants during your shoulder replacement surgery.

“Technology has improved not only how we plan for surgery but also how we execute it,” says Bender. “The customized guide shows us the exact angle we need to carry out the replacement exactly as we planned it.”

Reducing the Margin of Error

Together, advancements in surgical planning and implant design are reducing the margin of error in primary total shoulder replacements.

“It’s exciting to be at the forefront of these new technologies and techniques to improve this procedure better for our patients,” says Bender.

If you’re ready to take the next step, our joint replacement specialists can provide the latest technology and techniques for the best results and fastest recovery. Call 317. 817.1200 to schedule a consultation.

More Resources for You:

• Learn more about the different types of shoulder replacement surgery and how your surgeon can help determine if one is right for you.
• Understand the importance of the three steps of the pre-operative process.
• Find out how long it takes to recover from shoulder replacement surgery.
• See what makes reverse shoulder replacement surgery different from a primary replacement.