New Options for Shoulder Replacement

Summit sports medicine and shoulder surgery expert Michael Freehill, M.D., shares details of new shoulder replacement technologies.

Shoulder replacement surgery can significantly enhance a patient’s quality of life. But when considering the procedure, some patients are concerned about how the shoulder replacement might limit their lifestyle in the future. Fortunately, the technology involved in shoulder replacement surgery is always evolving, explains Summit shoulder expert Michael Freehill, M.D.

“Traditionally, the artificial shoulder joint is composed of metal and plastic components. If a patient abuses the mechanical parts, it may reduce the artificial joint’s lifespan,” Dr. Freehill said. “We work with patients to modify their activities. That they can still enjoy their chosen sport or recreational activity while also protecting the joint so that they can enjoy it for a long time.”

What is new in shoulder replacement?

Advancements in the makeup of those artificial joint components are developing rapidly. These can also help extend the lifespan of shoulder replacement. One type of less invasive implant — called a stemless implant — doesn’t require the implant to extend into the canal of the bone. “We’ve had very good results with those implants,” Dr. Freehill said.

Another technology that has seen good results is the reverse shoulder replacement. It has become the most commonly used shoulder implant type. Using the reverse shoulder replacement technology, Dr. Freehill said, “We can create implants that help us to take care of significant bone wear or loss, enabling us to treat more complex issues in the shoulder with greater reliability and predictability.”

At Summit, shoulder surgeons including Dr. Freehill are using computer 3D modeling technology to convert a patient’s preoperative imaging studies to a 3D computer model. Using that model, Dr. Freehill said, “We can conduct a virtual simulation of the surgery, test different implants to see how they fit, and determine how the implant would be best positioned within the shoulder itself. Using this technology, we can predict the implant type, how it will be seated, and even generate a special guide to align the implant optimally during shoulder replacement surgery.”

New frontiers in shoulder replacement

Over the next few years, shoulder surgeons will be able to develop 3D-printed, patient-specific implants that fit into the patient’s anatomy like a puzzle piece. And eventually, surgeons will be able to use robotic-assisted surgical technology. Surgery will be guided by the surgeon through virtual reality or mixed reality headsets according to the computerized plan.

New materials have been developed and are currently going through the U.S. Food and Drug Administration’s (FDA) approval process. This will eliminate the need to put a plastic shoulder socket in the patient for shoulder replacement. “This new material is designed to be more bone-friendly. This affords a younger, active patient the opportunity return to a very active, athletic lifestyle without damaging the joint,” Dr. Freehill said. He and others on the Summit team look forward to FDA approval in the next six to 12 months.

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