Mayo Clinic Health Matters

Custom-fitted joints a new option in shoulder replacement surgery


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Shoulder replacement surgery is done to relieve pain and other symptoms that result from damage to the shoulder joint. Common conditions that can damage the shoulder joint include osteoarthritis, rotator cuff injuriesand fractures, among others. 

Thanks to improved surgical techniques and an aging population, the number of shoulder replacement surgeries is increasing.

"The rate of usage of shoulder replacement in the United States has increased dramatically," explains Dr. Joaquin Sanchez-Sotelo, a Mayo Clinic orthopedic surgeon. "And I think there are two reasons. One is that implants are better. And also, that patients now are more active with their upper extremities later in life. So, they need the procedure because they want to have a life where they can enjoy activities pain-free."

Traditionally, shoulder replacement removes damaged areas of bone and replaces them with standard parts made of metal and plastic. Joint replacement surgery could be a challenge if some of the bone is missing, the bone quality is poor, or if a bone graft is not accurate. 

Now, thanks to new technology, there is another option. Using CT scans and 3D-printed models, some patients can receive joint replacements that are created to be custom fit to their anatomy. 

"The benefit is you are guaranteeing the patient that the implant is going to fit his or her shoulder, No. 1," says Dr. Sanchez-Sotelo. "No 2., it decreases surgical time tremendously. Because in the past, you had to get exposure and then prepare the bone until it fits one of the off-the-shelf implants. Now you know that the implant is going to fit the patient right out of the box. So surgery time is less." 

There are some limitations to use of the new implants. People with severe deformities may not be candidates, and people who require surgery quickly may not have time to wait for a custom implant to be built. 

Despite these limitations, Dr. Sanchez-Sotelo says, like artificial intelligence and mixed reality, custom-fitted joints could be another game-changer in orthopedics and another tool for surgeons to help patients.

"I think this is going to transform our practice," says Dr. Sanchez-Sotelo. "Technology is advancing so fast in medicine and orthopedic surgery. I'm just excited to see how we can change the operation, make it faster, make it easier, and lead to a much better outcome."

On the Mayo Clinic Q&A podcast, Dr. Joaquin Sanchez-Sotelo, discusses advances in shoulder replacement surgery, including custom-fitted implants.

The custom-fitted shoulder implant discussed in this podcast is produced by Strkyer. Dr. Sanchez-Sotelo and Mayo Clinic receive consulting fees and royalty payments from Stryker for shoulder arthroplasty products; however, Dr. Sanchez-Sotelo and Mayo Clinic do not have any relevant financial conflicts with this specific device.



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