Advances in Shoulder Surgery

The shoulder is a complex ball-and-socket joint made up of bones, tendons and ligaments, and many nerves. Mount Sinai Brooklyn offers the most advanced treatments for your shoulder, including new mixed reality shoulder surgery and patient-matched implant (custom-fit joint replacement). Shoulder problems and painful injuries can affect people of all ages. Our goal is to get you back to your daily routine and sports activity as quickly as possible.

There are many possible causes of shoulder conditions. The most common causes include rotator cuff conditions, such as tendonitis and tears; shoulder instability and sports injuries, including biceps and labrum; shoulder fractures; shoulder arthritis; and complex revisions of prior surgery.


Treatments for shoulder injury include nonsurgical treatments, as well as surgery options.

Nonsurgical Treatments
Nonsurgical treatments for shoulder conditions include physical therapy, medications, and cortisone injections. If these are not effective, you may be a candidate for shoulder surgery.

Our orthopedic surgeons diagnose and care for your shoulder pain. After a physical examination and radiology tests to determine the extent of the disease or damage, your orthopedic surgeon will recommend surgical options available at Mount Sinai Brooklyn, including:

  • Arthroscopic Surgery – This is a minimally invasive procedure that allows the surgeon to view the inside of your shoulder joint to further determine the best course of treatment, as well as to remove bone spurs and scar tissue that could be causing the pain and loss of motion.
  • Reconstructive Surgery – Our surgeons perform shoulder reconstruction surgery on patients whose joint is causing chronic pain and loss of motion by repairing of torn ligaments and other soft tissue.
  • Total Shoulder Joint Replacement Surgery – Patients who have severe arthritis and whose rotator cuff tendons are still intact can benefit from total shoulder joint replacement.
  • Reverse Shoulder Replacement Surgery – This surgery helps patients with severe arthritis, rotator cuff tears, and bone loss. It involves the replacement of the ball and socket but switches their positions. For the appropriate patients, this surgery greatly reduces pain and restores motion.

New Technologies and Approaches

At Mount Sinai Brooklyn, we are committed to investigating and using innovative technologies to provide our patients with the safest and best outcomes. Two recent advancements in shoulder surgery are the use of mixed reality and patient-matched implants, with each having significant advantages over more traditional approaches. In fact, Mount Sinai Brooklyn was the first hospital in the New York State to perform a pioneering shoulder replacement surgery using mixed reality.

Mixed Reality
Mixed reality is an advanced technology that combines the use of virtual reality and augmented reality. This new technology allows an orthopedic surgeon to plan the entire shoulder replacement surgery using images of your shoulder’s exact anatomy. Using mixed reality allows the surgeon to help achieve a near 100 percent anatomical fit for the shoulder joint. Based on a preoperative CT scan of the shoulder, this technology enables the doctor to create a highly detailed map of the shoulder joint, allowing each surgical step to be fully planned. During the surgery, the doctor wears special goggles, which project a 3D hologram image of the patient undergoing the procedure.

This new system allows surgeons to use hand gestures and voice commands to view and manipulate the hologram image of the patient’s preoperative plan from inside the headset lens. The use of mixed reality allows the surgeon to superimpose the 3D surgery plan over the open surgical site on the operating table, providing a very detailed, personalized level of prosthetic placement. Mixed reality also allows surgeons to have immediate access to a patient’s history, X-rays, three-dimensional CT scans, and implant choices throughout the operation—critical, real-time information that can help maximize patient outcomes.

This advanced technology helps decrease the risks of improper placement, reduces the risks of early joint loosening, and protects soft tissue around the shoulder. Our goal is to use this new technology to plan all shoulder replacement surgeries when possible. Over time, this promising technology may be used for orthopedic trauma, as well other joint replacements.

Patient-Matched Implant
Traditional shoulder replacement surgery requires the removal of damaged areas of bone and replaces them with standard parts made of metal and plastic. When bone is missing or the bone quality in the joint is poor, a joint replacement surgery could be a challenge. Thanks to a new technology, patient-matched implant (custom-fit joint replacement), there is now another innovative option. Using CT scans, patients can receive joint replacements that are created to be custom fit to their anatomy, virtually guaranteeing the implant will be a perfect fit.

Patient-matched implant technology is designed to create an exact anatomical fit for your shoulder joint. This match is created by using a preoperative CT scan image of your joint to manufacture the replacement. The shoulder replacement you receive is specific for you. The patient-matched joint increases efficiency by decreasing surgical time, with fewer surgical steps and less need for bone reshaping. In addition, the patient-matched implant offers a quicker recovery time, because it is less invasive and results in a greater range of motion and preservation of bone tissue and ligaments.

Although most patients will be eligible for the patient-matched implant, there are some limitations for the use of these 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.

Why Mount Sinai Brooklyn
As a full service community hospital located in the heart of Brooklyn, we offer individualized orthopedic care in your neighborhood. Without leaving the borough, you can receive the entire continuum of care at Mount Sinai Brooklyn from lab tests to radiological testing to your surgical procedure. Our orthopedic service offers the most advanced surgical treatments for virtually every joint disorder. 

Our Team

Dave Shukla, MD