The Future of Total Shoulder Replacement Now Available in Brooklyn

Brooklyn, NY — Surgeons at Maimonides Medical Center in Brooklyn, NY, have performed one of the nation’s first Mixed Reality (MR) shoulder replacement surgeries using advanced virtual technology. The procedure was performed on March 30, 2023, by surgeons Jack Choueka, MD, Chair of the Department of Orthopaedic Surgery and Rehabilitation at Maimonides Health, and Ramin Sadeghpour, MD, shoulder and upper extremity surgeon at Maimonides Bone and Joint Center.

Advanced surgical technology isn’t new to the Maimonides surgical team. For years, the team has used 3D computer modeling software to perform “virtual dry run surgeries.” That software helps surgeons determine the optimal size and position of implants to achieve the best postoperative motion and function. The introduction of mixed reality (MR) technology has revolutionized this process. “This integration allows surgeons to develop and execute highly personalized surgical plans with greater precision, ultimately improving patient outcomes,” said Dr. Choueka.

This latest procedure, combined with MR technology bring pre-operative planning and real-time execution closer together, enabling a more streamlined and precise surgical process. By displaying the 3D holographic surgical plan within the surgeon’s field of view, MR technology reduces the need for additional screens and allows for more efficient and accurate implant placement.

Ahead of the MR shoulder replacement surgery, the Maimonides team who currently perform more shoulder replacements  than any group in Brooklyn, developed a surgical plan personalized to the patient. During surgery, the MR headset facilitated the integrations of the plan into the surgeon’s field of view, allowing for more efficient visualization and execution.

During the surgery, the Maimonides surgeons wore headsets that superimposed a 3D hologram based on software-created CT scans of the patient, Maria,  over the line of sight. This technology allowed the surgeons to see the anatomy and surgical site precisely and helped guide the exact placement of the prosthetic. The replacement surgery took about 90 minutes to complete.

“I had a large rotator cuff tear that led to arthritis of the shoulder,” said Maria. “The pain became a 10 out of 10. I couldn’t use my arm for anything, even simple tasks. I also had a lot of trouble sleeping at night.” Maria is the first patient at Maimonides to have shoulder replacement surgery using the new MR technology.

“It’s important to continuously advance the field of surgery and bring innovative technology into the operating room,” said Dr. Sadeghpour. “The field of surgery is becoming increasingly sophisticated. We’ve come a long way from the days when we would reference X-rays during surgery and needed to continuously glance up to ensure we were pinpointing the right area.”

Dr. Choueka said the team plans to incorporate MR technology into all shoulder replacement surgeries at Maimonides adding, “we will explore the potential of MR technology in other orthopedic fields, such as trauma and reconstructive surgery. Our goal is to leverage the benefits of MR technology to enhance patient care across various specialties.”

MR technology also offers a valuable learning tool for trainees, exposing them to cutting-edge advancements in surgical techniques. Familiarity with MR technology can help the next generation of surgeons contribute to the ongoing development of these innovations.

Patients can expect improved motion and function following surgery, and recovery depends on comprehensive postoperative protocols and a patient’s commitment to rehabilitation.

“The MR technology provides patients the best chance of achieving their goals by optimizing implant placement for improved motion, function, and longevity, ultimately reducing the likelihood of revision surgeries,” said Dr. Choueka, “It’s exciting to bring our patients here in the borough the newest technology and innovations. This technology sets a new benchmark for what can be achieved in shoulder replacement procedures, pushing the boundaries of surgical excellence. We anticipate that future advancements will provide more direct guidance and real-time feedback during surgical procedures, further improving patient care.”

Maimonides is among a small group of health systems nationwide using this next-generation technique. Maimonides plans to conduct clinical studies on MR technology device outcomes as the technology evolves.

To view video of the surgery, click here.

About Maimonides Medical Center

Maimonides Health is Brooklyn’s largest healthcare system, serving over 300,000 patients each year through the system’s three hospitals, 1,800 physicians, and more than 80 community-based practices and outpatient centers. The system is anchored by Maimonides Medical Center, one of the nation’s largest independent teaching hospitals and home to centers of excellence in numerous specialties; Maimonides Midwood Community Hospital (formerly New York Community Hospital), a 130-bed adult medical-surgical hospital; and Maimonides Children’s Hospital, Brooklyn’s only children’s hospital, and only pediatric trauma center.

Maimonides’ clinical programs rank among the best in the country for patient outcomes, including its Heart and Vascular Institute, Neurosciences Institute, Bone and Joint Center, and Cancer Center. Maimonides is an affiliate of Northwell Health and a major clinical training site for SUNY Downstate College of Medicine. For additional information, please visit

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