Digital Health and Smart Technologies in Shoulder Arthroplasty: Emerging Tools and Clinical Implications.

Abstract

Purpose: Shoulder arthroplasty has evolved substantially in surgical technique, implant design, and indications. Careful coordination across the patient care pathway remains central to optimizing outcomes. Concurrently, rapid advances in digital health, wearable technologies, smart implants, and intraoperative innovations are being explored across orthopedics, with emerging applications in shoulder arthroplasty.

Objective: This narrative review synthesizes current evidence on digital technologies relevant to shoulder arthroplasty, with particular attention to the strength and origin of the available data.

Patients and methods: A structured review of recent literature was performed, including primary studies in shoulder arthroplasty as well as relevant evidence extrapolated from hip and knee arthroplasty. Areas examined included CT-based 3D planning, navigation, patient-specific instrumentation, robotics, augmented/mixed reality, mobile health (mHealth) platforms, wearable devices, tele-rehabilitation, sensor-enabled implants, and artificial intelligence (AI).

Results: In shoulder arthroplasty, digital planning tools, navigation systems, and patient-specific instrumentation have demonstrated improvements in implant positioning accuracy in selected studies; however, evidence linking these technologies to superior long-term clinical outcomes remains limited. Robotic systems and augmented reality applications are in early investigational phases. Postoperative digital health tools, including tele-rehabilitation and wearable monitoring, have shown non-inferior functional outcomes compared with conventional care in hip and knee arthroplasty, with only preliminary and pilot data currently available in shoulder populations. Sensor-enabled implants and AI-based predictive models represent emerging areas of research, but external validation, workflow integration, and cost-effectiveness analyses remain insufficient.

Conclusion: Digital and smart health technologies in shoulder arthroplasty are evolving and largely investigational. While early findings and extrapolated evidence from other arthroplasty domains suggest potential benefits in planning accuracy, patient engagement, and outcome monitoring, robust shoulder-specific clinical validation is limited. Further prospective studies are required before widespread clinical adoption can be recommended. This narrative review synthesizes emerging evidence in this field, which is currently dominated by feasibility studies, technical reports, and early-phase clinical investigations, with limited high-level outcome data specific to shoulder arthroplasty.