Robotic surgery expands into complex shoulder replacements

Robotic-assisted surgery is moving beyond traditional hip and knee replacements into increasingly complex orthopaedic procedures, with a recent surgical milestone in Australia demonstrating how the technology is expanding into shoulder replacement surgery.

Orthopaedic surgeon Dr. Joe Coory recently performed Australia’s first shoulder replacement using Stryker’s fourth-generation Mako robotic-arm system at Maroochy Private Hospital in Queensland.

The procedure involved a reverse total shoulder replacement, a technically demanding operation commonly performed in patients with severe arthritis, significant rotator cuff damage or certain complex fractures.

The achievement highlights how advances in robotics, three-dimensional imaging and surgical planning are expanding the range of procedures that can benefit from computer-assisted precision.

Moving beyond hips and knees

Robotic-assisted surgery is increasingly used in hip and knee replacements, helping surgeons plan procedures and position implants according to individual patient anatomy.

Shoulder replacement presents additional challenges.

The shoulder is one of the body’s most mobile joints, with relatively small bone surfaces and considerable anatomical variation. Successful replacement requires precise implant positioning while preserving surrounding bone and soft tissues.

In reverse shoulder replacement, the normal ball-and-socket arrangement is reversed, allowing the deltoid muscle to compensate for a damaged rotator cuff.

Stryker’s Mako technology uses three-dimensional CT imaging to develop a patient-specific surgical plan. During surgery, the robotic arm assists the surgeon with preparing bone and positioning implants according to that plan.

The robot does not operate independently. The surgeon remains in control throughout the procedure.

According to the Australian report, Dr. Coory has performed more than 100 robotic-assisted shoulder replacements using earlier technology since August 2025.

The latest Mako system introduces improvements designed to enhance surgical precision and operating-room workflow.

Robotic surgery gaining momentum in Canada

Canadian hospitals are also increasing their use of robotic-assisted orthopaedic surgery.

According to the Canadian Institute for Health Information (CIHI), robotic assistance was used in 3.1 per cent of hip and knee replacements performed in Canada during 2024–2025, compared with just 0.8 per cent in 2022–2023.

While conventional procedures still account for most joint replacements, the figures demonstrate growing adoption of robotic technology.

Canada has also contributed to advances in surgical guidance for complex shoulder procedures.

At St. Joseph’s Health Care London, orthopaedic surgeon Dr. George Athwal has pioneered mixed-reality technology that allows surgeons to visualize three-dimensional shoulder anatomy during surgery.

Using a specialized headset, the technology overlays digital images of the patient’s anatomy and planned implant onto the surgical field, helping guide instrument positioning.

Although mixed-reality guidance differs from robotic-arm surgery, both technologies demonstrate how digital innovation is transforming complex orthopaedic procedures.

The future of robotic-assisted surgery

As robotic systems become more sophisticated, their applications are expanding beyond established procedures into surgeries involving increasingly complex anatomy.

For hospitals, these technologies offer the potential for improved surgical planning, greater precision and more personalized procedures.

However, higher accuracy does not automatically translate into better long-term patient outcomes. Further clinical research is needed to determine whether robotic-assisted shoulder replacement improves recovery, reduces complications or extends implant longevity.

Cost, surgeon training and operating-room integration also remain important considerations.

The Australian milestone represents another step in the evolution of surgical robotics and raises the possibility that robotic-assisted shoulder replacements could eventually become more widely available in Canadian hospitals.

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