Robotic assisted reverse total shoulder arthroplasty: narrative review and surgical technique of humeral and glenoid preparation

Shoulder arthroplasty is an effective treatment for a broad spectrum of shoulder pathologies, with component positioning being a key critical factor for success. Three-dimensional preoperative planning software improves deformity visualization and implant selection, yet translating digital plans into accurate bone preparation and component implantation remains a challenge. Current enabling technologies such as patient-specific instrumentation, navigation, and mixed reality aim to assist with intraoperative execution but have their own limitations. Robotic assistance integrates preoperative plans with real-time optical tracking and a robotic arm to guide version, inclination, and depth during humeral osteotomy and glenoid reaming. This review summarizes the evolution of advanced execution modalities and describes the surgical technique and workflow of a Robotic Surgical Assistant (ROSA) Shoulder System for a robotic assisted reverse total shoulder arthroplasty (RSA).