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Rare, High-Tech, Mixed Reality Surgery

November 13, 2021

Morristown Medical Center uses new technology for shoulder replacement operations

Groundbreaking shoulder surgeries are now being performed at Morristown Medical Center – one of only a few hospitals in the U.S. chosen to take it on. Shoulder replacement surgery serves to replace arthritic surfaces in the shoulder with artificial parts. Complicating this is the unique anatomy of the glenoid socket and humeral ball, which often present a significant challenge due to anatomical variations and deformities. Mixed reality – which is performed by Eric Black, MD, an orthopedic surgeon specializing in shoulder and elbow surgery, anchors virtual objects into the real world and allows the surgeon to interact with the objects before and during surgery.

This technology can be used to assist in the placement of implants during shoulder replacement surgery, specifically in complex cases. It can also be used as an educational tool to teach other surgeons how to navigate complicated cases. Less than a dozen U.S. surgeons are able to use the technology.

Mixed reality also allows surgeons to have immediate access to patient history, X-rays, three-dimensional CT scans and implant choices throughout the operation. This allows surgeons real-time access to critical information that can help facilitate accurate implant placement, avoid complications and maximize patient outcomes.

Complex shoulder replacements are Dr. Black’s specialty. On average, surgeons who are considered to perform a “high volume” of shoulder replacements in the U.S. perform about 10 annually. Dr. Black does about 160 or more each year.

“Mixed reality is an incredible technology that synthesizes the online preoperative planning software with real-time data analysis during surgery. This allows the surgeon to accurately implement a surgical plan with incredible accuracy,” Dr. Black says. “Surgical steps such as visualizing a humeral cut as well as positioning the glenoid implant can be made entirely more efficient with this technology for a fraction of the cost of a robot but with the same accuracy. It is a complete game changer, and I am honored to be a part of the rollout.”

As a teaching tool, mixed reality has the potential to allow surgeons who do not have a lot of experience with a certain procedure or implant to invite another surgeon to be a surgical mentor and guide them through the operation remotely. As a virtual hologram projected above the patient, surgical mentors can watch the surgeon perform the operation and provide feedback with the use of real-time visual cues.

Mixed reality can be a powerful tool for education, clinical assessment and intraoperative navigation. It is at the forefront of orthopedics, with the primary goals to enhance patient outcomes and improve implant longevity.

“At Morristown Medical Center, we are committed to investigating and utilizing the latest technology for the benefit of our orthopedic surgeons and the patients in order to provide the patient with the safest procedures and best outcomes,” says James Wittig, MD, an orthopedic surgeon and chairman, Orthopedic Surgery Morristown Medical Center and medical director, Orthopedics, Orthopedic Oncology and Sarcoma Surgery, Atlantic Health System. “Dr. Black is a true innovator in the realm of mixed reality for surveillance procedures and is representative of one of the innumerable outstanding orthopedic surgeons we have in the department.”


At Morristown Medical Center, we are committed to investigating and utilizing the latest technology for the benefit of our orthopedic surgeons and the patients in order to provide the patient with the safest procedures and best outcomes.”

– James Wittig, MD, chairman, Orthopedic Surgery Morristown Medical Center and medical director, Orthopedics, Orthopedic Oncology and Sarcoma Surgery, Atlantic Health System