Scripps Developing ‘Smart Shoulder’ Device to Improve Surgery
Researchers designing implant to enhance shoulder function

Researchers designing implant to enhance shoulder function
In 2004, Scripps orthopedic surgeons made history. Clifford Colwell, MD, implanted the world’s first electronic prosthetic knee, replacing a patient’s failing joint and subsequently collecting valuable data on how everyday activities impact the knee. The findings earned the team multiple prestigious awards and ultimately led to more effective knee implants.
Now, two decades later, Scripps hopes to use the same approach to the shoulder.
Scripps Clinic researchers have secured grant funding from the National Institutes of Health to develop a prototype of a rechargeable “smart shoulder” — a Wi-Fi- and sensor-equipped device that will track shoulder usage and provide new insight into the joint’s inner workings. The initial phase, which will demonstrate proof of concept, will be conducted at the Shiley Center for Orthopaedic Research and Education (SCORE).
“We learned a lot from the e-knee, but the shoulder is much more complex, and it’s difficult to understand biomechanically what happens in the shoulder,” explains Darryl D’Lima, MD, PhD, director of orthopedic research at Scripps Health and the initiative’s co-lead investigator.
“Our goal with the smart shoulder is to measure force, acceleration, range of motion and activity. Collecting and analyzing this data will help us better anticipate forces from common activities — especially the activities patients find challenging after surgery — and determine how we can improve shoulder replacement surgery and prosthetics.”
Bringing the lab to the patient
The first placement of a smart shoulder in a living patient is likely a few years away, but Scripps orthopedic surgeons are using advanced technology to develop and refine other new treatments.
“With the smart shoulder, we’re trying to bring the lab to the patient. We can also bring patients’ problems to the lab and then use our skills and advanced technologies to find solutions,” says Heinz Hoenecke, MD, an orthopedic surgeon at Scripps Clinic, and co-lead investigator.
For example, when mapping out a complicated procedure, surgeons can use a robotic arm to simulate movement and measure force placed on the reconstruction or repair. Surgeons also have access to 3D printing and robotic testing.
Advancing shoulder reconstruction techniques
Dr. Hoenecke is currently exploring new approaches to acromioclavicular reconstruction — more commonly known as a separated shoulder.
“There have been a lot of procedures developed for acromioclavicular reconstruction, and we still don’t have the best success rate, so I went to the lab to try to find out what factors we have to control. It turns out it’s a much more complicated problem than we thought,” he says.
He and his team have used computer modeling, cadaver testing and a 3D printed clavicle and shoulder blade, and then the robotic arm to determine the best suture configuration to hold the end of the clavicle in the right position.
Personalized shoulder care for every patient
Whether the patient is an elite athlete, weekend warrior or someone who injured their shoulder doing everyday activities, they can trust that Scripps physicians will use all available tools and techniques to coordinate a treatment plan that meets their individual needs.
“Our philosophy is to determine what the patient’s issues and goals are, then match that with an appropriate treatment option,” says Dr. Hoenecke. “It’s important to really listen to the patient — do they want to golf again or play cards or throw a football or swim? Then we use the latest technology for assessment and explain their treatment options, so they can make a decision on what they think is best for them.”

This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.