DALLAS – August 26, 2021 – UT Southwestern Medical Center is one of only 15 surgical centers in the world that use next-generation augmented reality (RA) in the operating room for shoulder arthroplasty. Shoulder specialist Michael Khazzam, an associate professor of orthopedic surgery, became the first orthopedic surgeon in Texas to use the technique approved by the Food and Drug Administration while operating to restore shoulder function. .
Michael Khazzam, MD
“Basically, we can perform all surgery and estimate post-surgical mobility and function in virtual reality even before touching the patient in the operating room,” said Dr. Khazzam, who specializes in reconstructive and complex reconstructive surgery. shoulder. “I can show patients what we will do before surgery, which will help them feel more informed and involved in their care.”
When Monte Perkins arrived at UT Southwestern, the pain in his right shoulder was so intense that it “drove him to the ground,” he said. The 74-year-old Dallas resident had fallen in his front yard and broken two tendons, and during the following months, he and his wife, Lynda, visited several doctors for help.
Perkins is one of the first patients in Texas to undergo shoulder replacement surgery with RA. “It’s almost like a‘ Star Wars ’kind of thing,” said Perkins, a third-generation jeweler. “Dr. Khazzam was able to cover everything and make sure everything fit together perfectly, like a puzzle. “

The use of an augmented reality surgical plan results in the highest level of precision surgery.
For years, RA has been used before surgery to develop a 3D model of the procedure, which allows for more preservation of the patient’s natural anatomy. This latest development allows surgeons to use real-time RA techniques by virtually superimposing the 3D surgical plan directly on the patient’s anatomy, providing a customized procedure with the highest level of accuracy, Dr. Khazzam, a member of the UTSW Sports Medicine and Shoulder Service Team. Dr. Khazzam has completed approximately 30 augmented reality shoulder replacements since April, including nearly 6,000 hip, knee and joint replacements completed at UTSW last year.
Preoperative shoulder computed tomography is introduced into special software that generates a 3D model of the patient’s anatomy. Doctors use the model to examine the patient’s anatomy, plan the incision points, mark the points of the anchor pins, and adjust the prosthetic device.

The patient replacing the shoulder Monte Perkins and his wife, Lynda, are happy with their results.
“We can conduct a virtual‘ dry run ’by implanting the shoulder around the software to be able to determine what works best for the patient’s anatomy and pathology,” Dr. Khazzam said. “Ultimately, this ‘dry run’ becomes our surgical plan.”
The use of Microsoft HoloLens AR glasses during surgery allows you to see, navigate and manipulate the entire surgical plan during the procedure. The surgeon can scroll through it and zoom in while comparing the plane in real time with the patient’s anatomy. The ability to refer to the plan during the operation adds another layer of control and balance to the already precise shoulder replacement process.
“Research shows that 3D modeling can result in a very accurate restoration of the patient’s anatomy and accurate positioning of the implant,” Dr. Khazzam said. “RA certainly seems like a game-changing breakthrough for shoulder repair and replacement surgery.”
About UT Southwestern Medical Center
UT Southwestern, one of the most important academic medical centers in the country, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes and includes 25 members from the National Academy of Sciences, 16 members from the National Academy of Medicine and 13 researchers from the Howard Hughes Medical Institute. The staff of more than 2,800 full-time professors is responsible for innovative medical advances and is committed to quickly translating science-based research into new clinical treatments. UT Southwestern physicians provide care in nearly 80 specialties to more than 117,000 inpatients, more than 360,000 emergencies, and monitor nearly 3 million outpatient visits a year.