Accuracy of robotically enhanced glenoid prosthesis positioning for total shoulder arthroplasty.

Robotic-Assisted vs. Patient-Specific Instrumentation in Reverse Total Shoulder Arthroplasty Arm 1: Robotic-Assisted Reverse Total Shoulder Arthroplasty (rTSA) - Intervention materials: MAKO robotic system equipped with advanced imaging and guidance systems for precise glenoid component implantation. Surgeons will utilize patient imaging data to map surgical plans pre operatively and to set parameters for alignment referencing used by the MAKO robot during surgery. Specifically, the MAKO assists the surgeon to determine more accurate preparation of glenoid bone.. - Procedures and Activities: The procedure will involve the utilization of robotic assistance during glenoid component placement. Surgeons, trained on the MAKO system, will follow standardized surgical protocols while implementing robotic assistance. - Personnel delivering the intervention: An orthopedic surgeon specializing in shoulder arthroplasty with at least 5 years of experience in robotic surgical techniques will lead the procedure. Prior to commencing this study, the investigative surgeon completed a learning curve of 20 patients. The learning curve for this procedure has not been accurately determined however for other robotic procedures such as hip and Knee arthroplasty, the Learning Curve is 7-9 cases. - Mode of Delivery: The intervention will be delivered face-to-face in an operating room setting. Each surgery will occur individually. - Frequency and Duration: Participants will undergo a single surgical intervention during the study, with follow-up assessments conducted at 2 years post-operatively. - Location: The surgery will take place in a hospital operating theatre setting. - Personalization/Adaptation of Intervention: Both interventions aim to implement precise positioning of the glenoid component based on pre-operational imaging. This will enable adaptation based on individual anatomical complexities, particularly in Arm 1 with robotic guidance that can be adjusted intraoperatively depending on real-time imaging feedback. -Intervention Adherence and Fidelity Assessment: Adherence to surgical protocols will be monitored by researchers through checklists that include confirming robotic setup, imaging alignment, and adherence to pre-operative plans. Training education for surgical staff on new technologies will be conducted to enhance fidelity in intervention delivery, improving consistency in procedure execution. Allocation to the intervention group (A) will be 15 consecutive recruitments and then subsequent recruitment to group B (control)