Validation of holographic computing for surgical navigation in  shoulder arthroplasty. A new technological paradigm.

Purpose Accurate placement of the guide wire is essential for optimal glenoid component positioning in reverse shoulder arthroplasty. Current navigation systems, while effective, are often costly and complex. The aim of this study was to evaluate the precision of guide pin placement using a new navigation system based on holographic computing through a spatial augmented reality mesh. Methods Five scapulae were reconstructed from patient CT scans to plan optimal glenoid inclination and version. Each was 3D-printed four times. Two surgeons (one in training and a shoulder specialist) inserted guide wires first freehand and then using a mixed reality navigation system. Post-placement CT scans assessed version and inclination angles. Errors were calculated as the difference between planned and obtained angles for both manual and navigated techniques. Results The mean error of the navigated system was 1.85° (SD: 2.08) compared to 10.75° (SD: 8.19) for the manual technique, with statistically significant differences. No significant differences were found between senior and junior surgeons. In the manual technique, errors increased in scapulae with greater deformities for both surgeons ( p  < 0.05), while the navigated method maintained accuracy regardless of deformity severity. Conclusions Holographic computer-assisted navigation in shoulder arthroplasty matches and improves the accuracy of guide needle positioning regardless of the surgeon's level of experience. Due to its accessibility and simplicity, it represents a promising technique for future surgical navigation.