At Barnes-Jewish Hospital, WashU Medicine orthopedic surgeon Jay Keener, MD and his team are advancing shoulder replacement surgery with leading-edge techniques—using innovative materials, advanced planning software, and customized implants—to help patients return to active lives with more personalized, durable treatment options.

Precision planning with images and 3D technology

CT imaging and 3D planning software allow surgeons to virtually map out each step of a shoulder replacement before making a single incision, helping ensure optimal implant sizing and placement, improved range of motion, and better patient outcomes.

“We’re able to plan the entire surgery digitally, based on the patient’s actual anatomy,” Dr. Keener says. “Then we bring that plan into the operating room using 3D-printed, patient-specific cutting guides.”

Custom implants for complex cases

“We are now able to print 3D custom implants to accommodate each patient’s unique anatomy, which is especially important when a prior shoulder replacement has failed,” Dr. Keener says. “This technology allows us to treat patients who would otherwise have limited options.”

WashU Medicine orthopedic surgeons are among the nation's most experienced in performing custom implant surgeries, helping patients to achieve the best possible fit, function, and results.

“Some of the newer custom implants have features that weren’t available before such as porous coatings for stronger fixation, precise 3D planning, and patient-specific guides that make them easier for surgeons to place with accuracy,” he adds. “And they’re more user-friendly for the surgeon. That kind of progress is making a big impact in complex cases.”

Pyrocarbon: A material that moves better

One of the most exciting material advancements is the use of pyrocarbon as a bearing surface in hemiarthroplasty procedures. Unlike traditional metal components, pyrocarbon is smoother, more wear-resistant, more biocompatible, and mimics the properties of bone.

“Pyrocarbon is slick and not as hard as metal, so it doesn’t wear out the socket as quickly,” Dr. Keener says. “Hemiarthroplasty used to mean more stiffness and faster glenoid wear,” says Dr. Keener. “With pyrocarbon, patients are staying active longer, with less pain and fewer complications.”

“Our team at WashU Medicine Orthopedics is leading a multi-center clinical trial, in collaboration with four other orthopedic centers, to compare pyrocarbon with traditional replacement materials,” he continues. “We’re expecting to see real advantages in longevity and patient satisfaction.”

Benefits of pyrocarbon in hemiarthroplasty:

• Improved durability: Pyrocarbon’s resistance to wear and abrasion may reduce the likelihood of revision surgery, supporting longer-lasting results for patients.
• Bone preservation: Because its elasticity more closely matches natural bone, pyrocarbon helps limit stress shielding and bone loss.
• Biocompatibility: Pyrocarbon reduces the risk of inflammation or complications from wear debris, contributing to smoother recoveries and lower complication rates.
• Smoother movement: Patients often experience more natural joint motion and improved comfort, which can translate to better functional outcomes and quality of life.
• Radiolucency: Surgeons can more easily monitor implant positioning and glenoid bone integrity over time, supporting better long-term management.

Care your patients can count on

WashU Medicine Orthopedics is recognized as a national leader, not only for its clinical expertise, but also for its commitment to education and research, leading innovative clinical trials and training the next generation of orthopedic surgeons.

By combining advanced surgical techniques, personalized care, and clear communication with referring physicians, the team ensures patients receive timely, expert treatment and superior outcomes.

To learn more about WashU Medicine Orthopedics, visit us online or call 314-514-3500.