200 Section - GPS for Surgeons: Media Framing and Patient Decision-Making in Navigation-Assisted Total Shoulder Arthroplasty

Advanced glenohumeral osteoarthritis of the dominant shoulder with intractable pain and five years of progressive functional decline, treated with computer-assisted navigation total shoulder arthroplasty (canTSA).

Case Description:

A 67-year-old woman with advanced glenohumeral osteoarthritis initially declined total shoulder arthroplasty (TSA) after encountering online media describing the procedure as “dangerous” and associated with “severe scarring.” Over time, she was exposed to articles and social media content portraying navigation- and robot-assisted TSA as safer and more precise. Common narratives, including testimonials such as “the robot makes it more accurate” and the metaphor “GPS for surgeons,” reframed her perception of surgical risk. This shift reduced anxiety, increased trust in the procedure, and ultimately led her to pursue canTSA. She underwent surgery successfully without complication and reported high postoperative satisfaction, improved function, and confidence in her decision, attributing these outcomes in part to reassurance gained from media-influenced narratives.

Discussions:

This case illustrates how online media narratives and social networks can shape patient expectations and decision-making regarding advanced surgical technologies. Crowdsourced survey studies demonstrate that many patients believe navigation- or robot-assisted orthopedic surgery results in superior accuracy, fewer complications, and faster recovery compared with conventional techniques, despite limited long-term comparative outcome data. Academic literature supports that computer-assisted navigation in total shoulder arthroplasty improves implant positioning and reduces malposition rates. However, the clinical significance, cost-effectiveness, and durability of these advantages remain under investigation. As utilization of shoulder arthroplasty continues to increase, clinicians should anticipate media-influenced perceptions and address them through evidence-based counseling to support informed, shared decision-making.

Conclusions:

This case highlights the impact of media portrayals on patient perceptions and adoption of navigation-assisted TSA. Physiatrists and orthopedic teams should integrate awareness of media-driven beliefs into evidence-based counseling to support informed, shared decision-making regarding emerging surgical technologies.