The evolution of virtual reality in shoulder and elbow surgery

Virtual Reality (VR) in orthopedic surgery has significantly increased in popularity in the areas of preoperative planning, intraoperative usage, and for education and training; however, its utilization lags behind other surgical disciplines and industries. The use of VR in orthopedics is largely focused on education and is currently endorsed by North American and European training committees. The use of VR in shoulder and elbow surgery has varying levels of evidence, from I to IV, and typically involves educational randomized controlled trials. To date, however, the terms and definitions surrounding VR technology used in the literature are often redundant, confusing, or outdated. The purpose of this review, therefore, was to characterize previous uses of VR in shoulder and elbow surgery in preoperative, intraoperative, and educational domains including trauma and elective surgery. Secondary objectives were to provide recommendations for updated terminology of immersive VR (iVR) as well as provide a framework for standardized reporting of research surrounding iVR in shoulder and elbow surgery.