**1. Introduction**

The growth in total shoulder arthroplasty over the past 20 years has been exponential. From 1993 to 2007, primary procedures increased 369% [1]. Revision shoulder arthroplasty increased 431% during the same period. During the timing of this explosion, numerous innovations have occurred, most importantly the development of the reverse shoulder arthroplasty (RSA). Currently, RSA accounts for over 70% of the shoulder arthroplasties performed in the U.S. With the expansion of shoulder arthroplasty, and specifically RSA, numerous other innovative designs have been developed in recent years to address more and more complicated pathology to hopefully reduce the increasing revision burden and improve outcomes.

Innovations currently available with anatomic total shoulder arthroplasty include shorter stem designs and augmented inlay glenoid components. Regarding RSA, metal augmentation, including custom augments on both the glenoid and humeral side have expanded indications in cases of bone loss. In the setting of revision arthroplasty, humeral options include convertible stems and newer tools to improve humeral implant removal. New strategies for treatment and surgical techniques have been developed for recalcitrant shoulder instability, acromial fractures, and infections after RSA. Finally, computer planning, navigation, PSI, and augmented reality are imaging options now available that have redefined preoperative planning and indications as well intraoperative component placement.

#### **2. New Perspectives and Innovations in Anatomic Shoulder Arthroplasty**

*2.1. Humeral Component Innovations*
