Exactech Unveils First Large-Scale CT Radiomic Analysis of Shoulder Bones and Muscles, Establishing the Foundation for the Future of Personalized Pre-Operative Planning

GAINESVILLE, Fla., Sept. 9, 2025 /PRNewswire/ -- Exactech, a global medical technology leader, has announced the publication of a landmark research study in JSES International: the first large-scale, fully automated CT radiomic analysis of the bones and muscles in the shoulder.

Using an AI-based framework, researchers analyzed pre-operative CT images and clinical outcomes from more than 4,000 patients treated with Exactech's Equinoxe^® shoulder system and automatically extracted radiomic features—quantitative numerical representations of segmented image shape, pixel density and textures—from the deltoid muscle and scapular bone. Numerous radiomic measurements were identified that were predictive of pain, motion, and function following shoulder arthroplasty. Identification of clinically relevant radiomic measurements, that can be automatically extracted from pre-operative CT images, has great potential to expand the capabilities of pre-operative planning software and provide more-personalized predictions, with additional clinical decision support.

"Radiomics allows us to quantify data in a medical image and provide new insights related to the image pixels that we previously couldn't 'see' and didn't even know was important," said William Aibinder, MD. "Analyzing the radiomics of the deltoid muscle and scapular bone improved the accuracy of 70% our machine learning based clinical outcomes predictions. As models of more muscles and bones are trained and numerically analyzed, outcome predictions will be further improved, offering the potential for truly personalized patient outcome optimization."

"Radiomics converts ordinary CT images into a digital biopsy—providing numerous objective measurements of muscle and bone size, shape and quality," added Bruno Gobbato, MD. "Our new research illustrates how these pixel-level measurements correlate with pain, motion, function, and even some complications after shoulder arthroplasty. These capabilities shift how we utilize medical image data, from visual impression to quantifiable evidence, offering the potential to elevate pre-operative planning from educated guesswork to truly informed decision-making."

"Radiomic analysis will allow us to better understand our patients and guide them to the best available treatment of their condition," said Bradley Schoch, MD. "We are still early in the process of developing the clinical tools that will leverage this technology; however, our research demonstrates the potential for this technology to impact both our clinical practice and patient's lives in the very near future."

In addition to identifying the most clinically relevant radiomic features associated with shoulder arthroplasty clinical outcomes, this study also proposed a novel unsupervised machine learning based clustering analysis as a method to create new classification systems for bone and muscle morphology. This clustering analysis identified several unique morphologies of the deltoid muscle and scapula bone that were associated with differences in clinical outcomes before and after shoulder arthroplasty.

"Our team has created a novel automated image analysis tool that will change how orthopedic surgeons utilize CT image data to diagnosis their patients and plan treatment with shoulder arthroplasty," said Chris Roche, Exactech's Senior Vice President of Extremities. "Automated radiomic analysis of pre-operative CT image data allows us to fully characterize the bones and muscles of an individual patient's shoulder joint, evolving diagnosis from a subjective classification to quantification on a continuum. This evolution will represent a paradigm shift for the future of pre-operative planning and clinical decision support software. Capabilities like these are only possible with the help of artificial intelligence."

To learn more about Exactech's commitment to clinical research and innovative surgical solutions, visit www.exac.com.

About Exactech
Exactech is a global medical technology leader that empowers orthopaedic surgeons with innovative implants, surgical instruments and the Active Intelligence® (AI) ecosystem of smart technologies to give patients EXACTLY what they need to regain mobility. Visit www.exac.com for more information and connect with us on LinkedIn, Vumedi, YouTube, Instagram and X.

SOURCE Exactech, Inc