Surgical planning and notetaking are two areas where orthopedic and spine AI programs are making outsized impacts, according to surgeons.
AI-powered scribes are increasing practice efficiency while also curbing physician burnout with its time-saving transcriptions.
However, orthopedic AI is not taking over every aspect on the continuum of care, surgeons still need to be able to perform and complete procedures without relying on AI that can be spotty and misinformed at times.
These four surgeons connected with Becker’s about where AI is improving orthopedic care, and where it still has a way to go.
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Editor’s note: This response has been lightly edited for clarity and length.
Question: Where do you see the most meaningful near-term application of AI in orthopedic care, and where do you think the hype outpaces the reality?
Harpreet Bawa, MD. Orthopedic Surgeon at Southern California Orthopedic Institute (Northridge): The most meaningful near-term applications of AI in medicine revolve around the personalization of patient care. We are already seeing AI integrated into diagnostic processes, from MRI reads to the analysis of patients’ subjective symptom reports. From a clinical standpoint, patients are arriving better informed, which helps us tailor care and manage expectations more effectively.
That said, conservative treatments still center on injections, oral medications and physical therapy. We have yet to see AI meaningfully change the types of injections or medications we utilize, though this may be an area of future growth, as it remains in its nascent stages. Peptide therapies are one domain being actively discussed, and AI may assist with better testing and formulation of these treatment modalities going forward.
We are beginning to see personalization extend into surgical planning and execution as well. Better data inputs encompassing patient anatomy, lifestyle and demographics are enabling more clinically relevant, individualized decisions. My own practice is a reflection of this shift: I have transitioned entirely to robotic-assisted knee replacement surgery, which allows me to visualize each patient’s unique anatomy and dimensions and make adjustments tailored to that individual. As time goes on, surgical plans will become increasingly customized, and AI will play a central role in helping us better target treatments for each specific patient.
Overall, AI in orthopedic surgery is still in its early stages. Looking ahead, it holds great promise for refining treatment plans, improving surgical recovery and enhancing patient outcomes. Yet despite these advances, it is imperative that physicians recognize one enduring truth: AI and technology will never replace the doctor-patient relationship.
Jeffrey Carlson, MD. Orthopedic Spine Surgeon at Orthopaedic & Spine Center (Newport News, Va.): I believe adding AI to transcribe the office visit is a very meaningful addition. The AI scribe can take better notes than the providers of the patient’s history and document the conversations around the treatment options while not interrupting the patient’s conversation with the doctor. It can be a great time saver for physicians as well. A review of the AI transcription can be very time efficient and may decrease the costs that are related to documentation. There is a learning curve, but I think the AI scribe will be well worth the effort.
AI in the operating room is overhyped. The surgeon will have to know his procedure more than an AI assistant. The AI may make the surgeon less efficient and have to spend more time trying to correct any misleading by the AI. Surgeons should not become too dependent on the machines in the room. There will always be glitches and power outages that will require the surgeon to finish the procedure without these tools.
Matthew Harb, MD. Orthopedic Surgeon and Hip and Knee Specialist at The Centers for Advanced Orthopaedics (Washington, D.C.): I believe the most meaningful near-term applications of AI in orthopedic care will be on the clinical and operational side rather than within the technical execution of surgery itself. We are already seeing AI used by patients to better understand symptoms and generate differential diagnoses prior to evaluation, which can help guide more informed visits. Additionally, AI-assisted imaging interpretation is improving access and efficiency, particularly in settings where specialized expertise may not be immediately available.
One of the most impactful areas moving forward will be in perioperative optimization using AI to identify high-risk patients, improve preoperative clearance and help mitigate complications. This is an area where surgeons currently rely heavily on experience and fragmented data, and AI has the potential to bring more consistency and predictive accuracy.
We are also seeing real gains from AI-driven medical scribes, which reduce documentation burden and allow physicians to focus more on patient interaction. In the operating room, forms of AI and computer assistance are already being used to help confirm implant positioning and alignment in joint replacement procedures.
Where I think the hype outpaces reality is in the idea that AI will meaningfully replace surgical decision making or technical skill in the near term. Surgery remains highly nuanced, and outcomes are still largely dependent on surgeon judgment and experience. For now, AI is best viewed as an adjunct, one that can enhance efficiency, improve risk stratification and support better overall patient care, rather than replace the surgeon’s role.
Yu-Po Lee, MD. Orthopedic surgeon at UCI Health (Irvine, Calif.): Currently, the most meaningful near-term applications of AI in orthopedic care are focused on administrative and medical records efficiency and preoperative planning. AI scribes have been developed and are currently being employed in clinics to assist in taking notes and recording patient and physician interactions. Using “ambient scribes” can be helpful in reducing physician time in note writing. This would be immensely beneficial in improving clinic visits because it allows physicians to spend more time with their patients rather than record keeping. Saving physicians one or two hours of work after every clinic day would also improve physician mental health and prevent burnout.
Another area where AI is having an impact is surgical planning. In deformity cases, patients have spines that have deviated from the normal spinal alignment. There are programs now which help surgeons in planning surgery. Spine instrumentation is a powerful tool in correcting deformity. Procedures such as Smith-Peterson osteotomies and pedicle subtraction osteotomies can be powerful tools in correcting deformity. But there are many nuances in deformity surgery. How many levels need to be fused? Is an osteotomy needed to correct the deformity? If so, which osteotomies are the best for the deformity and how many osteotomies would be needed? These are only a few of the questions surrounding deformity surgery. But programs such as UNiD have evaluated large databases to help surgeons plan their surgeries. From this programming, there are now surgery specific rods that can be manufactured that are made prior to surgery so that surgeons have a template of what the final alignment of the spine will be. This helps at the time of surgery to reduce surgery time.
There has been increasing use of robotic surgery to assist in placing instrumentation in spine surgery. This is another area where AI could be very helpful in improving spine surgery. The use of robotics can reduce radiation to surgeons and staff, improve efficiency by decreasing operative times and improve accuracy in cases where the anatomy is challenging or deformed.
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