AI-Enhanced Surgical Decision-Making in Orthopedics: From Preoperative Planning to Intraoperative Guidance and Real-Time Adaptation

Abstract

Artificial intelligence (AI) is affecting the practice of orthopedic surgery, offering innovative solutions from preoperative planning to intraoperative guidance and real-time adaptation. This review highlights current advancements in AI-driven imaging analysis, anatomical segmentation, and implant selection, highlighting improvements in surgical precision, efficiency, and patient-specific customization. Intraoperatively, AI enables real-time image processing, integration with robotic systems, and adaptive feedback mechanisms that enhance accuracy, reduce complications, and personalize care. Clinical applications span joint replacement, spine, and trauma surgery, where AI supports diagnosis and offers support in decision-making, often surpassing conventional methods. Despite these promising developments, challenges remain regarding data quality, model generalizability, transparency, and ethical considerations. Future directions emphasize explainable AI, multimodal data integration, and closer synergy between AI, robotics, and digital health to advance personalized orthopedic care.