Artificial intelligence in orthopaedics should be built with surgeons, not just for them!
Surgical artificial intelligence (AI) is typically validated on one patient population and then deployed unchanged into another, without surgeon input into its design. AI in orthopaedics should be built with surgeons, not simply for them: Surgeons should hold shared authority over the clinical question, data curation, validation, implementation, monitoring and retirement of any tool they use. Specialty-tuned models outperform general-purpose systems on some tasks, but the margin is modest and likely to narrow as generalist models improve. The more durable distinction is who controls the update loop-who can retrain a model on local outcomes, audit its failures and withdraw it when it drifts. Trial evidence shows that a clinician kept in that loop by design, not as an afterthought, outperforms working alone. What determines whether orthopaedic AI fulfils its promise is not model architecture, but who stays accountable to the surgeon at the bedside when the model needs to change.
Authors
- Philipp Wilhelm Winkler (ORCID: https://orcid.org/0000-0002-3997-1010)
- Elmar Herbst (ORCID: https://orcid.org/0000-0002-5652-0692)
- Romain Seil (ORCID: https://orcid.org/0000-0001-8806-9384)
- Gergely Pánics (ORCID: https://orcid.org/0000-0002-4504-3923)
- Kristian Samuelsson (ORCID: https://orcid.org/0000-0001-5383-3370)
- Volker Musahl (ORCID: https://orcid.org/0000-0001-8881-6212)
- Umile Giuseppe Longo (ORCID: https://orcid.org/0000-0003-4063-9821)
- Felix Conrad Oettl (ORCID: https://orcid.org/0000-0001-9721-685X)
- Michael T Hirschmann
- Balint Zsidai
- STEFANO ZAFFAGNINI
- Eric Hamrin Senorski
- Yinan Yu
- Christophe Ley
- Thomas Tischer
- Jacob Oeding
- Michael Hantes
- Ting Cong
Institutions
- Semmelweis University (HU)
- Johannes Kepler University of Linz (AT)
- University of Thessaly (GR)
- Università Campus Bio-Medico (IT)
- Centre Hospitalier de Luxembourg (LU)
- University of Pittsburgh (US)
- University of Basel (CH)
- University of Luxembourg (LU)
- Sahlgrenska University Hospital (SE)
- Fédération Internationale de Football Association (CH)
- Kantonsspital Baselland (CH)
- Malteser Waldkrankenhaus Erlangen (DE)
- Kepler Universitätsklinikum (AT)
- Istituto Ortopedico Rizzoli (IT)
- Universitätsklinik Balgrist (CH)
- Uzsoki Hospital (HU)
- Universitätsmedizin Rostock (DE)
- Campus Bio Medico University Hospital (IT)
- Kantonsspital Baselland Standort Bruderholz (CH)
- Gelenkpunkt (AT)
- Chalmers University of Technology (SE)
- University of Gothenburg (SE)
Publication Details
- Journal
- Knee Surgery Sports Traumatology Arthroscopy
- Published
- 2026-09-30
- DOI
- https://doi.org/10.1002/ksa.70628
- Primary Topic
- Artificial Intelligence in Healthcare and Education
- Type
- article
- Field-Weighted Citation Impact
- 0.00