Precision medicine in orthopaedics: A review of current technologies and future directions

To synthesise the paradigm shift towards precision medicine in orthopaedics, where individual anatomical, biomechanical, molecular and kinematic characteristics are integrated into clinical decision-making. Unlike traditional approaches applying uniform protocols, this review outlines how precision orthopaedics aims to tailor surgical techniques, implant selection, component positioning and rehabilitation strategies to the unique profile of each patient, thereby improving outcomes and predictability.

This narrative review synthesises current concepts and evidence supporting patient-specific care. The methods discussed encompass a wide range of technological and biological innovations, including advanced imaging, robotic-assisted surgery, artificial intelligence (AI), molecular diagnostics, functional assessment tools and personalised therapeutic platforms that are shaping modern orthopaedic practice across multiple subspecialties.

In total knee arthroplasty, personalised alignment restores native joint lines, while robotic systems execute plans with submillimetre accuracy, reducing alignment outliers and potentially improving functional outcomes. In total hip arthroplasty, spinopelvic analysis mitigates instability risk, a critical factor for patients with spinal stiffness. Intraoperative technologies like robotics, patient-specific instruments and augmented reality improve the precision of implant placement and reduce radiation exposure in trauma. Beyond arthroplasty, AI accelerates early diagnosis of osteoarthritis, while molecular biomarkers (e.g., alpha-defensin) offer >95% accuracy in diagnosing periprosthetic joint infection. Finally, AI-guided digital platforms and motion tracking are used to deliver personalised rehabilitation protocols.

Precision medicine encompasses a wide range of powerful tools, many of which are already in clinical use. However, their full and effective integration requires continued research, long-term validation, cost-effectiveness analyses and interdisciplinary collaboration. The future of orthopaedics is anchored in delivering the right intervention for the right patient at the right time, guided by robust, individualised data and sound clinical judgement.

Level V.