Patient Perceptions of Artificial Intelligence in Orthopaedic Surgery: Identifying Potential Barriers to Acceptance...

Despite growing enthusiasm for artificial intelligence (AI) implementation in orthopaedic care, patient attitudes toward AI adoption remain unexplored. This study assesses patient perceptions of AI integration in diagnosis, treatment, and patient communication in orthopaedic surgery.

A 28-question survey was administered to patients in hand surgery, orthopaedic oncology, and joint replacement surgery clinics. The survey queried patients' baseline comfort with AI and its perceived strengths, weaknesses, risks, and benefits.

Among 300 patients, the median age was 59 years. Most (55.2%) were comfortable with AI-assisted radiologic diagnosis, 58.3% with robot-assisted surgery, and 34.7% with AI-driven communication tools. Higher education and income correlated with greater AI acceptance (P < 0.001). Patients with lower education levels perceived fewer benefits in daily AI use and a less positive impact of surgical outcomes (P = 0.03, P = 0.05). Common concerns included loss of patient-surgeon relationships (70.0%), surgeon overreliance on AI (56.9%), and lack of individualized care (51.5%). Men were more accepting of AI use in diagnosis and surgery (P < 0.03), whereas women were more concerned about AI perpetuating biases (P = 0.05). Older patients were less comfortable with using AI for diagnostics (P < 0.001).

As AI implementation in orthopaedic care expands, women, older patients, and patients with lower education and household income levels may feel less comfortable with AI integration, threatening their quality of clinical care. Universal concerns about AI implementation include AI potentially weakening the patient-surgeon relationship. Targeted patient education efforts to address common concerns about AI adoption will enable orthopaedic surgeons to responsibly integrate these tools into practice.