Generative artificial intelligence as a research partner in orthopaedics: State of the art

The integration of artificial intelligence (AI) into medicine has progressed from discriminative models to generative AI (GenAI), which can synthesize novel content. For orthopaedic surgeons, scientific publication remains a vital marker of academic success but is often constrained by clinical workload. This review proposes a structured, practical framework to help orthopaedists effectively harness AI tools, transitioning from opaque, "black box" generation to grounded, verifiable research assistance through retrieval-augmented generation (RAG). A PubMed search was conducted to explore the application of GenAI in the context of orthopaedic scientific research. An interactive review with experts in GenAI was also conducted, from which the proposed structure was developed. From this synthesis, a three-phase workflow is proposed: (1) evidence selection using semantic discovery systems to identify and map relevant literature beyond keyword matching; (2) data extraction and synthesis employing RAG-based systems to anchor AI responses to verified PDF sources, thereby minimizing hallucinations; and (3) drafting and refining using large language models (LLMs) for structured composition, linguistic clarity, and iterative manuscript improvement. The workflow integrates platform features to enhance efficiency, accuracy, and accessibility in orthopaedic research. When applied within a controlled, evidence-grounded environment, these systems can automate literature synthesis, expedite data extraction, and assist with scientific writing, while preserving authorial intent and accountability. However, challenges remain. Risks include algorithmic bias, "hallucinations", privacy concerns, and ethical issues related to authorship. Despite these limitations, AI represents a paradigm shift in orthopaedic scholarship, functioning as a cognitive exoskeleton that augments rather than replaces human expertise. With vigilant human oversight and adherence to journal ethics, orthopaedic surgeons can leverage AI to enhance research productivity, reproducibility, and quality while upholding the highest standards of scientific integrity.