Artificial intelligence in orthopedic regenerative medicine: from design to clinical translational pathways

Orthopedic regenerative medicine (ORM) addresses musculoskeletal disorders in which effective repair requires coordinated structural reconstruction, biological repair, mechanical adaptation, and functional recovery. These processes generate heterogeneous information across biomaterials, construct design, imaging, intraoperative execution, rehabilitation monitoring, and clinical follow-up. Artificial intelligence (AI) is increasingly relevant for organizing multimodal data and supporting decision-making across regenerative care. This review summarizes current applications of AI in ORM, focusing on regenerative design and fabrication, intraoperative guidance, postoperative monitoring, repair evaluation, and clinical translational pathways. In regenerative design, AI can assist the optimization of material composition, scaffold architecture, biofabrication parameters, and construct performance by linking design variables with biological and biomechanical outcomes. During intervention and recovery, AI-supported systems may improve defect-specific spatial matching, support longitudinal functional assessment, and help identify delayed or unfavorable repair trajectories through integrated analysis of imaging, wearable, and clinical data. The review also discusses translational challenges, including data heterogeneity, limited external validation, algorithmic bias, interpretability, regulatory requirements, and governance constraints. AI may help connect design, intervention, monitoring, and feedback within a continuous analytical workflow, but future progress will require robust datasets, prospective validation, clinically interpretable models, and implementation strategies aligned with regenerative practice.