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Artificial Intelligence Applications in Implant Positioning, Dislocation Risk Prediction, and Surgical Indications in
Mihai Emanuel Gherghe1,2, Alex-Gabriel Grigore2, Iosif-Aliodor Timofticiuc1
1Faculty of Medicine, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Background:
Artificial intelligence (AI) is becoming increasingly integrated into orthopaedic surgery for tasks such as implant positioning, dislocation risk prediction, and surgical decision-making. However, the current evidence varies widely across anatomical regions and applications.
Methods:
A structured narrative review was conducted using PubMed and Web of Science Core Collection to identify studies applying machine learning or deep learning in orthopaedic procedures, focusing on parameters such as the anatomical region addressed, data types used, primary AI tasks, evaluation designs, and validation strategies. Reviews and meta-analyses were excluded. Study selection was summarized using a PRISMA-style flow diagram, and included studies were narratively synthesized according to anatomical region, AI task, imaging modality, validation strategy, and clinical relevance.
Results:
We identified three main application areas: (1) AI in imaging-driven planning and implant positioning, often linked with navigation or robotic systems; (2) postoperative evaluation related to implants; and (3) prediction of clinically relevant outcomes such as dislocation risk. The strongest evidence is found in hip arthroplasty, where AI improves measurement accuracy and workflow efficiency, whereas applications in knee, shoulder, and spine surgery are less developed and often supported by smaller studies. Although existing risk prediction models demonstrate good performance, their generalizability is hindered by limited external validation and inconsistent reporting.
Conclusions:
Overall, while AI shows significant promise in enhancing various aspects of orthopaedic surgery, stronger links between technical advancements and patient outcomes are needed. Future research should prioritize extensive validations, workflow-aware evaluations, failure analysis, and adherence to AI-specific reporting guidelines to facilitate safe and effective clinical implementation.
