# When Intuition Meets the Algorithm: Medico-Legal Implications of Artificial Intelligence-Driven Decision-Making in Orthopedics

## TL;DR

This paper explores how AI is changing orthopedic surgery and the legal implications for healthcare professionals relying on these systems.

## Contribution

The paper introduces a medico-legal analysis of AI-driven decision-making in orthopedics, focusing on liability and stakeholder responsibilities.

## Key findings

- AI is reshaping decision-making in orthopedic surgery by providing predictive and analytical support.
- The use of AI is redefining human error and the relationship between surgeons and technology.
- Healthcare liability frameworks are being affected by the integration of AI in surgical practice.

## Abstract

Orthopedic surgery is undergoing a transformation driven by artificial intelligence (AI), which is reshaping clinico-surgical decision-making. While the operative strategy and professional responsibility traditionally relied on the surgeon’s intuition and manual skills, advanced algorithms now provide predictive, analytical, and procedural decision supports. This paradigm shift is redefining the concept of human error as well as the relationship between technological tools and human decision-makers. As a result, the foundational elements of the healthcare liability framework are being affected. This paper offers a narrative discussion on selected applications of artificial intelligence in orthopedic surgical practice, including patient risk stratification, surgical indication and prosthesis positioning, with a particular focus on the liability implications for healthcare professionals who rely on these systems in terms of therapeutic decision-making. The aim is then to provide a comprehensive medico-legal perspective within the highly regulated and high-risk field of biomedicine, acknowledging and critically assessing the roles and responsibilities of all stakeholders involved—patients, healthcare professionals, innovative technologies, healthcare organizations, and facility management—while balancing innovation, evidence-based practice, and accountability in healthcare delivery.