Application progress and thinking of generative artificial intelligence in orthopedics clinical practice_West China Medical Journal

Authors：

LI Peifang , CHEN Xi , ZHANG Lin ,  CHEN Jiali ,  NING Ning

Department of Orthopedic Surgery, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

CHEN Jiali, Email: cjl85614115@163.com; NING Ning, Email: gkningning@126.com

Keywords：

Generative artificial intelligence; orthopedics; clinical decision support

DOI：

10.7507/1002-0179.202508103

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Generative artificial intelligence (AI) technology plays a significant role in enhancing data application capabilities, improving disease diagnosis and treatment plans, and advancing health management, drug development, genetic analysis, and precision medicine. However, due to the diagnostic complexity, treatment diversity, and high technical demands of orthopedic diseases, the application of generative AI in orthopedics is still in its early exploration stage. This paper, based on the experience of applying generative AI, summarizes the concept, working principles, progress of application in orthopedics, as well as the existing shortcomings and optimization strategies, aiming to provide valuable insights for the application of generative AI in orthopedics clinical practice.

Citation： LI Peifang, CHEN Xi, ZHANG Lin, CHEN Jiali, NING Ning. Application progress and thinking of generative artificial intelligence in orthopedics clinical practice. West China Medical Journal, 2025, 40(9): 1371-1375. doi: 10.7507/1002-0179.202508103 Copy

1.	李佩芳, 陳佳麗, 寧寧, 等. ChatGPT 在醫學領域的應用進展及思考. 華西醫學, 2023, 38(10): 1456-1460.
2.	白潔, 周進祝. ChatGPT 生成式 AI 時代《醫學統計學》教育的挑戰與應對. 繼續醫學教育, 2024, 38(8): 136-139.
3.	顏見智, 何雨鑫, 駱子燁, 等. 生成式大語言模型在醫療領域的潛在典型應用與面臨的挑戰. 醫學信息學雜志, 2023, 44(9): 23-31.
4.	Singhal K, Azizi S, Tu T, et al. Large language models encode clinical knowledge. Nature, 2023, 620(7972): 172-180.
5.	Peng C, Yang X, Chen A, et al. A study of generative large language model for medical research and healthcare. NPJ Digit Med, 2023, 6(1): 210.
6.	Wu C, Lin W, Zhang X, et al. PMC-LLaMA: toward building open-source language models for medicine. J Am Med Inform Assoc, 2024, 31(9): 1833-1843.
7.	吳騰. 生成式人工智能技術賦能智慧醫療建設的風險與規制. 醫學與社會, 2025, 38(3): 9-16.
8.	劉泓澤, 王耀國, 唐圣晟, 等. 醫學大語言模型的應用現狀與發展趨勢研究. 中國數字醫學, 2024, 19(8): 1-7, 13.
9.	王芳, 朱學坤, 劉清民, 等. 生成式人工智能研究進展. 圖書與情報, 2024(4): 45-64.
10.	王碩, 劉天語, 汪琛, 等. 試論生成式人工智能的醫療應用能力與風險邊界. 醫學與哲學, 2024, 45(12): 1-5.
11.	Chen Y, Esmaeilzadeh P. Generative AI in medical practice: in-depth exploration of privacy and security challenges. J Med Internet Res, 2024, 26: e53008.
12.	Zhu J, Jiang Y, Chen D, et al. High identification and positive-negative discrimination but limited detailed grading accuracy of ChatGPT-4o in knee osteoarthritis radiographs. Knee Surg Sports Traumatol Arthrosc, 2025, 33(5): 1911-1919.
13.	Temel MH, Erden Y, Ba?c?er F. Evaluating artificial intelligence performance in medical image analysis: sensitivity, specificity, accuracy, and precision of ChatGPT-4o on Kellgren-Lawrence grading of knee X-ray radiographs. Knee, 2025, 55: 79-84.
14.	Pagano S, Holzapfel S, Kappenschneider T, et al. Arthrosis diagnosis and treatment recommendations in clinical practice: an exploratory investigation with the generative AI model GPT-4. J Orthop Traumatol, 2023, 24(1): 61.
15.	Du K, Li A, Zuo QH, et al. Comparing artificial intelligence-generated and clinician-created personalized self-management guidance for patients with knee osteoarthritis: blinded observational study. J Med Internet Res, 2025, 27: e67830.
16.	Gan W, Ouyang J, She G, et al. ChatGPT’s role in alleviating anxiety in total knee arthroplasty consent process: a randomized controlled trial pilot study. Int J Surg, 2025, 111(3): 2546-2557.
17.	You M, Chen X, Liu D, et al. ChatGPT-4 and wearable device assisted intelligent exercise therapy for co-existing sarcopenia and osteoarthritis (GAISO): a feasibility study and design for a randomized controlled PROBE non-inferiority trial. J Orthop Surg Res, 2024, 19(1): 635.
18.	肖仰華, 徐一丹. 大規模生成式語言模型在醫療領域的應用: 機遇與挑戰. 醫學信息學雜志, 2023, 44(9): 1-11.
19.	Duffourc M, Gerke S. Generative AI in health care and liability risks for physicians and safety concerns for patients. JAMA, 2023, 330(4): 313-314.
20.	楊淑琪, 朱政, 王佳清, 等. 基于證據的醫療生成式人工智能大語言模型的構建和應用進展. 護士進修雜志, 2025, 40(12): 1317-1325.
21.	Preiksaitis C, Rose C. Opportunities, challenges, and future directions of generative artificial intelligence in medical education: scoping review. JMIR Med Educ, 2023, 9: e48785.
22.	Lusetti F, Maimaris S, La Rosa GP, et al. Applications of generative artificial intelligence in inflammatory bowel disease: a systematic review. Dig Liver Dis, 2025: S1590-8658(25)00734-0.
23.	施亦龍, 許鑫. ChatGPT 機器回答與知乎人工回答的比較. 圖書館論壇, 2024, 44(1): 151-159.
24.	Carroll AN, Storms LA, Malempati C, et al. Generative artificial intelligence and prompt engineering: a primer for orthopaedic surgeons. JBJS Rev, 2024, 12(10): e24.00122.
25.	宋筱璇, 徐丹, 張紫蘊, 等. 提示詞重構類型對 AI 生成內容效果的影響. 圖書館論壇, 2025, 45(4): 129-138.

1. 李佩芳, 陳佳麗, 寧寧, 等. ChatGPT 在醫學領域的應用進展及思考. 華西醫學, 2023, 38(10): 1456-1460.
2. 白潔, 周進祝. ChatGPT 生成式 AI 時代《醫學統計學》教育的挑戰與應對. 繼續醫學教育, 2024, 38(8): 136-139.
3. 顏見智, 何雨鑫, 駱子燁, 等. 生成式大語言模型在醫療領域的潛在典型應用與面臨的挑戰. 醫學信息學雜志, 2023, 44(9): 23-31.
4. Singhal K, Azizi S, Tu T, et al. Large language models encode clinical knowledge. Nature, 2023, 620(7972): 172-180.
5. Peng C, Yang X, Chen A, et al. A study of generative large language model for medical research and healthcare. NPJ Digit Med, 2023, 6(1): 210.
6. Wu C, Lin W, Zhang X, et al. PMC-LLaMA: toward building open-source language models for medicine. J Am Med Inform Assoc, 2024, 31(9): 1833-1843.
7. 吳騰. 生成式人工智能技術賦能智慧醫療建設的風險與規制. 醫學與社會, 2025, 38(3): 9-16.
8. 劉泓澤, 王耀國, 唐圣晟, 等. 醫學大語言模型的應用現狀與發展趨勢研究. 中國數字醫學, 2024, 19(8): 1-7, 13.
9. 王芳, 朱學坤, 劉清民, 等. 生成式人工智能研究進展. 圖書與情報, 2024(4): 45-64.
10. 王碩, 劉天語, 汪琛, 等. 試論生成式人工智能的醫療應用能力與風險邊界. 醫學與哲學, 2024, 45(12): 1-5.
11. Chen Y, Esmaeilzadeh P. Generative AI in medical practice: in-depth exploration of privacy and security challenges. J Med Internet Res, 2024, 26: e53008.
12. Zhu J, Jiang Y, Chen D, et al. High identification and positive-negative discrimination but limited detailed grading accuracy of ChatGPT-4o in knee osteoarthritis radiographs. Knee Surg Sports Traumatol Arthrosc, 2025, 33(5): 1911-1919.
13. Temel MH, Erden Y, Ba?c?er F. Evaluating artificial intelligence performance in medical image analysis: sensitivity, specificity, accuracy, and precision of ChatGPT-4o on Kellgren-Lawrence grading of knee X-ray radiographs. Knee, 2025, 55: 79-84.
14. Pagano S, Holzapfel S, Kappenschneider T, et al. Arthrosis diagnosis and treatment recommendations in clinical practice: an exploratory investigation with the generative AI model GPT-4. J Orthop Traumatol, 2023, 24(1): 61.
15. Du K, Li A, Zuo QH, et al. Comparing artificial intelligence-generated and clinician-created personalized self-management guidance for patients with knee osteoarthritis: blinded observational study. J Med Internet Res, 2025, 27: e67830.
16. Gan W, Ouyang J, She G, et al. ChatGPT’s role in alleviating anxiety in total knee arthroplasty consent process: a randomized controlled trial pilot study. Int J Surg, 2025, 111(3): 2546-2557.
17. You M, Chen X, Liu D, et al. ChatGPT-4 and wearable device assisted intelligent exercise therapy for co-existing sarcopenia and osteoarthritis (GAISO): a feasibility study and design for a randomized controlled PROBE non-inferiority trial. J Orthop Surg Res, 2024, 19(1): 635.
18. 肖仰華, 徐一丹. 大規模生成式語言模型在醫療領域的應用: 機遇與挑戰. 醫學信息學雜志, 2023, 44(9): 1-11.
19. Duffourc M, Gerke S. Generative AI in health care and liability risks for physicians and safety concerns for patients. JAMA, 2023, 330(4): 313-314.
20. 楊淑琪, 朱政, 王佳清, 等. 基于證據的醫療生成式人工智能大語言模型的構建和應用進展. 護士進修雜志, 2025, 40(12): 1317-1325.
21. Preiksaitis C, Rose C. Opportunities, challenges, and future directions of generative artificial intelligence in medical education: scoping review. JMIR Med Educ, 2023, 9: e48785.
22. Lusetti F, Maimaris S, La Rosa GP, et al. Applications of generative artificial intelligence in inflammatory bowel disease: a systematic review. Dig Liver Dis, 2025: S1590-8658(25)00734-0.
23. 施亦龍, 許鑫. ChatGPT 機器回答與知乎人工回答的比較. 圖書館論壇, 2024, 44(1): 151-159.
24. Carroll AN, Storms LA, Malempati C, et al. Generative artificial intelligence and prompt engineering: a primer for orthopaedic surgeons. JBJS Rev, 2024, 12(10): e24.00122.
25. 宋筱璇, 徐丹, 張紫蘊, 等. 提示詞重構類型對 AI 生成內容效果的影響. 圖書館論壇, 2025, 45(4): 129-138.

West China Medical Journal

Application progress and thinking of generative artificial intelligence in orthopedics clinical practice

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content