Artificial Intelligence Scribes in Orthopaedic Surgery: A Narrative Review.

INTRODUCTION: The growing applications of artificial intelligence (AI) is transforming the healthcare landscape by reshaping diagnostics, workflow operations, and clinical decision making. Among its most promising application in surgery is the development of AI scribes designed to reduce the burden of documentation. This review examines standard and emerging documentation tools with a focus on orthopaedic surgery.

METHODS: A narrative review of the applications of AI and AI scribes in orthopaedic surgery was done. Literature searches were conducted using PubMed and Google Scholar through July 2025. Keywords included AI, documentation, scribes, AI scribes, and electronic health record. Articles were included if they focused on clinical documentation with particular relevance to orthopaedic surgery. In addition, a targeted review of commercially available AI scribe platforms was conducted, extracting advertised features including orthopaedic note tailoring, EHR integration, security policies, cost, strengths, and potential areas of consideration.

RESULTS: The standard documentation approaches, including human transcription services, medical scribes, and frontend speech recognition software, provide partial relief from documentation burden but remain limited by cost, scalability, and workflow integration. Although human transcription services and medical scribes can capture nuanced clinical information and provide real-time support, they are constrained by turnaround time, financial burden, and scalability challenges. By contrast, emerging AI scribe platforms offer EHR-integrated, ambient documentation solutions but vary widely in cost, scalability, and orthopaedic-specific customization, highlighting ongoing challenges in addressing the unique documentation demands of orthopaedic practice.

DISCUSSION: AI scribes represent a promising evolution in clinical documentation for orthopaedic surgery. Although early results are encouraging, further specialty-specific validation is needed to address orthopaedic workflows, ensure accuracy, and define optimal implementation strategies; however, ethical considerations and patient privacy protections remain essential to safe and responsible implementation.