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A practical guide to the implementation of AI in orthopaedic research—Part 7: Risks, limitations, safety and verification of medical AI systems

Philipp W. Winkler, Bálint Zsidai, Eric Hamrin Senorski, James A. Pruneski, Michael T. Hirschmann, Christophe Ley, Thomas Tischer, Elmar Herbst, Ayoosh Pareek, Volker Musahl, Jacob F. Oeding, Felix C. Oettl, Umile Giuseppe Longo, Kristian Samuelsson, Robert Feldt, ESSKA Artificial Intelligence Working Group

2025Journal of Experimental Orthopaedics14 citationsDOIOpen Access PDF

Abstract

Artificial intelligence (AI) has been influencing healthcare and medical research for several years and will likely become indispensable in the near future. AI is intended to support healthcare professionals to make the healthcare system more efficient and ultimately improve patient outcomes. Despite the numerous benefits of AI systems, significant concerns remain. Errors in AI systems can pose serious risks to human health, underscoring the critical need for safety, as well as adherence to ethical and moral standards, before these technologies can be integrated into clinical practice. To address these challenges, the development, certification, and deployment of medical AI systems must adhere to strict and transparent regulations. The European Commission has already established a regulatory framework for AI systems by enacting the European Union Artificial Intelligence Act. This review article, part of an AI learning series, discusses key considerations for medical AI systems such as reliability, accuracy, trustworthiness, lawfulness and legal compliance, ethical and moral alignment, sustainability, and regulatory oversight. Level of Evidence: Level V.

Topics & Concepts

CertificationHealth careEngineering ethicsSoftware deploymentRisk analysis (engineering)Patient safetyApplications of artificial intelligenceKnowledge managementComputer scienceEngineering managementEngineeringBusinessArtificial intelligencePolitical scienceLawOperating systemArtificial Intelligence in Healthcare and EducationClinical Reasoning and Diagnostic SkillsExplainable Artificial Intelligence (XAI)