The integration of artificial intelligence (AI) into orthopaedic practice is rapidly becoming a clinical reality rather than a theoretical prospect. This review reframes the discussion from the fear of physician replacement to the concept of augmentation of clinical expertise.

It examines the risks of deskilling, defined as the loss of existing competencies, and never-skilling, where trainees fail to acquire fundamental skills due to early reliance on automated systems. At present, most AI applications function as supportive tools rather than autonomous agents, helping reduce administrative burden and improve diagnostic standardization. This creates an opportunity for upskilling, allowing clinicians to dedicate more time to higher-value clinical activities.

However, achieving this benefit requires deliberate educational strategies that emphasize critical oversight, ensuring physicians retain responsibility for validating AI outputs. In the foreseeable future, AI is unlikely to replace orthopaedic surgeons but will instead reshape their professional role. By automating routine tasks, it may enable physicians to focus more on complex decision-making, procedural excellence, and patient-centered care.

The key challenge will be ensuring that AI remains a tool for professional advancement rather than a driver of clinical skill erosion.