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We conducted a narrative review exploring the bioethical considerations of AI use in the orthopedic clinical setting, focusing on 4 core principles\u2014autonomy, beneficence, nonmaleficence, and justice\u2014to provide orthopedists with a practical framework for AI\u2019s implementation. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework to conduct a comprehensive PubMed search; 89 articles were evaluated and 23 met our inclusion criteria. Across these studies, bioethical considerations for the clinical implementation of AI tools consistently emerged, most commonly concerning privacy, bias, transparency, informed consent, and regulation. We offer recommendations for strengthening privacy safeguards, adopting bias mitigation strategies, improving transparency through explainable AI tools, and establishing clear regulatory frameworks with lifecycle evaluation.<\/jats:p>","DOI":"10.1177\/15563316251340303","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T01:22:16Z","timestamp":1748654536000},"page":"274-282","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Bioethical Considerations of Deploying Artificial Intelligence in Clinical Orthopedic Settings: A Narrative Review"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6943-3088","authenticated-orcid":false,"given":"Lulla V.","family":"Kiwinda","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-109X","authenticated-orcid":false,"given":"Sophia D.","family":"Kocher","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna R.","family":"Bryniarski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian A.","family":"Pean","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA"},{"name":"Duke Margolis Institute for Health Policy, Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.52312\/jdrs.2022.57906"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/frai.2024.1477447"},{"key":"e_1_3_2_4_2","article-title":"A comprehensive exploration of artificial intelligence in orthopaedics within lower-middle-income countries: a narrative review","volume":"74","author":"Banatwala U","year":"2024","unstructured":"Banatwala U, Ibrahim MT, Shaikh RH, Shahzad H, Hoodbhoy Z, Noordin S. 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