HSS Study Finds AI Tool Improves Patient Readiness for Joint Replacement Surgery
Preparing for major orthopedic procedures like hip or knee replacement can be an overwhelming experience for patients. The process often brings a flood of questions about pain, recovery, and what to expect during and after surgery. Recognizing these challenges, researchers at the Hospital for Special Surgery (HSS) in New York have explored an innovative way to bridge communication gaps and enhance patient confidence through the use of artificial intelligence (AI).
At the American Association of Hip and Knee Surgeons (AAHKS) annual meeting, HSS researchers presented groundbreaking findings showing that an AI-based educational tool can effectively prepare patients for joint replacement surgery. Their study demonstrated that AI can serve as a reliable, personalized, and accessible educational companion, helping patients feel more supported both before and after surgery.
Personalized AI for Orthopedic Patients
To conduct the study, HSS researchers partnered with Aidify, a company specializing in medical AI solutions, to create a custom-tailored AI (CTAI) platform. This system was trained on educational materials specifically developed and approved by HSS orthopedic surgeons. By using authentic and validated clinical information, the chat-based platform provided accurate and surgeon-specific answers to patient questions about their upcoming total joint arthroplasty (TJA) procedures — including hip and knee replacements.
According to Dr. Eytan M. Debbi, MD, PhD, senior author of the study and hip and knee replacement surgeon at HSS, the initiative focused on addressing a critical gap in patient education. “Our study showed that most patients found the technology easy to use and helpful in making them feel ready and confident going into surgery,” said Dr. Debbi. “This tool not only improved their understanding but also provided reassurance that they were receiving information directly aligned with their surgeon’s guidance.”
Patients in the trial were given access to the CTAI system via a secure email link. Once logged in, they could type questions related to their specific surgery and receive instant, personalized answers from the chatbot. The AI was able to provide explanations on a variety of topics, ranging from surgical preparation and pain management to dietary restrictions and post-operative care routines.
Enhancing Understanding and Reducing Anxiety
For many orthopedic patients, especially those undergoing joint replacement, pre-surgical anxiety can be high. Traditional patient education materials—such as pamphlets and printed guides—are often difficult to interpret, overly general, or insufficiently tailored to individual concerns.
The CTAI tool, however, offered an interactive and dynamic alternative. “This platform can provide round-the-clock access to reliable, doctor-specific guidance and reduce the risk of getting inaccurate or irrelevant information from other general-purpose tools like Google or ChatGPT,” explained Dr. Karlos Zepeda, DO, the study’s lead author and clinical research coordinator at HSS.
In essence, the AI system served as a virtual extension of the surgical team, available 24/7 to address patient concerns. Patients could revisit topics multiple times and clarify details without feeling rushed—an advantage that can be difficult to achieve in traditional clinical interactions.
Key Findings from the Study
The study involved 40 patients scheduled to undergo hip or knee replacement at HSS. Of these, 32 patients actively engaged with the chatbot platform. The results were highly encouraging:
- 85% of patients said they understood the responses provided by the AI.
- 75% reported that the tool helped them feel well prepared for surgery.
- More than 80% stated that they would recommend the platform to others preparing for similar procedures.
Dr. Debbi highlighted how patient confidence improved as a result of constant access to accurate information. “Patients find comfort knowing they can reach out to the chatbot anytime,” he said. “It gives them the sense that they are always connected to our office and can get their questions answered whenever they need it.”
The CTAI tool fielded a wide range of patient questions, most of which were submitted before surgery. Common topics included:
- Pre-surgical activity and exercise guidelines
- Medication use and restrictions
- Post-operative recovery timelines
- Pain and wound management
- Possible complications and follow-up instructions
As patients transitioned through surgery and recovery, the volume of questions decreased—indicating that the AI effectively addressed their primary concerns early in the care journey.
Improving Health Literacy and Engagement
One of the most significant outcomes of the study was the improvement in patient health literacy. According to Dr. Zepeda, the AI-enabled platform not only enhanced understanding but also promoted a stronger sense of empowerment and preparedness among patients.
“Our findings show that CTAI improves patients’ health literacy, which enables more understanding, confidence, and preparedness before surgery,” he said. “This directly impacts patients’ overall satisfaction and care experience.”
Enhanced health literacy is a key determinant of surgical outcomes. Patients who clearly understand their care plans are more likely to follow preoperative instructions, manage post-surgical recovery effectively, and avoid complications that could lead to readmissions.
Bridging the Age Gap in Technology Use
One of the study’s most surprising findings was how easily older patients—many of whom were in their 60s and 70s—adapted to the AI platform. Orthopedic surgeons had initially expressed concern that older adults might find the chatbot format intimidating or confusing.
However, this proved not to be the case. “I was surprised that older patients were able to deal with the technology as easily as they did and be as satisfied as they were with it,” said Dr. Debbi. “Some even preferred interacting with the chatbot over their surgeon.”
This preference underscores a crucial advantage of AI in healthcare communication: constant availability without physician burnout. “Surgeons cannot be available to patients 24 hours a day,” Dr. Debbi explained. “But AI can review things with multiple patients at a time, whenever and as many times as they want, without overburdening staff.”
Reducing Staff Workload and Streamlining Communication
The use of CTAI has implications beyond patient education—it also offers operational benefits to clinical teams. By addressing common, repetitive questions in real time, the system can reduce the workload on surgeons and nursing staff.
“The power of AI can extend the surgeon and their team to more patients by efficiently addressing patient concerns and ensuring they consistently receive the right information exactly as their surgeon intended,” said Dr. Zepeda.
If the chatbot encounters a question outside its programmed knowledge base or detects an urgent issue, it immediately instructs patients to contact their doctor, call 911, or use the MyChart/Epic patient portal to reach their provider. Each flagged query is reviewed and escalated to ensure patient safety and that no issue goes unresolved.
“We are still in the research phase and very carefully monitor every question that comes in to make sure nothing slips through the cracks,” Dr. Zepeda added.
About HSS
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 16th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2024-2025), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2025-2026). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a fifth consecutive year (2025). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.
