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Orthopedic Surgery Practice & Decision Support

No patient is average.
Neither is the plan.

FirstAssistantAI is an AI first assistant for the orthopedic surgeon: it reads your case, weighs it against the current literature, and hands back the evidence-based plan, predicted outcome, op note, and codes in seconds. Everything is scored to the patient in front of you, not a population average. You make every call; it wins back your time.

See how scoring works
Free for every surgeon. No credit card.HIPAA compliant

Built by Edwin Chaharbakhshi, MD, a surgeon with a computer science background, for surgeons. Every recommendation is reviewed before it reaches you.

Case workspace
Reviewed
Case · ACL reconstruction
24M · pivoting athlete · + medial meniscus tear
88
Predicted outcome score
0/100
Evidence-based estimate of expected result for this plan
Return to sportL1
0%
1-yr graft survivalMeta
0%
Expected IKDC gainRCT
+0
Return to playCohort
~0 mo
Plan · BTB autograft, meniscus repair
29888~24.3 wRVU
ACL graft choiceMeta-analysis 2026Meniscus repair vs resectionRCT 2025Return-to-sport criteriaCohort 2025Tibial slope & graft failureLevel II 2025Rotator cuff repair augmentationRCT 2026TSA vs rTSA outcomesMeta-analysis 2025Hip labral repair outcomesCohort 2026Total ankle vs fusion functionMeta-analysis 2024
Why we exist

The way it has been

  • Care that varies from one surgeon to the next.
  • Evidence that never reaches the operating room.
  • “It went well” instead of outcomes anyone can measure.

That era is ending.

The best evidence in the world belongs in every operating room, calibrated to the patient in front of you. Not a population average. Not last decade's data. We are building the clinical decision layer for surgery. That is why it is free for every surgeon.

The clinical decision layer for surgery

What it is

One case in. The plan, the prediction, and the paperwork out. You make every decision; it measures every result.

0
studies appraised and evidence-graded
0
validated PROM instruments
0
procedure modules, and growing
Weekly
literature sync behind every recommendation
01It does the work for you

Less time on charting.More of the revenue you earned.

FirstAssistantAI takes on the lookup, the note, the coding, and the follow-up. It is the work that eats your day and quietly drains your margin, handed back to you done so your practice keeps the time and the money.

Notes drafted for you

The operative note and clinic documentation come back written and ready to review. Less charting after hours.

Revenue you stop missing

CPT and wRVU are derived from the plan, so you stop under-coding and capture every dollar you earned.

Follow-up on autopilot

PROMs and check-ins go out automatically, tracking outcomes without tying up your staff.

02The effortless record

Do the case once.The record writes itself.

One entry. Decision support, evidence, codes, op note, prognosis, and outcomes back in seconds.

Dictation / H&P
24M, acute ACL tear, pivoting athlete.
MRI: full-thickness ACL, medial meniscus repairable.
Exam: Lachman 2B, pivot shift 2+, slope 12°.
Plan: BTB autograft + meniscus repair.
Predicted outcomeReviewed
88
88/100
Evidence-based estimate
Return to sport85%
Graft survival93%
Op noteCPT 29888Prognosis~24.3 wRVU
1Enter the case once (paste or dictate)2Reviewed result returns in seconds3Op note, codes, and record written
Predicted outcome

This patient vs. the cohort

cohort avg ~72likely 80–9288406080100Predicted outcome score

The score is a calibrated likely range, not a single number, plotted against outcomes for similar cases. Tuned to this patient, not a population mean.

Paste or dictate

No new fields and no forms. Drop in a dictation or copy your existing note.

Op note and codes, drafted

The operative note, CPT, and wRVU come back drafted for your review. Capture every dollar you earned.

Seconds per patient

A full evidence-graded result comes back fast enough to use mid-clinic.

HIPAA compliant

Patient data is encrypted in transit and at rest and handled to HIPAA standards.

03Coverage

Shoulder to ankle.Scope to arthroplasty.

Seven evidence-graded procedure modules across the joints you operate on. New modules ship regularly.

3 pathways

Shoulder

Rotator cuffInstabilityTSA / rTSA
2 pathways

Hip

FAI / labral repairHip arthroplasty
3 pathways

Knee

ACL reconstructionMeniscusKnee arthroplasty / PFA
2 pathways

Ankle

Total ankle arthroplastyAnkle fusion
04How it works

Calibrated to your patient,not the population.

Each case is weighed against current evidence and adjusted for the patient in front of you. The full model is proprietary, and a clinician reviews every output before release.

  1. 01

    Read the case

    Diagnosis, imaging, exam, and history come together into a structured picture of the patient.

  2. 02

    Match the evidence to this patient

    The plan is broken into the decision points that matter, each weighed against current literature and adjusted for this patient's profile.

  3. 03

    Apply guardrails, then a clinician

    Imaging and intra-operative findings override the model. A clinician reviews the result before release.

  4. 04

    Return decision support and its paper trail

    You get a predicted outcome plus the prognosis, documentation, and billing that follow.

Explore a sample case:
Worked example · ACL reconstruction
24M · pivoting athlete · + medial meniscus tear
Inputs parsed
from one note
ActivityTegner 9
Lachman2B
Side-to-side6 mm
Pivot shift2+
Tibial slope12°
MeniscusMedial PH, repairable
Bone bruiseLateral FC
Time to OR3 wk
Findings surfaced
Posterior tibial slope 12°: elevated graft-failure risk, counsel and weigh slope management on any revision.
Meniscus tear in the red-red zone: repair favored over resection to preserve the cartilage long term.
Tegner 9 pivoting demand: BTB autograft prioritized for return-to-sport durability over hamstring.
Decision domains
Role in plan
Lvl IGraft selectionPrimary
Lvl IMeniscus managementSupporting
Lvl IISlope / revision riskSupporting
adjustPatient & activity factorsModifier

A sample of the factors considered, shown by role rather than exact weight. The full model weighs many more variables and is proprietary.

Imaging and intra-op findings override the model
Reviewed by a clinician before release
Predicted outcome
0/100
PrognosisDocumentationCPT 29888
Augmentation, not replacement

You make the call.It makes you sharper.

Decision support that surfaces the score and the evidence. The surgeon decides, always.

Decision support, not autonomous
05Always current

The literature updates weekly.So do your recommendations.

Every recommendation is cited and current. You never practice on last decade's data.

Anything older than 2018 is flagged for review, never used silently
Evidence librarySynced weekly
Studies graded2018 → now
+18 graded this week
Recently graded
ACL graft choice
NewMeta-analysis 2026
Meniscus repair vs resection
RCT 2025
Return-to-sport criteria
Cohort 2025
Anything older than 2018 is flagged for review
06Better for the patient

Patients feel the difference,not the software.

The same evidence that sharpens your plan gives patients a clearer, calmer experience.

Clearer expectations

Patients who understand their likely outcome, not just hear it went fine. Fewer surprises and less anxiety.

Shared decision-making

Walk through options with data they can see, not just reassurance, and decide together.

Closer follow-up

Automated check-ins capture how they are actually doing and surface the patients who need attention.

What your patient hearsPlain language
Likely back to sport~9 months
Expected functionGood to excellent
Re-tear risk discussed~7%
Grounded in current evidence, explained simply
07Self-improvement that knows you

Get better,measurably.

FirstAssistantAI tracks every outcome, benchmarks you against the national cohort, and shows you exactly where to grow.

You can't improve what you don't measure.

PROMs trajectory

Recovery, tracked to one year

IKDCKOOS-Sport
0255075100KOOS-Sport 44 · Pre-opKOOS-Sport 55 · 6 wkKOOS-Sport 68 · 3 moKOOS-Sport 82 · 6 moKOOS-Sport 91 · 1 yrIKDC 38 · Pre-opIKDC 47 · 6 wkIKDC 63 · 3 moIKDC 79 · 6 moIKDC 89 · 1 yrPre-op6 wk3 mo6 mo1 yr

Patient-reported outcomes captured automatically at each visit.

National benchmarking

You vs the national cohort

YouAll users
Return to sport0%
1-yr graft survival0%
1-yr IKDC (of 100)0
Follow-up PROM capture0%

Your results against every other surgeon on the platform and published benchmarks.

'Surgery went well' isn't data.Now you can prove it.

Structured PROMs turn every case into evidence of your results: for you, your patients, and your future partners or payers. As reimbursement increasingly follows outcome scores, you will already have the data to show.

For attendings

Everything one case produces.

Enter the case once and walk away with the full record, ready for your review.

Medical-legal documentation

Every decision documented and defensible, with the evidence cited and timestamped.

Prognosis handout

Patients understand their likely outcome, not just hear it went fine.

CPT and wRVU capture

Codes and bundling derived from the plan. Capture every dollar you earned.

PROMs enrollment

Outcomes captured automatically from pre-op through long-term follow-up.

National benchmarking

See where you stand against the national cohort and your own record.

The career log

From your first case to your thousandth, one record that follows you.

Free for residents and fellows

Walk into every case already prepared.

FirstAssistantAI builds the evidence-graded plan, pulls the relevant literature, and shows the reasoning behind each step, so you learn the why and not just the what. From your first case to your thousandth, it is the same record.

  • Case prep grounded in current evidence
  • Board-relevant reasoning, step by step
  • Citations you can actually go read
  • Verify with your program email
Get started free
For practices & groups

Outcomes infrastructure for the whole practice.

The platform is free for every surgeon individually. Enterprise adds the shared layer a group needs: standardized PROMs across every surgeon, dashboards for leadership, and the outcomes data that payers and value-based contracts increasingly require.

Practice-wide PROMs

One standardized outcomes pipeline across every surgeon and case. No chasing follow-ups.

Leadership dashboards

Outcomes by surgeon, procedure, and service line. See variation, prove quality.

Reimbursement-ready

The PROMs and quality data MIPS and payer contracts ask for, already collected.

Admin, roles, SSO & BAA

Centralized user management, single sign-on, and a practice-level Business Associate Agreement.

Priced per practice. We will scope it with you.
Practice outcomes
Live
Surgeons
0
PROM capture
0%
Cases tracked
0
PROM capture by service line
Sports medicine94%
Arthroplasty90%
Hand & upper ex88%
Foot & ankle81%
Aggregated and de-identified for reporting
Security & privacy

Built for clinical data.

Patient data is protected at every step, and it stays yours.

Encrypted in transit and at rest
HIPAA-aligned handling, Business Associate Agreement available
Your data is yours, and we never sell it
De-identified for research; patient identifiers protected
Role-based access and SSO for Enterprise
Every recommendation reviewed by a clinician
Pricing

Free for every surgeon.

The full platform is free for individual surgeons, residents and fellows included. Practices that want to collect outcomes across their whole group can talk to us about Enterprise.

Free

For every surgeon
Free
  • Full evidence-based scoring engine
  • Predicted outcome & prognosis
  • Documentation, op note & CPT/wRVU
  • Your own PROMs collection & tracking
  • National benchmarking
  • Current-literature recommendations

Enterprise

Let's talk
  • Everything in Free, across your whole group
  • Practice-wide PROMs collection
  • Group & cohort outcome dashboards
  • Service-line benchmarking
  • Reimbursement & value-based-care readiness
  • Admin, roles & SSO
  • Practice BAA & onboarding

Individual access is free with no credit card. Enterprise is priced per practice. Reach out and we will scope it with you.

FAQ

Common questions.

The questions surgeons ask us most, answered plainly.

No. It is clinical decision support. It surfaces evidence, a predicted-outcome estimate, and draft documentation for you to review. You make every clinical decision, and the software never acts on its own.

It is built and used as clinical decision support, not an autonomous or diagnostic device. It does not diagnose or treat. It presents evidence and recommendations for a licensed clinician to review and act on, and your judgment governs every case.

You are. The surgeon keeps full clinical authority and responsibility at all times. The tool informs your judgment rather than replacing it, and imaging and intra-operative findings always take priority over the model.

No. It is an evidence-based estimate of the likely result for a given plan, not a promise of any individual outcome. Results vary from patient to patient, and the estimate is meant to support your conversation with the patient, not stand in for it.

Each case is weighed against current, peer-reviewed orthopaedic literature and adjusted for the specific patient, and the evidence behind every recommendation is shown to you. The underlying model and its weighting are proprietary. Older evidence is flagged for review rather than used silently, and a clinician reviews outputs before they reach you.

Yes. Patient data is encrypted in transit and at rest and handled to HIPAA standards, and we provide a Business Associate Agreement. Your data is yours, and we do not sell it.

No. It is built to augment, not replace. It takes on the lookup and documentation burden so you and your team can focus on the patient, while you stay in control of every call.

You paste or dictate your note and get the result in seconds. There is no new system to learn and nothing to rip out and replace to get started.

Yes. The full platform is free for every individual surgeon, with no credit card, whether you are a resident, fellow, or attending. There is no catch. Our business is the practice-scale outcomes layer (Enterprise PROMs collection), not your data, and we do not sell your data.

Enterprise is for practices and groups that want to collect and benchmark patient-reported outcomes across all of their surgeons, with shared dashboards, admin and roles, and a practice-level agreement. It is priced per practice. Reach out and we will scope it with you.

Still have a question? Email us.

Onboarding now

Bring evidence to the table before the first incision.

Whether you are leading cases or preparing for them, this is the easiest way to put AI to work in your practice.