Generative artificial intelligence (AI) technology plays a significant role in enhancing data application capabilities, improving disease diagnosis and treatment plans, and advancing health management, drug development, genetic analysis, and precision medicine. However, due to the diagnostic complexity, treatment diversity, and high technical demands of orthopedic diseases, the application of generative AI in orthopedics is still in its early exploration stage. This paper, based on the experience of applying generative AI, summarizes the concept, working principles, progress of application in orthopedics, as well as the existing shortcomings and optimization strategies, aiming to provide valuable insights for the application of generative AI in orthopedics clinical practice.