An apparatus includes a processor and a non-transitory memory. The processor is configured to receive pre-operative patient specific data. The pre-operative patient specific data is inputted to a first machine learning model to determine a first predicted post-operative joint performance data output including first predicted post-operative outcome metrics. A reconstruction plan of the joint of the patient is generated based on a medical image of the joint, and at least one arthroplasty surgical parameter obtained from the user. The at least one arthroplasty surgical parameter is inputted into a second machine learning model to determine a second predicted post-operative joint performance data output including second predicted post-operative outcome metrics. The second predicted post-operative joint performance data output is updated to include an arthroplasty surgery recommendation, in response to the user varying the at least one arthroplasty surgical parameter, before the arthroplasty surgery, during the arthroplasty surgery, or both.