Utilizing Atlas-Based Modeling to Predict Knee Joint Cartilage Degeneration: Data from the Osteoarthritis Initiative.

Currently, there are no clinically available tools or applications which could predict osteoarthritis development. Some computational models have been presented to simulate cartilage degeneration, but they are not clinically feasible due to time required to build subject-specific knee models. Therefore, the objective of this study was to develop a template-based modeling method for rapid prediction of knee joint cartilage degeneration. Knee joint models for 21 subjects were constructed with two different template approaches (multiple templates and one template) based on the MRI data. Geometries were also generated by manual segmentation. Evaluated volumes of cartilage degeneration for each subject, as assessed with the degeneration algorithm, were compared with experimentally observed 4 year follow up Kellgren-Lawrence (KL) grades. Furthermore, the effect of meniscus was tested by generating models with subject-specific meniscal supporting forces and those with the average meniscal supporting force from all models. All tested models were able to predict most severe cartilage degeneration to those subjects who had the highest KL grade after 4 year follow up. Surprisingly, in terms of statistical significance, the best result was obtained with one template approach and average meniscal support. This model was fully able to categorize all subjects to their experimentally defined groups (KL0, KL2 and KL3) based on the 4 year follow-up data. The results suggest that a template- or population-based approach, which is much faster than fully subject-specific, could be applied as a clinical prediction tool for osteoarthritis.