ARTIFICIAL INTELLIGENCE IN THE EARLY DETECTION AND PROGRESSION PREDICTION OF OSTEOARTHRITIS: A NARRATIVE REVIEW OF CURRENT TECHNOLOGIES AND CLINICAL IMPLICATIONS

Authors

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.5620

Keywords:

Osteoarthritis, Artificial Intelligence, Deep Learning, Early Detection, Large Language Models, Clinical Implications

Abstract

Background and Objectives: Knee Osteoarthritis (KOA) is a leading cause of global disability, yet current management remains reactive due to the limitations of the Kellgren-Lawrence (KL) grading system. This review aims to synthesize technological advancements from 2018–2026 to provide a framework for AI-driven precision orthopedics.

Methods: A comprehensive narrative review was conducted by searching major electronic databases for peer-reviewed research focusing on AI-driven KOA diagnostics and prognosis. Evidence was categorized into seven thematic domains, ranging from automated grading to omics-based molecular discovery.

Findings: Technical analysis reveals that multi-stage pipelines utilizing YOLOv2 and Faster R-CNN isolate joint spaces with over 98% accuracy, reducing diagnostic errors by 5–7%. Natural Language Processing (NLP) models, specifically BiLSTM architectures, identify KOA risk 24 to 36 months before radiographic confirmation with an AUC of 0.911. Multi-modal frameworks like LBTRBC-M achieve a predictive AUC of 0.913 for structural progression and improve the prognostic accuracy of resident physicians from approximately 45% to over 66%. Furthermore, Generative AI (GPT-4) delivers personalized patient guidance 14 times faster than clinicians. In molecular research, AI has identified PDK1 as a critical regulatory gene for chondrocyte autophagy.

Conclusions: AI is shifting KOA management from reactive diagnosis to proactive health forecasting. However, the wide-scale adoption of these technologies depends on robust socio-ethical governance, addressing algorithmic bias, and fostering trust through Explainable AI. Future frontiers include the development of "digital twins" and integrated omics-imaging models.

References

Abdullah, S. S., & Rajasekaran, M. P. (2022). Automatic detection and classification of knee osteoarthritis using deep learning approach. La Radiologia Medica, 127(4), 398–406. https://doi.org/10.1007/s11547-022-01476-7

Aldhafeeri, F. M. (2025). Governing artificial intelligence in radiology: A systematic review of ethical, legal, and regulatory frameworks. Diagnostics, 15(18), 2300. https://doi.org/10.3390/diagnostics15182300

Bugday, B., Bingol, H., Yildirim, M., & Alatas, B. (2025). Enhancing knee osteoarthritis detection with AI, image denoising, and optimized classification methods and the importance of physical therapy methods. PeerJ Computer Science, 10, e2310. http://dx.doi.org/10.7717/peerj-cs.2766

Butler, D., Hilton, A., & Carneiro, G. (2025). Risk estimation of knee osteoarthritis progression via predictive multi-task modelling from efficient diffusion model using X-ray images. arXiv. https://doi.org/10.48550/arXiv.2506.14560

Chen, P., Gao, L., Shi, X., Allen, K., & Yang, L. (2019). Fully automatic knee osteoarthritis severity grading using deep neural networks with a novel ordinal loss. Computerized Medical Imaging and Graphics, 75, 84–92. https://doi.org/10.1016/j.compmedimag.2019.06.002

Du, K., Li, A., Zuo, Q.-H., Zhang, C.-Y., Guo, R., Chen, P., ... & Li, S.-M. (2025). Comparing artificial intelligence-generated and clinician-created personalized self-management guidance for patients with knee osteoarthritis: Blinded observational study. Journal of Medical Internet Research, 27, e67830. https://doi.org/10.2196/67830

Guan, B., Liu, F., Haj-Mirzaian, A., Demehri, S., Samsonov, A., Guermazi, A., & Kijowski, R. (2022). Deep learning approach to predict pain progression in knee osteoarthritis. Skeletal Radiology, 51(2), 363–373. https://doi.org/10.1007/s00256-021-03773-0

Joseph, G. B., McCulloch, C. E., Nevitt, M. C., Lane, N. E., Majumdar, S., & Link, T. M. (2025). Machine learning models for clinical and structural knee osteoarthritis prediction: Recent advancements and future directions. Osteoarthritis and Cartilage Open, 7, 100654. https://doi.org/10.1016/j.ocarto.2025.100654

Liu, Y., Molchanov, V., Brass, D., & Yang, T. (2025a). Recent advances in omics and the integration of multi-omics in osteoarthritis research. Arthritis Research & Therapy, 27, 100. https://doi.org/10.1186/s13075-025-03563-2

Liu, Y., Xiao, G., Zhang, Y., Wang, X., Jia, J., Xie, A., ... & Zhang, K. (2025b). Predictive value of machine learning in knee osteoarthritis progression: Systematic review and meta-analysis. Journal of Medical Internet Research, 27, e80430. https://doi.org/10.2196/80430

Ma, Z., Liu, Y., Zhang, Z., Chen, R., Fan, H., Cao, X., & Ni, L. (2025). Clinical applications of large language models in knee osteoarthritis: A systematic review. Frontiers in Medicine, 12, 1670824. https://doi.org/10.3389/fmed.2025.1670824

Ou, J., Zhang, J., Alswadeh, M., Zhu, Z., Tang, J., Sang, H., & Lu, K. (2025). Advancing osteoarthritis research: The role of AI in clinical, imaging and omics fields. Bone Research, 13, 48. https://doi.org/10.1038/s41413-025-00423-2

Pham, T. (2025). Ethical and legal considerations in healthcare AI: Innovation and policy for safe and fair use. Royal Society Open Science, 12(3), 241873. https://doi.org/10.1098/rsos.241873

Shahid, S., Wali, A., Javaid, A., Zikria, S., Osman, O., & Rasheed, J. (2025). Potential of AI-based diagnostic grading system for knee osteoarthritis. Frontiers in Medicine, 12, 1707588. https://doi.org/10.3389/fmed.2025.1707588

Sharma, D. (2026). Artificial intelligence, machine learning and omic data integration in osteoarthritis. Osteoarthritis and Cartilage, 34, 311–320. https://doi.org/10.1016/j.joca.2025.10.012

Sun, Y., Liu, J., Deng, C., Peng, C., Pan, S., & Liu, X. (2026). Nomograms based on X-ray radiomics for predicting pain progression in knee osteoarthritis using data from the Foundation for the National Institutes of Health: Development and validation study. JMIR Medical Informatics, 14, e78338. https://doi.org/10.2196/78338

Tandon, M., Chetla, N., Mallepally, A., Zebari, B., Samayamanthula, S., Silva, J., ... & Sukhija, K. (2025). Can artificial intelligence diagnose knee osteoarthritis? JMIR Biomedical Engineering, 10, e67481. https://doi.org/10.2196/67481

Thanyakunsajja, N., Jitkajornwanich, K., Xu, S., Shin, D., & Charoenporn, P. (2025). Early diagnosis of knee osteoarthritis with a natural language processing-driven approach based on clinician notes: Development and validation study. JMIR Formative Research, 9, e64536. https://doi.org/10.2196/64536

Tiulpin, A., Thevenot, J., Rahtu, E., Lehenkari, P., & Saarakkala, S. (2018). Automatic knee osteoarthritis diagnosis from plain radiographs: A deep learning-based approach. Scientific Reports, 8, 1727. https://doi.org/10.1038/s41598-018-20132-7

Tolpadi, A. A., Lee, J. J., Pedoia, V., & Majumdar, S. (2020). Deep learning predicts total knee replacement from magnetic resonance images. Scientific Reports, 10, 6371. https://doi.org/10.1038/s41598-020-63395-9

Wang, C.-T., Chang, K.-T., Lai, F., Pao, J.-L., Lin, S.-M., & Chang, C.-H. (2025). Simplifying knee OA prognosis: A deep learning approach using radiographs and minimal clinical inputs. Diagnostics, 15(19), 2543. https://doi.org/10.3390/diagnostics15192543

Wang, T., Liu, H., Zhao, W., Cao, P., Li, J., Chen, T., ... & Li, S.-M. (2025). Predicting knee osteoarthritis progression using neural network with longitudinal MRI radiomics, and biochemical biomarkers: A modeling study. PLoS Medicine, 22(8), e1004665. https://doi.org/10.1371/journal.pmed.1004665

Downloads

Published

2026-03-25

How to Cite

Piotr Tryczyński, Jakub Wrona, Jakub Sałak, Piotr Helbin, Aleksandra Gralec, Sebastian Ożga, Wiktoria Donocik, & Aleksandra Spirkowicz. (2026). ARTIFICIAL INTELLIGENCE IN THE EARLY DETECTION AND PROGRESSION PREDICTION OF OSTEOARTHRITIS: A NARRATIVE REVIEW OF CURRENT TECHNOLOGIES AND CLINICAL IMPLICATIONS. International Journal of Innovative Technologies in Social Science, 3(1(49). https://doi.org/10.31435/ijitss.1(49).2026.5620