# A Progressive Risk Formulation for Enhanced Deep Learning based Total Knee Replacement Prediction in Knee Osteoarthritis

arXiv: https://arxiv.org/abs/2406.10119 · HTML: https://mlsanity.com/paper/2406.10119/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 11 of its 46 references that are in the map.
- First posted on arXiv 14 Jun 2024.

## Builds on (most cited first, 11 of 11)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [Automatic Knee Osteoarthritis Diagnosis from Plain Radiographs: A Deep Learning-Based Approach](https://mlsanity.com/paper/1710.10589/) (2017)
- [Multimodal Machine Learning-based Knee Osteoarthritis Progression Prediction from Plain Radiographs and Clinical Data](https://mlsanity.com/paper/1904.06236/) (2019)
- [Automatic Grading of Individual Knee Osteoarthritis Features in Plain Radiographs using Deep Convolutional Neural Networks](https://mlsanity.com/paper/1907.08020/) (2019)
- [Learning to Compare Longitudinal Images](https://mlsanity.com/paper/2304.02531/) (2023)
- [Deep learning predicts total knee replacement from magnetic resonance images](https://mlsanity.com/paper/2002.10591/) (2020)
- [Deep learning-based algorithm for assessment of knee osteoarthritis severity in radiographs matches performance of radiologists](https://mlsanity.com/paper/2207.12521/) (2022)
- [Automated Detection of Patellofemoral Osteoarthritis from Knee Lateral View Radiographs Using Deep Learning: Data from the Multicenter Osteoarthritis Study (MOST)](https://mlsanity.com/paper/2101.04350/) (2021)

## Built on by (most cited first, 1 of 1)

- [Self-Supervised Learning for Knee Osteoarthritis: Diagnostic Limitations and Prognostic Value of Hospital Data](https://mlsanity.com/paper/2603.24903/) (2026)

## Abstract (arXiv)

We developed deep learning models for predicting Total Knee Replacement (TKR) need within various time horizons in knee osteoarthritis patients, with a novel capability: the models can perform TKR prediction using a single scan, and furthermore when a previous scan is available, they leverage a progressive risk formulation to improve their predictions. Unlike conventional approaches that treat each scan of a patient independently, our method incorporates a constraint based on disease's progressive nature, ensuring that predicted TKR risk either increases or remains stable over time when multiple scans of a knee are available. This was achieved by enforcing a progressive risk formulation constraint during training with patients who have more than one available scan in the studies. Knee radiographs and MRIs from the Osteoarthritis Initiative (OAI) and Multicenter Osteoarthritis Study (MOST) were used in this work and deep learning models were trained to predict TKR within 1, 2, and 4-year time periods. The proposed approach, utilizing a dual-model risk constraint architecture, demonstrated superior performance compared to baseline - conventional models trained with standard binary cross entropy loss. It achieved an AUROC of 0.87 and AUPRC of 0.47 for 1-year TKR prediction on the OAI radiograph test set, considerably improving over the baseline AUROC of 0.79 and AUPRC of 0.34. For the MOST radiograph test set, the proposed approach achieved an AUROC of 0.77 and AUPRC of 0.25 for 1-year predictions, outperforming the baseline AUROC of 0.71 and AUPRC of 0.19. Similar trends were observed in the MRI testsets