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Artificial Intelligence-Based Proximal Bone Shape Asymmetry Analysis and Clinical Correlation with Cartilage
Rafeek Thahakoya1,2, Rupsa Bhattacharjee1, Misung Han1
1Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA.
Bioengineering (Basel, Switzerland)
|February 27, 2026
Summary
Hip osteoarthritis (OA) shows bone shape asymmetry linked to cartilage health and function. Region-specific asymmetry in the proximal femur correlates with impaired functional performance and altered acetabular cartilage T1rho values.
Area of Science:
- Orthopedics
- Radiology
- Biomedical Engineering
Background:
- Hip osteoarthritis (OA) is a degenerative joint disease affecting cartilage and bone.
- Proximal femur bone shape alterations are observed in hip OA, but their clinical significance remains unclear.
- Understanding the relationship between bone morphology, cartilage composition, and function is crucial for managing hip OA.
Purpose of the Study:
- To investigate proximal femur bone shape asymmetry in hip OA patients.
- To explore associations between bone shape asymmetry, cartilage composition, and functional performance.
- To evaluate the potential of bone shape features as imaging biomarkers for hip OA.
Main Methods:
- Bilateral hip MRI was performed on 47 hip OA participants using 3.0 T scanner with specific sequences.
- Automatic 3D proximal femur segmentation using a U-Net framework with human-in-the-loop refinement.
- Quantification of bone shape asymmetry, cartilage relaxation times (T1rho), and functional performance (chair stand test).
Main Results:
- Accurate proximal femur segmentation achieved (DSC: 96.48%, Hausdorff Distance: 4.66 mm).
- Increased posterior-lateral-superior bone asymmetry correlated with poorer chair stand test performance (rho = -0.41, p = 0.006).
- Anterior-lateral-inferior bone asymmetry positively correlated with acetabular cartilage T1rho values (rho = 0.37, p = 0.006).
Conclusions:
- Region-specific proximal femur bone shape asymmetry is associated with cartilage characteristics in hip OA.
- Bone shape features correlate with functional impairment, suggesting their potential as clinical imaging biomarkers.
- These findings highlight the intricate relationship between bone morphology, cartilage health, and functional outcomes in hip OA.
