Knee Osteoarthritis Labeling Assistant

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Knee osteoarthritis (Knee-OA) is a debilitating bone and joint disease with the potential to necessitate joint replacement. It poses a significant health concern, as it carries a substantial lifetime risk of 45% [1]. This condition affects an enormous population, with over 200 million patients worldwide [2]. Furthermore, the high prevalence of knee X-rays in the European Union in 2020, totaling approximately 100 million [3], underscores the urgent need for effective strategies to manage and treat Knee-OA.


Radiographs not related to pain over time

Cost driver


KOALA enhances physician agreement rates, offers precise measurements, and streamlines workflow for more efficient knee X-ray assessments.

Reliable measurements

87% sensitivity and 83% specificity discerning mild from moderate and severe knee OA based on KL score (>=2) [5]

Standardized reading

23% increase in physician’s agreement rate to gold standard [6]

Increased throughput

Workflow time savings range up to 25 days per year



Knee-OA has a lifetime risk of 45%



Over 200M knee-OA patients worldwide


K €

The annual cost per patient ranges up to €10k

Product description

KOALA supports physicians in detecting signs of knee osteoarthritis based on standard joint parameters and OARSI criteria of standing radiographs of the knee.


  • Kellgren & Lawrence grade
  • Minimum joint space width
  • Joint space narrowing
  • Sclerosis
  • Osteophytosis


Saves time

Enables instant, verifiable decision making in difficult cases

Easy to monitor

Facilitates monitoring of knee osteoarthritis progression


Enhances diagnosing and reporting knee osteoarthritis according to the latest clinical guidelines

Intended use

IB Lab KOALA is a radiological fully-automated image processing software device intended to aid medical

professionals in the measurement of minimum joint space width; an assessment of the severity of sclerosis,joint space narrowing, and osteophytes based OARSI criteria for these parameters; and, the severity of radiographic knee OA based on Kellgren & Lawrence Grading of standing, fixed-flexion radiographs of the knee. It should not be used in-lieu of full patient evaluation or solely relied upon to make or confirm a diagnosis. The system is to be used by trained professionals including, but not limited to, radiologists, orthopedics, physicians and medical technicians.


[1] Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, Dragomir A, Kalsbeek WD, Luta G, Jordan JM. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008 Sep 15;59(9):1207-13. doi: 10.1002/art.24021. PMID: 18759314; PMCID: PMC4516049.

[2] GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1545-1602. doi: 10.1016/S0140-6736(16)31678-6. Erratum in: Lancet. 2017 Jan 7;389(10064):e1. PMID: 27733282; PMCID: PMC5055577.

[3] Based on IB Lab Market Study


[5] KOALA fda 510(k) Summary 

[6] Nehrer, S., Ljuhar, R., Steindl, P., Simon, R., Maurer, D., Ljuhar, D., ... & Paixao, T. (2019). Automated Knee Osteoarthritis Assessment Increases Physicians’ Agreement Rate and Accuracy: Data from the Osteoarthritis Initiative. Cartilage, 1947603519888793. 

What our customers say:

Jack Farr - Orthopedist

ImageBiopsy AI software is highly accurate and efficient within our PACS system, which provides valuable information on the status of the knee along the continuum of chondrosis to arthrosis.

Jack Farr, MD

The integration of the AI ​​solutions by ImageBiopsy Lab into our RIS and PACS is easy and well done. It is fun to work with and the clarity of the visualized report is an ideal support for our patient consultation.

Jochen Mueller-Stromberg, MD

AI-based solutions reduce the amount of work and the findings become more accurate. An objective value is given which can be used both for monitoring and forecasting the progress. We offer something that others don’t have.

Michael Gruber, MD

Exact diagnosis and reproducible follow-up exams are indispensable for a successful osteoarthritis therapy. Software-based methods can assist the physician in the therapy management and adjustment process.

Prof. Jochen Hofstätter, MD