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Finite element models of the knee can be used to identify regions at risk of mechanical failure in studies of osteoarthritis. Models of the knee often implement joint geometry obtained from magnetic resonance imaging (MRI) or gait kinematics from motion capture to increase model specificity for a given subject. However, differences exist in cartilage material properties regionally as well as between subjects. This paper presents a method to create subject-specific finite element models of the knee that assigns cartilage material properties from T 2 relaxometry. We compared our T 2 -refined model to identical models with homogeneous material properties. When tested on three subjects from the Osteoarthritis Initiative data set, we found the T 2 -refined models estimated higher principal stresses and shear strains in most cartilage regions and corresponded better to increases in KL grade in follow-ups compared to their corresponding homogeneous material models. Measures of cumulative stress within regions of a T 2 -refined model also correlated better with the region's cartilage morphology MRI Osteoarthritis Knee Score as compared with the homogeneous model. We conclude that spatially heterogeneous T 2 -refined material properties improve the subject-specificity of finite element models compared to homogeneous material properties in osteoarthritis progression studies. Statement of Clinical Significance: T 2 -refined material properties can improve subject-specific finite element model assessments of cartilage degeneration., (© 2022 Orthopaedic Research Society. Published by Wiley Periodicals LLC.)

This paper presents a novel method for informing cartilage material properties in finite element models from T 2 relaxometry. In the developed pipeline, T 2 relaxation values are mapped to elements in subject-specific finite element models of the cartilage and menisci. The Young's modulus for each element within the cartilage is directly calculated from its corresponding T 2 relaxation voxel value. Our model was tested on a single subject (Subject ID 9932809, Kellgren-Lawrence grade 2) from the Osteoarthritis Initiative dataset at baseline imaging. For comparison, an identical finite element model was built with homogeneous material properties. Kinematics of the stance phase of a standard gait cycle were used as model constraints. Simulation results were compared qualitatively to the MRI Osteoarthritis Knee Score (MOAKS) from the same baseline timepoint. Our T 2 -refined material model showed higher maximum shear strain in regions with moderate cartilage loss as compared to the homogeneous material model, and the homogeneous model showed higher maximum principal stress and maximum shear strain in regions with no cartilage loss. These results show that a homogeneous material model likely underestimates tissue strains in regions with cartilage damage while overestimating strains in regions with healthy cartilage. This preliminary study demonstrates that T 2 -refined material properties are more appropriate than assumptions of homogeneity in predictive models of cartilage damage.Clinical relevance- The proposed pipeline demonstrates a computationally efficient way to improve the subject-specificity of finite element models used for evaluation of osteoarthritis.