Knee Osteoarthritis (KOA) is a common musculoskeletal condition that significantly affects mobility and quality of life, particularly in elderly populations. However, training deep learning models for early KOA classification is often hampered by the limited availability of annotated medical datasets, owing to the high costs and labour-intensive nature of data labelling. Traditional data augmentation techniques, while useful, rely on simple transformations and fail to introduce sufficient diversity into the dataset. To address these challenges, we propose the Key-Exchange Convolutional Auto-Encoder (KECAE) as an innovative Artificial Intelligence (AI)-based data augmentation strategy for early KOA classification. Our model employs a convolutional autoencoder with a novel key-exchange mechanism that generates synthetic images by selectively exchanging key pathological features between X-ray images, which not only diversifies the dataset but also ensures the clinical validity of the augmented data. A hybrid loss function is introduced to supervise feature learning and reconstruction, integrating multiple components, including reconstruction, supervision, and feature separation losses. Experimental results demonstrate that the KECAE-generated data significantly improve the performance of KOA classification models, with accuracy gains of up to 1.98% across various standard and state-of-the-art architectures. Furthermore, a clinical validation study involving expert radiologists confirms the anatomical plausibility and diagnostic realism of the synthetic outputs. These findings highlight the potential of KECAE as a robust tool for augmenting medical datasets in early KOA detection.
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