Knee disorders are a major indication for musculoskeletal imaging, yet MRI reliability remains constrained by signal nonuniformity, motion artefacts, protocol variability, and reader-dependent effects. This study presents an integrated two-vector framework that couples (i) a fuzzy diagnostic control-risk model with (ii) a quantitative digital-maturity assessment to strengthen MRI-based diagnosis of knee pathology. The vertical vector characterizes organizational readiness through a weighted fuzzy aggregation of six capability agents (technical, information and analytical, mathematical/model, metrological, human resources, and software support). The horizontal vector estimates producer’s and consumer’s risks as misclassification probabilities relative to an acceptance boundary, driven by measurement/interpretation uncertainty, variability of the decision threshold, and the ratio of instrumental to physiological dispersion. Simulation results indicate that error probabilities increase sharply when threshold uncertainty exceeds 20–25% and rise by approximately 15–20% as the standard-deviation ratio approaches unity. To connect diagnostic reliability with downstream mechanics, a FE analysis of the tibial insert in TKA under $F=1150$ N at 0° flexion predicts a peak contact pressure of 85.449 MPa and a maximum UHMWPE von Mises stress of 43.686 MPa, identifying wear-critical contact zones. Overall, the proposed framework provides interpretable quantitative targets for QA, protocol refinement, and resource allocation in radiology services undergoing digital transformation, and offers a reproducible pathway for linking imaging reliability to biomechanical risk.