“Movement generates movement”

The CoxaTrain is a long-awaited innovation for non-surgical treatment in cases of osteoarthritis of the hip. This brace allows patients to get back into a more physiological range of movement. Martina Ivanda, Head of the Orthopedic Department at Rose Hospital in Horn-Bad Meinberg, Germany, has kept a close eye on such a case for three months.

“In a way, it’s quite simple,” says Martina Ivanda, “movement generates movement.” With this statement, she puts the problems faced by patients with osteoarthritis of the hip in a nutshell. It is the pain – or the fear of it – and the lack of confidence during standing and walking that force patients into relief postures or make them avoid movement altogether – this is a downward spiral. “And eventually, the body’s compensating mechanisms will no longer work.” Martina Ivanda, Specialist in Orthopedics and Trauma Surgery, is head of the orthopedics department at Rose Hospital in Horn-Bad Meinberg, focusing on non-surgical recovery following hip, knee and spine surgery. In 2019, around 1,400 orthopedics patients were treated at Rose Hospital, including approximately 400 hip patients aged between 40 and 90. Usually, the rehabilitation phase takes three weeks and has the goal of activating and mobilizing by means of stretching and strengthening the muscles to increase stability and improve gait.

Breaking through the pain cycle

For the orthopedist, the CoxaTrain is much more than just a new medical aid. “It’s the first hip brace that is easy to wear during non-surgical treatment of osteoarthritis. I can also imagine that it works well in post-operative care when there are muscular problems or instabilities after total hip replacement.” Martina Ivanda knows how much strength and technical sophistication are needed to impact the large joint. “It’s often the soft tissue that poses the problem, the myofascial system.” A brace that helps compensate for muscular imbalances in the lumbar, pelvic and hip region is all the more welcome. The pads in the sacroiliac area, above the gluteus medius muscle and the greater trochanter exert a muscle-relaxing friction massage – right in the areas where heel-to-toe and rotational movements are guided by the muscles. This helps rebalance strain that is adversely distributed. “The CoxaTrain can become a milestone in non-surgical treatment,” says Martina Ivanda, “it allows you to break the pain cycle and get patients moving again.”

“The CoxaTrain can become a milestone in non-surgical treatment. It allows you to break the pain cycle and get patients moving again.”
Martina Ivanda

Improved gait, longer walking distance

Martina Ivanda has a typical case in mind: Frank Hünkemeier, her husband. He works in sales and field service, so he is part of the common group of people who have to sit at a desk and in a car too much. And his hobby to make up for the inactivity at work, indoor football, is something that orthopedists dread. “For around nine months,” he reports, “I’ve had problems standing, putting my foot down and climbing the stairs … my right leg kept buckling – that was incredibly painful.” The CoxaTrain arrived just at the right time for him. It quickly proved to be a great support during fitness training and jogging: “I noticed that the times without pain kept expanding.” Martina Ivanda was able to observe the effects of the CoxaTrain in her husband for the first three months, “much more closely than would be possible with normal patient contact,” she explains. “His gait improved significantly.” Previously, the external rotation of the leg was very pronounced. Thanks to the firm guidance of the CoxaTrain, his leg could not escape into the incorrect posture as easily as before, and he started to put his foot down straight again. This provides relief to the hip, knee and ankle. “I can clearly see the difference in him, with and without the brace.” His walking distance also improved significantly: initially, Frank Hünkemeier only managed one or two kilometers without pain. But now, when wearing the brace, he can jog for four kilometers or more without having to stop.

The missing link for the time before and after surgery

As Martina Ivanda emphasizes, a non-surgical approach requires a lot of commitment from the patient, and the CoxaTrain can be the “missing link” to achieve this. It allows patients suffering from osteoarthritis to delay hip replacement and effectively use this time to strengthen their muscles and improve function. Of course, the right timing for the surgery must not be missed because otherwise, it would make recovery harder and longer. But the time frame from the onset of the condition to joint replacement surgery could be extended with the CoxaTrain. “This is an important aspect for younger patients and those who work.” Patients who are already used to exercise therapy and handling a brace have much better starting conditions for post-operative recovery. They are more stable in terms of muscles and stamina. “The pre-operative phase determines the subsequent surgical outcome,” the physician states.

CoxaTrain promotes movement

For Martina Ivanda, her husband’s experience of wearing the CoxaTrain proves what she expects from a brace for non-surgical treatment: it promotes movement and therefore lays the foundation for a sustainable improvement of the problems. “The product is so easy to handle,” Frank Hünkemeier reports, “during the first few days you have to get used to the guidance exerted by the lateral splint, but that happens quite quickly. You can’t really go wrong.” It is less suitable for sitting in the car, but excellent during movement.
And that’s what it’s all about, Martina Ivanda confirms, braces are designed to support functional treatment. She wants to bust the myth of atrophy: “The opposite is the case. Braces like the CoxaTrain promote mobility and motivate the wearer to dare and be active again.”

Images: Steffi Behrmann