Knee patients: digital detective work

Working with movement sequences requires high precision in terms of biomechanics. In the Offenbach “Zentrum für Bewegungsanalytik” (center for movement analysis), Christopher Mayer shows how he supports knee therapy with high-quality analyses in close cooperation with healthcare professionals. He also demonstrates what training plans using the GenuTrain and GenuTrain OA can achieve.

A courtyard building in Offenbach am Main, Germany. Christopher Mayer, expert orthotist as well as co-managing director at the medical supply retailer Schneider & Piecha, hauls in a low step and positions it on a six-meter-long, gray plastic track with measurement scales and colored lines. Thin joints in the gray surface show where the force plate, the sensory organ of the track, has been incorporated. This plate detects horizontal and vertical forces during walking, running and jumping in three-dimensional space. Three cameras are part of the computer-aided movement analysis. The images they record from the front, back and side show an integrated picture of the force vectors.
Tobias Steinbrecher (27), with the GenuTrain on his left knee, climbs onto the step. Christopher Mayer is focused on his screen. Steinbrecher jumps – a “drop jump”. He lands on the measurement platform three times with the left foot and three times with the right foot.

Visible added stability

The readings are transmitted immediately. Christopher Mayer compares them with the readings from six weeks ago and recognizes clear successes. He points to the first image: “This is the initial measurement: lateral tilt of the upper body, compensating movement when subjected to strain. That is an indication of weak lateral pelvic muscles and lateral lower torso muscles.” On the current image, after targeted training and equipped with a knee support, he can see the following difference: “The torso is stabilized in the active phase, the contact pressure of the kneecap in the trochlear groove is therefore significantly lower.” The movement analyst is more than happy. “This is an ideal result in my eyes,” he says to Tobias Steinbrecher. “It’s best if you continue to wear the GenuTrain and carry on with your training – then I’ll see you again in six months for your follow-up measurements.”

Problems with the lateral collateral ligament and meniscus brought Tobias Steinbrecher to Schneider & Piecha. He is an amateur athlete – with favorite sports that almost inevitably lead to the orthopedist’s practice: football, jogging, weight training. He has had knee problems for more than six years. “Football training on artificial turf,” he says succinctly, “when I turned, my knee didn’t turn along with me… That’s an injury that will haunt you.”
Christopher Mayer gave him the new GenuTrain. “It makes my knee more stable, it doesn’t give way anymore,” he says with joy, “and now, finally, I don’t have a swollen knee after weight training.” In addition, Tobias Steinbrecher also does the strengthening exercises Christopher Mayer recommended to him: “Every day for 30 minutes, without fail.” As an industrial specialist in the field of electrical engineering, he is also interested in the technical design of his support, of course. It is a real piece of innovation that ensures it stays in position with its textured high-low knitted fabric and the new two-component pad, the Omega+ Pad, that helps with intense targeted stimulation. “The level of compression is great,” Tobias Steinbrecher says, praising the support, “and the product withstands strain effectively, it doesn’t slip or lose its shape over time.” He also wore the previous model and believes: “The fit has improved even more.”
Next door, Jens Machacek, orthopedic shoemaker, and Stefan Bötticher, track bike pro, are getting ready for a bike fitting. Machacek is internationally known in the cycling community as a pioneer in bicycle biometrics. Since April 2020, he has been optimizing the load profile of cyclists at the Center for Movement Analysis at Schneider & Piecha. In order to improve performance and protect joints, the examination also includes cameras and sensors to analyze body statics as well as foot and leg axes, in addition to foot pressure measurements and saddle pressure measurements.

Identifiable relief

The second analysis patient of the day is already waiting at the gait track: Wolfgang Fuß. The 70-year-old former graduate in public management suffers from medial osteoarthritis of the knee, grade 3. His problems started about 15 years ago. “I played football for 36 years. After I turned 40, I played indoors – that’s hell for the knees!” He had three arthroscopies. The years went by but the pain remained. His osteoarthritis is a huge limitation for the passionate hiker and cyclist (“13,000 km in two years by ebike”). Today, after the first eight weeks with the GenuTrain OA, Wolfgang Fuß says: “Some irritation remains. But the threshold until I actually feel pain is much higher now. And my knee is much more stable, on cobblestones or uneven forest paths, too. Previously, my knee would get really hot after longer distances. But now, everything’s OK.” Will the readings confirm his impression? Wolfgang Fuß keeps walking up and down the track, first with shoes, then barefoot, always ensuring he contacts the measurement area. “Here,” Christopher Mayer says and points at the screen, “the force is no longer projected all the way to the hip. The vector has improved and now passes through the knee joint in a straighter line. That reduces pressure on the medial side.” The result is even better with shoes. Next to it, we can see the initial measurement from a few weeks ago: “A clear varus deformity with an increased force vector that is guided through the knee joint.” The situation has improved significantly, even if a certain axial misalignment remains. “That means there isn’t an effective relief phase because shock absorption is reduced.”
Wolfgang Fuß is pleased nevertheless. He wears his brace all day until the evening: “I don’t even notice it, there’s no pressure and no slipping.” He is especially fascinated with the integrated Boa® Fit System that helps to adjust the effect of the brace: “I can change the tension of the bands right through my pant leg, for example, tighten them a little when hiking on more difficult terrain.” Absolutely perfect for an active patient like Wolfgang Fuß, who enjoys being out and about.

Images: Michael Bause