Restored mobility 

Knee joint conditions are on an unstoppable rise. In orthopedic practices, they now make up the majority of cases, on average about 15 percent throughout Germany. In rural areas, the percentage is probably even higher, owing to the generally older population. A physician’s practice and a medical supply retailer report how osteoarthritis of the knee is treated in East Frisia.

The premises of Sanitätshaus Orthopädie- und Rehatechnik Tammen medical supply retailer as well as of Ostrhauderfehn Medical Treatment Center are located in a two-story brick building. Two healthcare facilities under one roof: downstairs, the family-run medical supply retailer, upstairs, an orthopedic specialist practice which is part of the treatment center. Both attract people from this region. “We proten ok platt”, meaning they also speak Low German, says the practice website, which also applies to the medical supply retailer, of course. Being able to make oneself understood easily and personally about the complex condition of osteoarthritis of the knee creates trust between patient, therapist and supplier. 

One in five patients has knee problems

The demographic change reaches the knee before all other joints. This also applies to Ostrhauderfehn, which Ahmed Nagla, Specialist in Orthopedics and Trauma Surgery witnesses every day. The orthopedist is sitting behind his desk at the treatment center pointing at a display board. “The knee joint is the joint subjected to most strain,” he explains. “As a consequence, osteoarthritis of the knee will develop more frequently with advancing age. In our practice, we see this problem in up to five patients every day. They visit us at a very late stage, usually between stage 3 and 4.” Osteoarthritis of the knee is divided into five stages. While stage 0 refers to a healthy knee, stage 3 and 4 refer to the final stages: cartilage damage also includes the bones or the cartilage layer has been completely worn away. “Patients are in pain,” Ahmed Nagla continues, “not always with the intensity you would assume based on the findings, but severe enough to act. Additionally, patients often suffer from joint instability because it’s not only the cartilage that is worn but the ligaments are also too loose. The good news is however: we have a simple, non-invasive option that is free from side-effects, which we can use to help 30, 40 percent of these patients quickly and perhaps permanently: supports.”

DAK: “Deficits in non-surgical knee treatment”

However, using supports and braces as part of multi-modal treatment is not yet on everyone’s radar. In light of the significantly increased number of prosthetic knee implants, the German health insurance provider DAK asks for reasons for this development in their most recent treatment report ‘Knee pain/osteoarthritis of the knee 2022.’1 According to the German S2k Guidelines “Indications for knee endoprostheses” provided by orthopedic and trauma surgery specialist associations (DGOU, DGU, DGOOC), a knee replacement should generally be preceded by three to six months of conservative treatment, during which the decision for an endoprosthesis is made jointly. However, the DAK report states the following: “Current treatment methods used before knee joint replacement show a lack of conservative options which are not based on medication in advanced stages of osteoarthritis of the knee, but could be used as an alternative or in parallel with surgical measures.”

“The knee joint is the joint subjected to most strain.”

Ahmed Nagla, Specialist in Orthopedics and Trauma Surgery

Efficient treatment in cases of osteoarthritis of the knee

In Ostrhauderfehn, they have recognized the signs of the times. ‘Supports’ is the key word for Henning Tammen, one of two junior managers of the medical supply retailer which is in close proximity to the practice. That is why many of Ahmed Nagla’s patients seek advice from the expert orthotist and his team one story down. The number of patients that come with a prescription for supports is high. Two supports or braces have become favorites.

Henning Tammen does not need a lengthy explanation why: “There are few alternatives to the GenuTrain and GenuTrain A3, specifically in cases of osteoarthritis of the knee,” he points out and adds: “There are other supports on the market, and patients can try them. But those provided by Bauerfeind simply fit best on the knee.”

Increasing mobility and improving overall well-being: “We don’t lose anything when we start treatment with supports”

Ahmed Nagla confirms Henning Tammen’s very practical approach to using supports in treatment: “In cases of osteoarthritis of the knee, you don’t have to throw the whole arsenal of conservative treatment at it,” Ahmed Nagla explains. “If we’re able to reduce a patient’s problems by half or two thirds merely by using the GenuTrain or GenuTrain A3 as a first step, then this is an amazing success, don’t you think? Of course, that depends on the patient’s goals and diagnosis. But 70-year-olds in particular, our largest group suffering from osteoarthritis of the knee, who to want go grocery shopping or for a walk with their dog again without feeling pain, are really pleased with supports. They give them back their mobility. And if that doesn’t work, we have other options in conservative or surgical treatment. We don’t lose anything when we start treatment with supports, we can only win.” And indeed: many patients are happy with supports as an immediate measure, reports the orthopedic specialist.

“There are few alternatives to the GenuTrain and GenuTrain A3, specifically in cases of osteoarthritis of the knee.”

Henning Tammen, Junior Manager of the medical supply retailer

Targeting painful areas through proprioception and mobilization

The painful knee is relieved and stabilized by compression supports, such as the GenuTrain or GenuTrain A3. During movement, they exert a pain-reducing intermittent compression massage, which stimulates circulation and activates the muscles stabilizing the joint. This helps improve coordination and the sense of stability.

The benefits of the classic GenuTrain primarily include neuromuscular activation in patients with general knee problems. After an injury or surgery, the GenuTrain supports natural movements during mobilization. It supports the knee and alleviates pain. Hoffa Spots and the meniscus wings on the sides have a direct effect on areas of the knee that are particularly sensitive to pain, such as Hoffa’s fat pad or the menisci.
The GenuTrain A3 provides an even wider range of effectiveness, in cases of osteoarthritis in particular: thanks to the softer, pressure-reduced knitted fabric, it is ideal for long-term treatment. Its special silicone pad also targets areas around the patella that are often painful in patients with osteoarthritis of the knee. The functional zones massage painful areas on the inside of the knee and activate the joint-stabilizing muscles, specifically the vastus muscle. This improves coordination and significantly alleviates symptoms.

That is probably the reason why Sanitätshaus Tammen’s patients suffering from osteoarthritis of the knee most often choose the GenuTrain A3 after they were able to compare different supports. Younger, sportier customers also prefer the GenuTrain A3 for its stabilizing properties, Henning Tammen reports.

“The hyaline cartilage doesn’t heal”

Demand for the GenuTrain and GenuTrain A3 is unlikely to decrease in the near future. “The hyaline cartilage doesn’t heal.” This assessment made by anatomist William Hunter as early as 1760 has not changed, even if selective surgical procedures can be successful. People live longer and this development is expected to increase the number of patients suffering from osteoarthritis of the knee. Severe obesity makes the situation even worse. Henning Tammen, too, observes an increase beyond the demographic effect – interestingly in younger, sporty people. Might this be due to an increased pressure to perform in the younger generation that pays little attention to their physical condition? The expert orthotist would not like to speculate. He is helping his patients with supports.

GenuTrain

• Provides targeted alleviation of knee pain and activates the body’s stabilizing mechanisms
• With two components in the Hoffa Spots and the meniscus wings on the sides, the Omega+ Pad targets the sensitive Hoffa’s fat pad and base of the meniscus with intense stimulation
• The heavily textured high-low knitted fabric ensures a secure fit and comprehensive proprioceptive stimulation
• Plastic stays on the sides with a flexible bending zone and practical donning and doffing aids
• Soft, breathable comfort zone at the back of the knee and reduced compression at the edgesLindert gezielt Knieschmerzen und aktiviert körpereigene Stabilisierungsmechanismen 

GenuTrain A3

• Offers early support for active patients with osteoarthritis of the knee
• Using friction zones with nubs, the two-component pad stimulates the joint-stabilizing vastus medialis muscle and the tibial edge around the pes anserinus, which is often irritated. The pad’s pressure massage point targets the anterior joint space on the inside of the knee and helps reduce pain in the medial capsular ligament area. Two additional friction points in the pad target the Hoffa’s fat pad below the kneecap, which is involved in anti-inflammatory immune responses
• Pleasant to wear, thanks to soft knitted fabric structure and comfort zone at the back of the knee
• Easy to put on, thanks to donning aids and expansion zone around the calf
• Remains securely in position, thanks to anatomical fit and silicone dots

Images: Bauerfeind, Steffi Behermann