Toward resilience: Managing osteoarthritis of the knee beyond just relief

According to Prof. Giuseppe Musumeci and Dr. Federico Roggio early diagnosis and personalized intervention strategies are within reach for osteoarthritis of the knee and about to transform its management. Technologies such as infrared thermography and inertial measurement units pave the way for real-time monitoring and may form powerful new alliances with exercise-based treatment und therapeutic enablers such as the stabilizing orthopedic support GenuTrain A3. A conversation with the two experts from the Research Center on Motor Activities, Centro di Ricerca in Attività Motorie (CRAM), at the University of Catania in Italy.

Prof. Musumeci: At CRAM we converge expertise in anatomy, biomechanics and digital technologies in order to develop comprehensive treatment approaches patients with musculoskeletal disorders and risk groups will benefit from. Our interdisciplinary research sets the focus on the capacity for active living. When it comes to osteoarthritis of the knee, we aim at transformation: We aim at taking the chances for an early diagnosis and conservative management, so that we can reduce the physical and psychological impact of one of the most widespread and debilitating disorders. Global estimates suggest that over 365 million people live with osteoarthritis, the knee being the joint most frequently affected. For many patients the condition is a chronic, life-altering issue that limits physical function, disrupts daily routines and diminishes overall quality of life. We want to go beyond pain relief and defensive damage control toward resilience via regular movement and regulated physical activity.

Dr. Roggio: Physical activity has proven to stand out as one of the most powerful non-pharmacological interventions. Low-impact activities that do not overload the joint, such as walking, swimming or cycling, are known to ameliorate symptoms and slow down progression. Regular movement stimulates the production of synovial fluid, which lubricates the joint and nourishes cartilage. So moderate exercise may maintain the fluids balance and counteract painful stiffness patients with osteoarthritis of the knee typically suffer from. A further aspect is muscle strength. Targeted exercises help to offload the joint in motion and improve alignment, thereby reducing strain and restoring a more physiological gait. Numerous clinical studies have shown that quadriceps strengthening, for example, leads to measurable pain reduction and significantly better motor function. Apart from that exercise is a cornerstone of weight management, lowering mechanical stress on the joint. Adjusted physical activity clearly ensures mobility with all its systemic benefits for cardiovascular health and a metabolic balance.

Prof. Musumeci: Not to mention the psychological benefits. Physical activity contributes to personal independence and emotional well-being. There is a strong correlation between osteoarthritis and mental issues such as depression and anxiety, as patients struggle with an increasingly limited lifestyle when daily activities and tasks like climbing stairs and walking moderate distances become challenges.

Dr. Roggio: The more we believe that it needs a transition from reactive rehabilitation to preventive and predictive medicine. Acting at the very beginning of structural degeneration with an exercise-based treatment that is individually adjusted to the patients is a promising treatment route and defines our anticipatory approach.

“Our interdisciplinary research wants to use the opportunities for early diagnosis and conservative treatment of osteoarthritis of the knee.”

Prof. Giuseppe Musumeci

Prof. Musumeci: By harmonizing modern technology with human-centered healthcare in a sustainable framework. Greater precision in diagnostics is possible and practicable. There are non-invasive procedures for monitoring joint function in real-time and detecting subtle alterations before the onset of irreversible damage. They can be performed quickly in outpatient settings and be put into a continuous process of adaptation and optimization with an array of individualized measures influencing musculoskeletal health. One of CRAM’s initiatives is the national project “Predictive Model of Osteoarthritis through the use of an Inertial Knee brace and Thermography”, funded by the Italian Ministry of Universities and research. It exemplifies our vision for a multimodal assessment for early intervention as it integrates artificial intelligence, thermal imaging and wearable sensors to identify early biomechanical and physiological signs of joint degeneration.

“Intervening right at the beginning of structural degeneration is promising and defines our preventive research approach.“

Dr. Federico Roggio

Dr. Roggio: Our research portfolio at CRAM encompasses a range of techniques, including infrared thermography for detecting inflammatory processes, inertial measurement units (IMUs) for detailed gait analysis, and electromyography (EMG) for assessing muscle activation patterns. These highly dynamic tools enable us to conduct precise evaluations of musculoskeletal function and to monitor osteoarthritis of the knee, especially in its earlier stages, facilitating diagnosis and personalized intervention strategies.

Dr. Roggio: Infrared thermography allows us to visualize temperature differences across the skin surface. In the context of osteoarthritis, elevated temperatures around the knee joint may indicate underlying inflammation, a key driver of pain and joint degradation. Using IMUs, we can assess gait patterns and thus obtain a clear picture of how osteoarthritis of the knee affects individual motor functions. IMUs consist of small, wearable sensors that track motion in real-time. Through gait analysis, we can detect compensatory patterns and asymmetries that might go unnoticed in a static clinical examination via X-rays or MRIs. In addition, EMG can reveal how patients with osteoarthritis specifically compensate for pain or instability. For instance, altered firing of the quadriceps or hamstrings may lead to imbalanced loads on the knee, exacerbating structural damage in the joint. By understanding these neuromuscular adaptations, we can design targeted intervention to restore balance and control.

Prof. Musumeci: For this kind of research, we also collaborate with international clinical institutions and industrial partners.

Prof. Musumeci: They are part of the targeted intervention. Exercise-based treatments might need the stabilizing power of orthopedic bracing, since beginning pain or instability can foster caution and insecurity. That makes it often difficult to initiate and continue physical activity. Supports and braces are therapeutic enablers promoting and rewarding motion.

Dr. Roggio: There are modern solutions such as Bauerfeind’s GenuTrain A3, a support that is specifically designed to address osteoarthritis of the knee related symptoms. They help to provide a sense of stability, reduce discomfort and empower patients to move with confidence, often enabling them to re-engage with physical activity and regain a sense of autonomy. The support’s medical compression and its massage effect during movement improve blood circulation. The stimulation of mechanoreceptors and their sensory feedback promote optimized joint positioning and counteract pathological malposition. Combined with digital diagnostic procedures and integrated AI models for classification and prediction, we could adapt orthopedic bracing to individual biomechanical needs more precisely – starting with supports for neuromuscular activation and changing at the right point in time to mechanically relieving braces, taking away pressure from the affected compartment of the knee, to complement targeted strengthening and stabilizing exercises.

Dr. Roggio: As researchers, we believe the most promising direction for managing osteoarthritis of the knee lies in the intelligent integration of high-tech assessment methods with time-tested therapeutic solutions like movement and bracing. Making sports medicine, biomechanics and data science meet each other is the order of the day.

Prof. Musumeci: The field of OA management is evolving toward a more personalized and data-driven approach. It is not a matter of choosing technology or tradition, but of bringing them together and building bridges between interdisciplinary science and orthopedic care. Osteoarthritis of the knee may be a life-altering condition, but by combining cutting-edge diagnostics, meaningful physical activity and stabilizing supports and braces, it does not have to limit a person’s potential. 

For more information about CRAM, click here.

Early osteoarthritis therapy with GenuTrain A3
The new GenuTrain A3 knee support generation aids kinesiotherapy when treating osteoarthritis of the knee. Its further developed properties include, for example, soft and elastic knitted fabric, a revised pad with friction points, and ergonomically shaped donning aids with reinforced gripping zones. Find out more.

Pictures: CRAM, Bauerfeind AG