In short
Dr. med. Mirela Borovac from Zurich SportClinic involves her patients suffering from osteoarthritis of the knee in the treatment process. Together, they work on the ideal extent of exertion and relief to maintain the ability to exercise and work. Supported by her, Zeljko Stojicic has been successfully managing his advanced osteoarthritis for 12 years. One measure: the flexible GenuTrain OA soft brace. The sports physician prescribes it for targeted relief and sees it as an instrument to work on the leg axis. Physicians and patients particularly value that the relieving effect of the GenuTrain OA can be adjusted as needed while the product is worn, allowing exercise, physiotherapy, and even extended periods of sitting and standing at work.
When it comes to treating osteoarthritis, Dr. med. Mirela Borovac, Chief Medical Officer for Athletes at Zurich SportClinic, believes it is important to point out what is possible. For her ambitious patients who want to practice sports, she has a treatment option for joint preservation, thanks to the adjustable GenuTrain OA.
When Zeljko Stojicic sat in front of his physician Dr. Mirela Borovac at Zurich SportClinic for the first time in 2012, he knew: “I’m going to need a knee replacement. That’s it.” For the previous six years, the medial osteoarthritis in his right knee had deteriorated rapidly, increasingly restricting the quality of life of this passionate amateur athlete. Football, basketball, running and skiing – everything was associated with extreme pain or was no longer possible. Dr. Mirela Borovac, Chief Medical Officer for Athletes in Hirslanden, “inherited” this patient from her predecessor. She read his file, studied X-rays and MRI images and listened to him carefully. She empathized with his desire to have surgery, and she remembers: “There were a lot of arguments for surgery. A previous ligament injury, bandy legs, cartilage abnormalities. But at that stage, Zeljko was only 42 years old.” In her eyes, he was too young for surgery, which could only have been a temporary solution. He would need another revision later on in life. She therefore suggested to continue conservative treatment instead. Zeljko, born in Serbia, was not exactly thrilled, but he trusted his physician and her conviction to try something new. “It was a long process, but he participated diligently,” she says with a smile, “and now he’s an expert, too.” “She motivated me,” states Zeljko Stojicic, “we started slowly, implementing different methods, with one shared goal. Thanks to her, I know my knee now and how to respond to its signals.”
Zeljko Stojicic visits Zurich SportClinic twice a year for check-ups.
Long-term treatment using the GenuTrain OA
Those two are an established team. They have gained experience with pain medication, physiotherapy and osteopathy as well as with foot orthoses and supports, and adapted it all to Zeljko Stojicic’ sporting habits. And they did that successfully. His knee is well enough so he can work and exercise. He is incredibly pleased with the current product: he has been wearing the flexible GenuTrain OA soft brace for three years now. It was developed for the targeted relief in cases of osteoarthritis of the knee and offers active patients like Zeljko Stojicic a lot of freedom – during movement and when it comes to adjusting the relieving effect. Double-crossed relief straps are integrated into its elastic knitted fabric that run across the thigh and calf, leaving the back of the knee free. With just one turn of the Boa dial, the wearer can adjust the tension exerted by the relief straps and therefore the force applied. “I noticed immediately how easy it is to adjust the brace,” the 54-year-old reports – it is possible any time and even through pants fabric when he wears the GenuTrain OA underneath clothing. Donning of the product is very easy in general – an advantage if you are out and about for work and leisure a lot and you take it just to be sure.
“The GenuTrain OA provides me with a treatment alternative that I wouldn’t want to do without.”
Dr. med. Mirela Borovac
Active treatment engagement
The GenuTrain OA is always a treatment option for Dr. Mirela Borovac when the knee needs to be relieved and distribution of strain is indicated. She uses it conservatively in cases of osteoarthritis, but also in a post-operative setting to promote healing following meniscus injuries. She has noticed increased compliance in those wearing the soft brace: “The GenuTrain OA provides me with a treatment alternative that I wouldn’t want to do without.” It increases patient engagement. “The brace is comfortable to wear. It offers patient flexibility, and the can adjust it themselves,” the sports physician explains. “The feeling of actively participating in treatment decisions is really important.” Her patient Zeljko Stojicic does not wear the brace every day but proactively and when he feels pain. For example, when the sales representative for a pharmaceutical company has to sit in his car for a long time or has to stand for several hours for meetings. He mainly wears it during active leisure time: at the gym, on long motorbike rides, when going for a walk or hiking. “I’m out and about in nature a lot with my wife,” he reports. “That wouldn’t be possible at all without the brace.” He therefore appreciates the sporty design as well as the breathable material, and he does not mind showing off the GenuTrain OA visibly in the summer when wearing shorts. “My wife likes it, and I notice people looking with interest.” He can also go skiing with it. Although he now no longer goes on the red but the blue slopes, and does not spend the whole day out in the snow but a maximum of three hours. Dr. Mirela Borovac does not think that skiing is a great activity in cases of osteoarthritis of the knee, but she adds with a smile: “It depends on the extent. Treatment also includes initially adjusting intensity and frequency of a favorite activity and checking what is possible at that stage.”
Zeljko Stojicic, a patient suffering from osteoarthritis and active amateur athlete, has been wearing the GenuTrain OA for three years.
Exercise means enjoying life
Trying something out is key for Dr. Mirela Borovac. The diverse condition of osteoarthritis is determined by so many different factors that treatment is a constant process of trial and error. “I always start from scratch,” she explains, “and go from there. For any adjustment, I have to know all alternatives and find an individual mixture. It’s a process of constant fine-tuning.” The specialist has been treating former professional athletes as well as ambitious amateur athletes at the SportClinic since 2015. They come from the surrounding areas but also from abroad and even overseas. Just like Zeljko Stojicic, most of her patients suffering from osteoarthritis of the knee are younger, with their condition being caused by sports injuries, and they want to be able to keep working. They are disciplined and performance-oriented, and they are highly compliant. But also have high expectations. “Very ambitious patients are shocked at first when they hear about possible restrictions. They need alternatives,” she explains. “I tell them that we’re in this together. We first respond to acute phases to prevent recurring problems. After that, we can look for other options. I want to help them continue with exercise.” For most, this synonymous with enjoying life. She does not want to take that away from them, also because of psychological aspects: “A condition can isolate patients. Not just at work, but in family life as well.”
“By listening to my patients, I learn about them and can therefore optimize my treatment approach.”
Dr. med. Mirela Borovac
Adjusting activities
Three factors are key: pain intensity, loss of function and reduced quality of life. “They determine our treatment plan,” the sports physician elaborates. Another part is explaining to patients that all phases of life have their own challenges. Priorities can change, along with associated treatment goals. Together with her patients, she checks at what level they can be active, whether and when intensity can be gradually increased or needs to be decreased. This may also mean considering another type of activity: can an ambitious tennis player start slowly and play rallies close to the net first? Can a marathon runner switch to cycling or go swimming to stay active? “In professional sports in particular, the MRI1 images often show the most severe osteoarthritis,” the physician reports, “meaning a change in habits is needed.” That is when limits have to be set, yet without stopping activity because that would eventually cause even more problems.
Physiotherapy wearing a brace
One part of non-surgical treatment in cases of osteoarthritis of the knee is physiotherapy, which can be started as soon as acute irritation has subsided. The specialist explains that, during physiotherapy, it can also make sense to wear a relieving brace like the GenuTrain OA. “To counteract relief posture, in particular. They’re often adopted to help relieve pain and can lead to inappropriate mechanical stress.” This can often cause additional pain, for example, in the foot, back or hip – and it can cause frustration. The flexible GenuTrain OA offers sufficient freedom of movement and helps train adjacent joints and muscles because the knee is relieved during treatment and hurts less. “At the SportClinic, we always look at the whole patient,”, explains Dr. Mirela Borovac, “and together, we decide what options we have.” She realized the following: while physicians used to dictate a certain treatment approach, patients now want to be part of the process. They know more and ask more questions. “By listening to my patients, I learn about them and can therefore optimize my treatment approach.”
“I know my knee now and how to respond to its signals.”
Zeljko Stojicic, osteoarthritis patient
12 years have passed since Zeljko Stojicic’ first meeting with Dr. Mirela Borovac and his urgent wish for a knee replacement. And for those same 12 years, they have managed to delay surgery together. Now, he visits the SportClinic for check-ups twice a year, he confidently shares experiences with his physician and discusses further measures as well as new approaches. He regularly taps his knee gently during the chat, smiles and says: “I accept this condition, and I’m always looking ahead. I know now: You can live with osteoarthritis.”
GenuTrain OA: targeted relief
The GenuTrain OA soft brace provides the medial and lateral knee compartment with relief according to the 3-point principle, while allowing plenty of freedom of movement for active patients suffering from osteoarthritis of the knee. It consists of an elastic 3D mesh with guided relief straps. They wind around the knee in a double figure-of-eight, leaving the bending zone at the back of the knee free.
Using the dial of the integrated Boa® Fit System, patients can individually adjust the degree of relief in the knee area themselves throughout the day. A patella pad on one side of the kneecap helps with the exact positioning of the brace and prevents local pressure peaks. A splint with a duo-centric hinge allows restriction when needed. The GenuTrain OA is listed in the German Medical Aids Directory issued by the German Statutory Health Insurance Funds under the medical aid number 23.04.03.3084. In Switzerland, the brace can also be reimbursed (MiGel number available). The product is supplied by orthotists, who also provide advice and fitting.
Zurich SportClinic – orthopedics for people with active lifestyles
Zurich SportClinic, Switzerland, was founded in 1999 by former national goalkeeper Roger Berbig. It specializes in sports surgery, sports medicine and related disciplines. Originally, the clinic’s focus was on the excellent medical treatment of athletes. But now, patients at the six Swiss locations include injured competitive athletes as well as amateur athletes and older patients with natural degenerative conditions of the locomotor system. In Hirslanden, eight experienced sports surgeons as well as a team of numerous healthcare professionals provide personalized treatment in the entire spectrum of orthopedics.
