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Functional BIOMECHANICs RESEARCH

“Shocking Research”
Osteoarthritis is a whole joint disease that not only affects cartilage but also has pronounced yet less well-understood influences on bone, ligaments, tendons, synovium and muscles. While the coordinated interplay between muscles and the joint facilitates movement, changes in movement and/or in ambulatory loads can also modulate this interrelationship and a change in one of these tissues in disease will inevitably affect the others. Therefore, studying movement and its effects on biological tissues is critical for gaining a better understanding of osteoarthritis.

The Osteoarthritis Research Center houses a state-of-the-art functional biomechanics laboratory where high quality movement studies are conducted involving a combination of 3D movement analysis, electromyography, barography, MRI imaging, strength measurement and blood sampling. We are an interdisciplinary international team of biomedical engineers, movement scientists, rheumatologist, and orthopaedic surgeons.

Technological developments

In collaboration with the expert Human Performance Laboratory (Calgary, Canada), we develop and apply novel electromyography technologies. Our recent studies have revealed a crucial relationship between osteoarthritis and chronic muscle atrophy. Proper treatment of muscle atrophy before and after joint replacement has a substantial positive effect on patient care.
An increasing number of patients require and benefit from permanent walking aids in form of crutches or walkers for maintaining mobility. However, crutch-assisted walking costs twice the energy of normal gait and induces greater loads on the upper extremities. Our clinical experience shows that patients using elbow crutches may suffer from pain, skin bruises or hematoma notably along the ulnar bone. In collaboration with an industry partner, we biomechanically evaluate and develop improved crutch designs to prevent injuries to the lower arm.

Optimizing functional outcome of ankle osteoarthritis

Osteoarthritis of the ankle joint typically develops after trauma and appears often asymmetrically, i.e. partially degenerated joint surface and joint axis deviation into varus or valgus. We evaluate functional biomechanical outcome and particularly the relevance of pre- and post-operative muscle activation in ankle osteoarthritis, joint preserving ankle realignment surgery, and ankle arthroplasty.

Preventing and treating knee osteoarthritis

Understanding biomechanical factors that increase the risk of the initiation and progression of knee osteoarthritis is a critical component in the prevention and treatment of this disease. Our team has a long track record of identifying these factors and designing interventions to slow down the disease progress. Our work focuses on establishing and optimizing emerging gait retraining interventions which are particularly promising because they do not require surgical intervention and may augment other interventions.

Optimizing functional outcome of total hip arthroplasty (THA)

The presence of an asymmetric or limping gait is critical for the long-term outcome of THA. Biomechanically, sufficient moments about the hip must be generated to facilitate ambulation where sagittal plane moments primarily generate forward progression and frontal plane moments are necessary for maintaining dynamic stability. While the inability to generate sufficiently large muscle moments in the sagittal and/or in the frontal plane are a potential cause for limping gait, limping gait may in turn require lower forces in some muscles and higher forces in other muscles. We compare the functional outcomes of different surgical approaches and identify patients at risk of poor functional outcome with the ultimate goal of improving THA outcome.

Lumbar spinal stenosis

Evidence suggests a link between osteoarthritis and muscle function. Because lumbar spinal stenosis is mostly a degenerative disease that includes osteoarthritis of the facet joints, this link of osteoarthritis and muscle function may also be present in this condition. We investigate the influence of decompressive surgery on biomechanical function in patients with lumbar spinal stenosis.

In vivo mechanosensitivity

The core of biomechanics is the influence of forces on biological organisms. The importance of the tight interplay between mechanical and biological factors in health and disease receives increasing scientific scrutiny. In a series of laboratory studies, we study the in vivo mechanosensitivity of involved tissues in humans with the ultimate goal of designing interventions—mechanical or pharmaceutical—that prevent or delay the onset of osteoarthritis or slow down its rate of progression.

Alpine biomechanics

We have recently co-founded the Center of Alpine Sports Biomechanics with the Spital Oberengadin in Samedan, Engadin. The Center’s location in the heart of the Swiss Alps at an elevation of 1700m above sea level is ideal for our research focus on functional biomechanics questions in alpine sports considering clinically relevant aspects. Currently, we investigate the biomechanics of alpine skiing in patients following total knee arthroplasty.