A Quebec technology, genougraphy, is revolutionizing the treatment of osteoarthritis of the knee. This form of osteoarthritis, the most likely to cause functional disabilities, affects nearly four million Canadians, or 13.6% of the population, according to the Public Health Agency of Canada.
This form of osteoarthritis is more common in people over the age of 60, but it also affects a significant proportion of younger people, even those in their forties. For reasons still unknown, women are more likely to develop osteoarthritis than men.
It is a degenerative disease that causes the breakdown of articular cartilage, the small membrane that protects the bones in our knee. It is known today that it is not only a condition associated with aging. It can be induced by stresses on the cartilage, such as a knee injury or a demanding professional occupation.
Certain anatomical peculiarities, or even heredity, can also cause “mechanical” dysfunction of our knee. It results in misalignment of the joint, thus exposing the cartilage to excessive stress. It is therefore essential and important to understand this dysfunction in order to correct it.
Our research in biomechanics, chronic pain, radiology, epidemiology, physiotherapy and data sciences have led us to develop and evaluate the clinical utility of a new technology, genougraphy, for the management of patients suffering from osteoarthritis in Quebec. The results of this study were published in 2020 in the journal Postgraduate Medicine.
(Image provided by the author)
Currently, osteoarthritis of the knee is diagnosed by physical examination and an x-ray. Mechanical dysfunction, on the other hand, is assessed through questions and observation of the knee. However, the questionnaires are subjective and the observation remains unquantified. The clinician observes the leg with the naked eye, but takes no action. This makes it difficult for the doctor to know the exact dysfunctions that are occurring, when they occurred and which of these dysfunctions is causing stress or deterioration of the joint.
3D knee movements
To date, the healthcare professional can offer his patient treatment to relieve his pain as well as physiotherapy exercises. However, to correct knee dysfunctions, it is necessary to target the dysfunctions that are not visible to the naked eye.
The genougraphy, which was marketed in 2011 after fifteen years of research, could however change the situation! This is a kind of electrocardiogram of the knee, which is performed using a harness attached to certain strategic areas of the leg. This technology was developed by researchers from the École de technologie supérieure, the Center hospitalier de l’Université de Montréal (CHUM) research center and TELUQ University.
As this technology measures in real time the movements in three dimensions (3D) of the knee as well as its rotations not visible to the naked eye, it allows to evaluate the joint with precision and objectivity. It helps healthcare professionals understand the source of stress on cartilage, providing motion analysis to detect deviations from what is considered normal.
Personalized care
Using this technology, professionals can offer personalized fixes to address the root cause of the problem, such as neuromuscular exercises that can be done at home or under the supervision of a physiotherapist or kinesiologist.
This technology is very promising, as suggested by the results of our clinical study conducted on 515 patients. The patients who benefited from the genougraphy and a personalized care plan were able to correct several biomechanical dysfunctions measured. Almost nine in 10 people (88%) who participated in the clinical study said they had exercised for at least three months, showing that they were committed to their treatment. Exercise adherence is a major issue in studies that analyze the effect of an exercise program.
In addition, the researchers observed an improvement in the functional state of the knee of these patients compared to that of the control group. These patients reported experiencing less pain and symptoms, and feeling better able to carry out their daily activities. In addition, they claimed to be more satisfied with their care and performed better in functional tests.
Already offered by more than a hundred clinics and hospitals in eight countries, genography is currently offered in Quebec in private clinics. Studies are underway to assess the impact of this tool on private costs and public health services, in order to offer it in the public system (hospitals and clinics).
In addition to giving hope to the thousands of patients struggling with osteoarthritis of the knee, this innovation shows, once again, that Quebec genius deserves all its letters of nobility.
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