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QUALITY OF LIFE: A SYSTEMATIC REVIEW. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST 
NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018.DOI: https://doi.org/10.33137/cpoj.v1i2.32033                                                                             

 

1 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (ORAL PRESENTATION) 

BENEFITS OF GENIUM MICROPROCESSOR CONTROLLED KNEE ON 

AMBULATION, MOBILITY, ACTIVITIES OF DAILY LIVING AND QUALITY OF 

LIFE: A SYSTEMATIC REVIEW 

Milana Mileusnic1* , Lena Rettinger1, Michael Jason Highsmith2, Andreas Hahn1 

1 Department of Clinical Research and Services, Otto Bock HealthCare Products GmbH, Austria.  
2 Extremity Trauma & Amputation Center of Excellence. U.S. Department of Veteran Affairs, Tampa, FL, USA.  

* Email: Milana.Mileusnic@ottobock.com 

DOI: https://doi.org/10.33137/cpoj.v1i2.32033  

INTRODUCTION 

Several years ago, a new microprocessor controlled knee 

(MPK), Genium, was introduced containing sensors, 

algorithms and technical solutions that enable a range of 

new functions to lower limb amputees. We conducted a 

systematic review to evaluate the effect of the knee on 

ambulation, mobility, activities of daily living (ADLs) 

and quality of life (QoL). 

METHODS 

The systematic review was conducted according to the 

Prisma Guidelines and recommendations of the State-of-

Science Evidence Report Guidelines of the AAOP. Three 

reviewers conducted the quality assessment 

independently. 

RESULTS 

Twelve articles were included in the review and reported 

of active subjects transitioning from C-Leg to Genium. 

The overall validity of the evidence was mostly medium 

and high (Figure 1). Common validity concerns included 

lack of blinding, incomplete reporting (fatigue & 

learning effect, attrition rate), effect size calculation, etc. 

Nine articles focused on ambulation, in particular on 

level walking, stairs and ramps 1-9. Biomechanical 

analysis reported of more physiological and symmetrical 

gait as well as reduction of loading and compensatory 

motion on sound side. Four square step test, Amputee 

Mobility Predictor and step activity derived functional 

level assessing the mobility were significantly 

improved6. Four publications addressing ADLs reported 

of significant improvements with values closer to able-

bodies subjects (i.e. domains upper-and lower-body 

strength, balance, coordination, endurance)6,9,11,12. Two 

articles reported of significant effect of Genium on 

QoL6,10.  
 

 

 

Figure 1. Number and quality of evidence across categories. 

CONCLUSION 

Quality of evidence is predominantly moderate and high. 

Genium resulted in more physiological gait, more evenly 

distributed loading and reduction in compensatory 

movements. Significant improvements are reported in 

mobility, QoL and especially safety and ability to 

conduct ADLs. 

SIGNIFICANCE 

Additional benefits could be observed with Genium in 

above knee amputees when compared to standard MPKs. 

Gait optimization could be relevant considering the long-

term risk of secondary physical conditions in the 

prosthetic wearers. 

REFERENCES 

1. Aldridge Whitehead JM, et al. Does a Microprocessor-

controlled Prosthetic Knee Affect Stair Ascent Strategies in 

Persons With Transfemoral Amputation? Clin Orthop Relat 

Res; 472, 3093-3101, 2014. DOI:10.1007/s11999-014-3484-2 

 

mailto:Milana.Mileusnic@ottobock.com
https://doi.org/10.33137/cpoj.v1i2.32033
https://doi.org/10.1007/s11999-014-3484-2


 

 

Mileusnic M, Rettinger L, Highsmith M.J, Hahn A. BENEFITS OF GENIUM MICROPROCESSOR CONTROLLED KNEE ON AMBULATION, MOBILITY, ACTIVITIES OF DAILY LIVING AND 
QUALITY OF LIFE: A SYSTEMATIC REVIEW. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST 
NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018.DOI: https://doi.org/10.33137/cpoj.v1i2.32033                                                                             

 

2 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (ORAL PRESENTATION) 

2. Bell EM, et al. Performance of conventional and X2® 

prosthetic knees during slope descent. Clin Biomech; 33, 26-

31, 2016. DOI:10.1016/j.clinbiomech.2016.01.008 

3. Bellmann M, et al. Immediate effects of a new 

microprocessor-controlled prosthetic knee joint: a comparative 

biomechanical evaluation. Arch Phys Med Rehab; 93, 541-

549, 2012. DOI:10.1016/j.apmr.2011.10.017 

4. Bellmann M, et al. Stair ascent with an innovative 

microprocessor-controlled exoprosthetic knee joint. Biomed 

Tech; 57, 435-444, 2012. DOI:10.1515/bmt-2011-0029 

5. Lura DJ et al. Differences in knee flexion between the 

Genium and C-Leg microprocessor knees while walking on 

level ground and ramps. Clin Biomech; 30, 175-181, 2015. 
DOI:10.1016/j.clinbiomech.2014.12.003 

6. Highsmith MJ, et al. Effects of the genium knee system on 

functional level, stair ambulation, perceptive and economic 

outcomes in transfemoral amputees. Technol Innov; 18, 139-

150, 2016. DOI:10.21300/18.2-3.2016.139 

7. Highsmith MJ, et al. Effects of the genium microprocessor 

knee system on knee moment symmetry during hill walking. 

Technol Innov; 18, 151-157, 2016. doi: 10.21300/18.2-

3.2016.151 

8. Highsmith MJ, et al. Short and mid-distance walking and 

posturography with a novel microprocessor knee. Technol 

Innov; 15, 359-368, 2014. DOI: 

https://doi.org/10.3727/194982413X13844488879302 

9. Hahn A, et al. Analysis of clinically important factors on the 

performance of advanced hydraulic, microprocessor-

controlled exo-prosthetic knee joints based on 899 trial fittings. 

Medicine; 95(45), e5386, 2016. 
DOI:10.1097/MD.0000000000005386 

10. Highsmith MJ, et al. Perceived differences between the 

genium and the c-leg microprocessor prosthetic knees in 

prosthetic-related function and quality of life. Technol Innov; 

15, 369- 375, 2014.    DOI: 

10.3727/194982413X13844489091297 

11. Highsmith MJ, et al. Functional performance differences 

between the Genium and C-Leg prosthetic knees and intact 

knees. J Rehabil Res Dev; 53, 753-766, 2016. DOI: 

10.1682/JRRD.2014.06.0149 

12. Kannenberg et al. Activities of Daily Living: Genium 

Bionic Prosthetic Knee Compared with C-Leg. J Prosthet 

Orthot; 25, 110-117, 2013. doi: 

10.1097/JPO.0b013e31829c221f 

DISCLOSURE 

M Mileusnic, L Rettinger and A Hahn are affiliated 

with Otto Bock Healthcare Products. 

 

 

 

 

 

 

 

 

https://doi.org/10.1016/j.clinbiomech.2016.01.008
https://doi.org/10.1016/j.apmr.2011.10.017
https://doi.org/10.1515/bmt-2011-0029
https://doi.org/10.1016/j.clinbiomech.2014.12.003
https://doi.org/10.21300/18.2-3.2016.139
https://dx.doi.org/10.21300%2F18.2-3.2016.151
https://dx.doi.org/10.21300%2F18.2-3.2016.151
https://doi.org/10.3727/194982413X13844488879302
https://doi.org/10.1097/MD.0000000000005386
https://doi.org/10.1682/JRRD.2014.06.0149

