Bouldering in Joshua Tree

Bouldering in Joshua Tree
Ronnie 15 feet off deck on the classic White Rastafarian.

Thursday, September 22, 2011

Otto Bock Genium Knee Product Profile

Hey Guys! Finally getting back into the swing of posting. There have been lots of really exciting things going on lately at work, and my first climbing trip of the Fall season is this weekend to Northwest Georgia to go explore the boulder fields of Rocktown and Zahnd.

One of our patients at POA, Karen Hughes, got the opportunity to try the Genium Knee and made a nice write up. Check it out along with video below!


POA has begun fitting the new Genium knee on patients and their feedback has been very informative. In an effort to share those helpful first impressions with the rest of the amputee community, I will begin posting patient feedback via written words, photos, and videos on this blog, starting with my own….


Karen Hughes, age 52, above-knee amputee
since age 13 due to osteosarcoma (bone cancer)

I was recently given an opportunity to try the new Genium knee by Otto Bock. I’d been following its evolution over the past five years, and looked forward to testing it myself. But at the same time I was trying to curb my enthusiasm for it a bit since I knew my insurance company would not likely pay for one. While I truly believe that this technology will be the standard for the future, I am concerned about its affordability and availability for all amputees. Incredibly, many of the private sector insurance companies are still denying microprocessor knees which have been on the market for 12 years because they consider them “experimental?!” Not much chance they’d cover this new and more expensive technology.

So with that in mind, I took my first few steps with the Genium knee. It was unlike my past experience with another Otto Bock knee, the C-Leg, which I found to be very controlling and robotic. The movement of the Genium knee was smooth and responsive in a way I have never experienced before.

Set-up was quick and easy, based on information provided by the knee which allowed the practitioners to fine tune the settings to my personal requirements. In less than 5 minutes I was ready to go!

The first thing I tried was going from a standing position to a seated one. The knee sensed my movement and released the knee instantly with just enough support; I didn’t have to push down with my foot to initiate it! Then I began to walk. Because I don’t choose to fully utilize the stance flexion feature of my current microprocessor knee (it inhibits my ability to control the prosthesis myself), I was worried that I would have difficulty adapting to the Genium. That was not an issue. I was amazed at how quickly I just relaxed into it! The motion was smooth and natural in a way that is different from other microprocessor knees. It seemed to respond faster and I was able to change direction and/or walking speed without even thinking about it. The knee intuitively knew what to do. I felt like I was walking on my two natural legs again! The Genium didn’t require me to initiate anything other than a normal walking motion – it was effortless.

Then I tried it on the stairs. I always use a handrail for support when walking down stairs foot over foot. I’ve never trusted the hydraulics in my knees enough to “ride them down.” This time I walked down without gripping the handrail; in fact, I barely touched it! The knee supported and released without hesitation or effort no matter where my foot was placed. Ascending the stairs required a backwards sweeping motion to activate the function, which I found awkward. However, I’m sure I’d be able to master it, with time and practice. That same motion is used to signal the knee to step over an obstacle. I tried using it to step over a curb and kept reverting back to my usual method - swinging it around and bringing the foot down heel first. Again, that is something I could easily learn to do if I desired.

I was also able to walk up and down a steep ramp without a thought. From what I have read, that was because gyros and sensors were making adjustments in heel rise as I moved. All I know is that it was very easy and required no extra effort.

Would I recommend the Genium to other above-knee amputees? In a heartbeat! There is nothing else like it on the market today. Although not everyone will utilize every single one of the knee’s features, its ability to sense where it is in space is HUGE, and something that would be beneficial for us all. I have seen ads and videos featuring young, athletic men using the Genium knee to help them do things faster, smoother and easier than they were able to before. While that in itself is exciting and definitely life-enhancing, I think Otto Bock is targeting too small a group. The people I believe it will impact most are “average” amputees of all ages and physical condition. The optimized performance of the Genium could give them the confidence to try things they never had the courage or stamina to try before! It could be life-changing.

All that being said, I also have had very good experience with my Plie’ microprocessor knee for the past 5 years. It allows me to do most things I want to do and is safe enough without being controlling during most activities. But the Genium is definitely more cutting edge and responsive, in a different class than all other microprocessor knees.

Overall, I was very impressed with the Genium knee, and I hope that this type of technology will soon be the standard for all prosthetic knees. Its important that we advocate for ourselves as a community to change the way insurance companies determine coverage of prosthetic devices. We need to push lawmakers to require insurance companies to cover prosthetic care on par with other essential medical care.

Monday, September 19, 2011

Last Residency Column for the O&P Edge Magazine

“Fifteen hundred years ago, everybody knew the Earth was the center of the universe. Five hundred years ago, everybody knew the earth was flat, and 15 minutes ago, you knew that humans were alone on this planet. Imagine what you’ll know tomorrow.”
-Agent K, Men in Black (1997)

Ronald Dickson

My residency experience has flown by. It is difficult to sit down and reflect on the experiences of the past year while still caught up in the whirlwind of the present. Workflow is a fickle thing in this field; it is hard to strike a perfect balance between not busy and swamped. While things have calmed down this month, the whole month previous was my biggest learning experience to date. Managing multiple patients every day allowed me to pull together all the skills I have acquired and implement my own clinical decisions with little assistance. It feels good to see all the pieces of knowledge I have gained over the past year come together.

Simply put, I love my profession. It is inspiring to see people of all walks of life overcome obstacles and adversity and be a part of that process. Doing the job right takes work, but there has never been a time where the extra effort spent on a patient wasn’t worth it. There is no amount of hours spent or check sockets fabricated that could diminish the feeling I get when a satisfied patient walks out the door with a smile on his or her face.

I have come a long way in the past year as both a practitioner and an individual, but I still have a long way to go on a journey that never really ends. I look at my boss, Stan Patterson, CP, who has been in this profession for approximately 20 years and never stops learning. Although he’s the owner of a successful P&O practice, he is constantly trying to better our day-to-day practices. I have come to appreciate the benefits of actively trying new techniques in order to make myself a better practitioner, even with the possibility of failure. I have come to believe that resisting new techniques and new technology can be damaging to the progression of the field, and it can also negatively impact the level of care available for patients. Prosthetics is a dynamic and changing field, and I know that if I don’t stay on top of my game for even one day, I could easily be at the bottom the next day.

Stan has always told me, “It takes five years until you really start to know what you are doing,” and I do not doubt that for one second. It takes time for everything to soak in. My whole process of fitting individuals with transfemoral amputations, for example, has changed drastically in the past three to four months, and I imagine that my approach will continue to evolve as I develop my skills. I am sure that a year from today I will not even recognize the practitioner that I am as I complete my residency. I know I have always tried my best, but looking back I already see times when I could have done better. While I cannot go back and fix what I did yesterday, I can change what I do tomorrow. I will embrace the experiences that come my way—both positive and negative—continue to learn every day, and actively work on making myself better so that I can directly influence the quality of people’s lives to the best of my ability and in the positive fashion I know I am capable of.

Thank you for letting me relate my experiences over the past year. It has been personally rewarding to share my thoughts with readers. These columns have allowed me to reflect in a way that I otherwise would not have taken the time to enjoy.

Ronald Dickson is a graduate of the bachelor of science in orthotics and prosthetics program at St. Petersburg College, Florida. He is a resident at Prosthetic and Orthotic Associates, Orlando, Florida, and has been sharing his experiences as he completes his residency.