Genium X4 microprocessor knee — redefining amputee mobility

10 years since Ottobock’s Genium X3 microprocessor knee was released, 11 September 2024 will see the release of the Genium X4 knee which is billed as “the revolutionary next generation” in the Genium family.  

With a price tag of £134,000 including two replacement sockets on a six-year cycle and two year (or 2.8 million steps) services, this promises to be a popular choice for prosthetists advising amputees in the claims arena. Against the X3 coming in at around £128,000 for the same period there is not a vast difference in cost for the marked improved function.

This new model boasts improved user function including facilitating a smoother gait pattern, better on slopes and walking backwards. With a reasonably modest price increase over the X3 this will be an attractive option for both amputees and insurers for the additional benefits it brings. The mobility scale for entry level applicability has been opened up to mobility Grade 2, but whether this is the right knee for an amputee will of course be person-dependent.

Heavier than the original Genium but lighter than the X3 at 1600g, the X4 also has a battery life of five days, depending on activity. Users are expected to be able to use the X4 earlier, i.e. as a starter or rehabilitation knee, rather than starting with something like a Kenevo. The ability to lock the stance and slowly go free enables this. It is also hoped that users can wear them to later in life and benefit from improved function along the way. With better normalisation of gait and improved symmetry, amputees can expect reduced incident of musculoskeletal problems.

Waterproof like the Genium and X3, trial users report clinically relevant improvement in many activities of daily living meaning increased independence and less reliance on the support of others. The Ottobock X4 clinical study included bilateral amputees and all users reported enhanced mobility. Within this study one user reported being able to go “anywhere” including ”navigating crowded, busy spaces, using escalators, pedalling a bike — I don’t have to think about it anymore, I just move”.

Both the X3 and its predecessor Genium are being discontinued on release of the Genium X4 in the UK in September 2024 but service plans will be honoured. For those currently trialling X3 there may be an opportunity to loan those for longer or buy a shorter three year warranty. Some may choose to swerve to the X4 now, however.

We can expect to see requests for X4 trials in the amputation claims space and, if the benefits are as promised by Ottobock, this new microprocessor is likely to be the knee of choice.