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Prof. Dr., PhD Annegret Mündermann

Department of Clinical Research
Profiles & Affiliations

Functional biomechanics in orthopaedics

The Functional Biomechanics Research Group strives to solve clinically motivated questions on diseases and conditions of the musculoskeletal system and to translate results of laboratory studies into the clinic. The joints of the human body perform fascinatingly complex movement patterns which involve the perfect interplay of many different factors. The research group is on its way to understand this system better to improve the treatment and rehabilitation of orthopaedic and trauma patients.


Members of the research group focus on three main fields of investigation. First, the research group aims to develop and optimize methods to understand the in vivo mechanosensitivity of musculoskeletal tissue​. The goal is to design interventions – mechanical or pharmaceutical – that prevent or delay the onset of osteoarthritis or slow down its rate of progression. Second, clinical questions relating to diagnostics, prevention and therapy of disease related gait and movement patterns are answered in multidisciplinary research teams of clinicians, movement scientists, engineers, and physiotherapists. Here, the research group combines novel portable IMU (Inertial Measurement Units) systems with camera-based motion analysis, novel markerless motion capture technologies and measurements of muscle activity, muscle strength and balance to identify the relevant factors of injury and disease mechanisms and the respective treatment. The third field of research is centred on innovation and product development within the field of functional biomechanics. Having established a long series of innovation together with orthopaedic surgeons at the Schulthess Clinic Zurich we now work on establishing protocols for based on different sensors for measuring shoulder translation in clinical practice, test the biomechanical performance of novel orthopaedic implants in the living patient as well as combinig these functional measurements with clinical registries aimed towards outcome-driven value-based health care.


The Functional Biomechanics Research group was formed in 2015 bringing together expertise in human biomechanics research and orthopaedic surgery and sports medicine. It is led by Prof. Dr. Annegret Mündermann. The Functional Biomechanics Research Group is part of the CADENCE Consortium located at the CADENCE Core Facility at the Department of Biomedical Engineering at the University of Basel. With her transition to the Schulthess Clinic in Zurich in early 2025, Prof. Dr. Mündermann expanded her clinical collaborations to the leading orthopaedic surgeons in the top orthopaedic clinic in Switzerland and combines her extensive research expertise with established and ongoing orthopaedic registries which uniquely facilitates bed side to bench to bed side research frameworks where scientists work hand in hand with clinicians and contribute to education in orthopaedics, sport science and physiotherapy. With more than 25 years of experience in functional biomechanics, members of the group have been delivering on the promise to generate scientifically founded knowledge to improve orthopaedic treatment.

Selected Publications

Herger, Simon, Nüesch, Corina, Liphardt, Anna-Maria, Egloff, Christian, & Mündermann, Annegret. (2025). Effect of older age and/or ACL injury on the dose–response relationship between ambulatory load magnitude and immediate load-induced change in serum cartilage oligomeric matrix protein [Journal-article]. Journal of Sport and Health Science, 14, 100993. https://doi.org/10.1016/j.jshs.2024.100993

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Croci, Eleonora, Künzel, Christoph, Gehring, Dominic, Müller, Andreas Marc, & Mündermann, Annegret. (2025). Comparison of shoulder kinematics between Theia 3D markerless motion capture and marker-based motion capture during full arm ranges of motion. Journal of Biomechanics, 191. https://doi.org/10.1016/j.jbiomech.2025.112905

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Bühl, Linda, Müller, Sebastian, Nüesch, Corina, Halbeisen, Florian Samuel, Mündermann, Annegret, & Egloff, Christian. (2025). Landing Biomechanics in Patients 2 Years After Augmented ACL Repair and 2 Years After Hamstring Autograft ACL Reconstruction Compared With Controls [Journal-article]. Orthopaedic Journal of Sports Medicine, 13(7). https://doi.org/10.1177/23259671251358386

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Wirth, Wolfgang, Herger, Simon, Maschek, Susanne, Wisser, Anna, Bieri, Oliver, Eckstein, Felix, & Mündermann, Annegret. (2025). Clinical validation of fully automated cartilage transverse relaxation time (T2) and thickness analysis using quantitative DESS magnetic resonance imaging [Journal-article]. Magnetic Resonance Materials in Physics, Biology and Medicine, 38(2), 285–297. https://doi.org/10.1007/s10334-025-01227-5

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Mündermann, Annegret, Nüesch, Corina, Ewald, Hannah, & Jonkers, Ilse. (2024). Osteoarthritis year in review 2024: Biomechanics [Journal-article]. Osteoarthritis and Cartilage, 32(12), 1530–1541. https://doi.org/10.1016/j.joca.2024.09.011

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Selected Projects & Collaborations

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CADENCE - Clinical Biomechanics and Ergonomics Engineering Equipment

Research Project  | 5 Project Members

In December 2021, the new research unit ‘Clinical Biomechanics and Ergonomics Engineering’ (CADENCE) was formed at Department of Biomedical Engineering (DBE) at the University of Basel (https://dbe.unibas.ch/en/research/biomechanics-and-biomaterials/cadence/) comprising the research groups ‘Functional Biomechanics’, ‘Robot-assisted Theragnostics’, ‘Paediatric Orthopaedic Biomechanics and Musculoskeletal Modelling’, and ‘Spine Biomechanics’. CADENCE facilitates innovative and groundbreaking interdisciplinary research in biomedical engineering and biomechanics and serves as teaching facility for courses on diagnostic and therapeutic technologies within the new Master of Science program and the PhD programs at the DBE. The R`Equip grant supports CADENCE in the purchase of a range of state-of-the-art sensor technologies and the world’s first 3D gait rehabilitation robot ‘The FLOAT’. This investment is critical for the unique and internationally leading role of the research groups in the research and innovation ecosystem in the Basel region.

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Dose-response relationship of in vivo ambulatory load and cartilage biomarkers: the role of age, tissue health and inflammation

Research Project  | 4 Project Members

Articular cartilage is an avascular and aneural tissue that facilitates joint motion with minimal friction. Osteoarthritis (OA) is a joint disease that affects the whole joint resulting in severe articular cartilage degeneration with a prevalence worldwide of more than 10%. Although the molecular mechanisms that trigger the pathological changes in OA are largely unknown, the ability of chondrocytes to respond to load is believed to play a critical role in maintaining healthy tissue and in the initiation of OA. Different modes of ambulation have resulted in increases of specific blood markers, and immobilization during bed-rest lead to reductions in the same blood markers. However, the dose-response relationship between ambulatory load and mechanosensitive blood markers, its biological variation in healthy persons and in patients with a high risk of developing OA (e.g. with increasing age or after joint injury), and its relevance for cartilage degeneration are unknown. Based on reported differences in the magnitude of load-induced changes in blood markers of articular cartilage depending on the type of physical activity, we have previously tested an experimental framework of a systematic and controlled modulation of weight bearing during a walking stress test that we propose to employ in this study. We will address the following specific aims: Specific Aim 1: Investigate the in vivo dose-response relationship between ambulatory load and mechanosensitive blood markers of articular cartilage using controlled weight bearing during a walking stress test and age, tissue status and the presence of inflammation as experimental paradigms. Specific Aim 2: Investigate the prognostic ability of the individual in vivo dose-response relationship between ambulatory load and mechanosensitive blood markers of articular cartilage for articular cartilage degeneration. Healthy subjects and subjects with previous anterior cruciate ligament (ACL) injury aged 20 to 50 years will be clinically assessed, undergo magnetic resonance imaging (MRI) of both knees, and complete questionnaires on physical function and physical activity. Participants will wear an activity monitor for the 7 days before and during the experiment to record their physical activity level. Each participant will complete three walking stress tests (30 minutes walking) on separate days with repeated blood sampling to assess load-induced changes in levels of mechanosensitive blood markers (COMP, MMP-3, PRG-4, ADAMTS-4). In each test, one of three different ambulatory loads will be applied (80, 100 and 120% body weight (BW)). Inflammation will be assessed as IL-6 serum concentration. Tissue status of articular knee cartilage will be assessed as MRI T2 relaxation time and cartilage thickness at baseline and at 24-month follow-up. This study can be considered as proof-of-concept of a potential diagnostic test (walking stress test) for cartilage mechanosensitivity and will provide first evidence of the role of age, tissue status and presence of inflammation on the dose-response relationship between in vivo ambulatory load and mechanosensitive blood markers of articular cartilage and its relevance for prognosing cartilage degeneration. These results will allow to judge the importance of mechanosensitive blood markers for in vivo mechanobiology of articular cartilage. The results of this study will reveal if the proposed experimental framework may be suitable in the area of cartilage engineering and transplantation and for testing pharmacologic agents and load-modifying interventions aimed at changing tissue metabolism in the context of OA pathomechanics that can be further investigated in ex vivo, in situ and in animal models of OA.

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Influence of additional weight carrying on load-induced changes in glenohumeral translation in patients with rotator cuff tear - a translational approach

Research Project  | 4 Project Members

The shoulder is a unique joint: the primary stabilization by the rotator cuff muscles facilitates a large range of motion that is a prerequisite for many daily, occupational and recreational activities. Accordingly, injury to the rotator cuff greatly affects joint function and limits the patients' activities. Rotator cuff tears are a common shoulder injury that sometimes remain undiagnosed because of limited symptoms. However, altered shoulder biomechanics because of injury - even when only subtle - can lead to secondary damage and degeneration including tendinopathy or osteoarthritis. Because of the overlying soft tissue, measuring shoulder biomechanics is complex. Motion of the healthy shoulder primarily comprises rotation with very small to no translation because of stabilization through muscle activity and is affected by muscle cross sectional area (MCSA) and shoulder anatomy including the critical shoulder angle (CSA) and glenoid inclination (GI). Although often clinically observed, inconclusive changes in shoulder translation have been reported in patients with rotator cuff tear. However, to date it is unknown how additional handheld weight similar to situations during daily, occupational or recreational activities affects glenohumeral translation in patients with rotator cuff tear. Based on previous methods for assessing glenohumeral translation, we have developed an in vivo, simulation and ex vivo experimental framework for systematically modulating additional weight during a loading shoulder abduction test that we propose to employ in this study. This framework allows us to assess the dose-response relationship between additional weight and glenohumeral translation termed load-induced glenohumeral translation (liTr). We will address the following specific aims in in vivo, simulation and ex vivo experiments: understanding the biological variation in liTr; understanding the influence of disease pathology on liTr; understanding the potential compensation of rotator cuff tear by muscle activation and muscle size; and understanding the association of liTr and patient outcomes. Patients with rotator cuff tears and asymptomatic persons with similar age and sex distribution will be clinically assessed and complete a loading shoulder abduction test while collecting single plane fluoroscopy images. The same test will be repeated while 3-dimensional (3D) motion data and electromyographic data is collected. In the motion analysis test and in the fluoroscopy test, handheld weight will be applied. LiTr will be calculated as the slope of a regression of the negative distance of the glenohumeral centre of rotation (GHJC) to the acromion and studied in relation to patient's functional scores, MCSA, tear size and type, and the CSA and GI. Moreover, we will extent a previously developed shoulder simulator to integrate glenoid specimen, anterior and posterior aspects of the deltoid muscle and facilitate simulation of individual tendon rupture. Subsequently, we will use this shoulder simulator in simulation and ex vivo experiments to systematically study the effect of tear size and type, CSA and GI in sawbones and human cadaveric specimen. Finally, we will compare results of in vivo, simulation and ex vivo experiments and formulate specific recommendation for clinic and rehabilitation. This study can be considered as proof-of-concept of a potential diagnostic test (loading shoulder abduction test) for glenohumeral translation and will provide first evidence of a dose-response relationship between additional weight and glenohumeral translation. Moreover, the simulation and ex vivo experiments using a shoulder simulator allow the systematic investigation of mechanical compensation for injury to one or more rotator cuff muscles. The results of this study are relevant for diagnostics, treatment and rehabilitation planning in this population.

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RetroBRACE II: Clinical and Functional Outcomes 2 Years After ACL Repair and InternalBrace Ligament Augmentation in Comparison With ACL Reconstruction

Research Project  | 5 Project Members

Injury of the anterior cruciate ligament (ACL) is one of the most common injuries of the knee. Since May 2016, patients with proximal ruptures of the ACL have been treated with direct repair and InternalBraceTM Ligament Augmentation at the University Hospital of Basel.

The remodelling of hamstring grafts used for ACL reconstruction is completed at the earliest 2 years after the surgery. The aim of this study is to assess the clinical, biomechanical and functional outcome 2 years after anterior cruciate ligament (ACL) repair and InternalBraceTM augmentation now in direct comparison to ACL reconstruction and to identify potential deficits compared to the contralateral healthy side as well as with a knee-healthy age-matched collective. In addition, socio-economic aspects such as return to work and sports and treatment cost will be compared between both techniques.