DE9316342U1 - Bandage for the knee joint - Google Patents

Description

Bandage for the knee joint

The invention relates to a bandage for the knee joint made of elastic bandage material in tubular form with a front bandage part and a rear bandage part and with at least one incorporated, longitudinally extending spring rod.

The knee is the joint in the body most prone to injury and most frequently affected by arthrosis, as it is unstable and bears the full weight of the body. Muscular imbalances are also often the cause of pain in the front of the kneecap. Especially in people with sedentary jobs, the hamstring muscles are usually shortened and pull the joint capsule backwards, which increases the pressure on the kneecap unphysiologically. Sports injuries to the knee joint occur primarily when playing football and skiing due to sudden twists and strains on the lower leg. Affections of the knee usually result in local pain. The complexity of the joint makes an accurate diagnosis difficult. Therefore, it often happens that patients do not receive the correct initial treatment, which can lead to later degenerative diseases.

A variety of therapeutic aids are available to treat knee injuries, for immobilization or movement restriction as well as for supporting and relieving the knee joint. The area of active bandages is also covered by a variety of products that cannot be found for any other part of the body. For example, DE-A-34 16 231 describes a knee bandage that can be slipped on made of elastic material with, if necessary,

incorporated, longitudinal springs to reinforce the medial and lateral sides of the knee joint, a recess for the patella and padding surrounding this recess, whereby the padding surrounding the recess is designed in such a way that a contact pressure is exerted on the patellar ligament, which relieves the femoro-patellar sliding bearing. The padding surrounds the recess in a U-shape, whereby the U-shape is open at the top. The padding is an elastic U-element incorporated into the knee support, which surrounds the recess exclusively on the sides and from below. This element is made of silicone material or rubber. Furthermore, the U-element is designed as a bead with a convex side towards the body. However, the essential feature of this knee support is that the main volume of the padding or bead is arranged above the patellar ligament. In addition to being comfortable to wear, the knee joint should be optimally relieved while being guided at the same time, in order to achieve the shortest and gentlest possible healing process in the event of injuries, irritations or other pathological conditions. However, this knee bandage does not relieve pressure on the patellar ligament, because the aim is to achieve a contact pressure on the patellar ligament. The knee joint bandage according to DE-U-90 04 consists of a knee sock made of an elastic material such as rubber fabric that tapers conically towards the bottom. The knee sock has two supports on the front of the kneecap that extend from the top to the bottom and support the kneecap on the side on its underside. This knee joint bandage should allow the height of the kneecap to be changed in relation to the muscles, but should not move the kneecap in relation to the kneecap.

Keep the sliding surface in a raised position by supporting the kneecap from underneath.

DE-A-39 91 3 34 describes an elastic knee joint bandage in a tube shape with an elastic profile insert that surrounds the kneecap in a recess. A flexible, non-stretchable tensioning element is embedded in the profile insert in a firm connection with it, which connects the areas of the profile insert adjacent to the kneecap poles on the fibula side in an arc around the kneecap in such a way that when the distance between these areas increases when the knee joint is bent, the distance of the arc from the connecting line of the kneecap poles is reduced and the relevant edge of the recess of the profile insert presses on the adjacent side of the kneecap, displacing it medially and centering it. This knee joint bandage is intended to dynamically act on a kneecap that is displaced from its ideal position either pathologically or, as a very common normal variant, on the fibula side when the knee joint is bent, in order to correct the position of the kneecap. When the knee joint is bent, the brace used in this knee joint support is pulled apart, with the result that the brace straightens up and the desired centering effect is not fully achieved.

The invention is based on the object of creating a bandage for the knee joint, hereinafter referred to as the Genu knee joint bandage, and a knee joint bandage based on this, hereinafter referred to as the patella knee joint bandage for use in cases of a lateralization tendency of the patella, with which the following should be achieved:

- Support of physiotherapy. An important part of physiotherapy treatment is stretching the hamstring muscles.

- Relief of the knee joint and patella.

- Bring about rapid reduction of swelling, pain relief and improvement of function.

- Applying intermittent compression and massage to the soft tissues of the joint.

- Avoiding unwanted pressure on the patella and the underlying cartilage.

- Reduction of the contact pressure on the patella.

- Maintaining the physiological gliding ability of the patella.

- Relief of the attachment of the hamstring muscles.

- Avoiding unwanted pressure on the nerves and vessels that run in the back of the knee.

- Avoid negative effects on muscle activity.

- Avoiding the bandage creasing in the back of the knee.

- No impairment of the function of the quadriceps tendon, to pull the patella into its correct position,

The patella knee joint bandage should also have the following properties:

- Lateral guidance of the patella to reduce lateral deviation.

This object is achieved in a bandage for knee joints by the features specified in claims 1, 2, 3, 4 and 5.

A Genu knee joint bandage according to claim 1 consists of a

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anatomically shaped tubular body made of a fabric or knitted fabric with an all-round insert made of a highly elastic wave knit, with spring rods incorporated into the tubular body material over the seams connecting the rear bandage part to the front bandage part. In the front bandage part, a first pad made of a soft or soft-elastic material is arranged in the area above the kneecap when the bandage is applied, leaving the quadriceps tendon free. According to claims 4 and 5, a second or a second and a third pad made of a soft or soft-elastic material is inserted into the rear bandage part, which acts on the attachment of the hamstring muscles. In addition to a U-shaped pad, a pad with the features of claim 2 can also be used.

The patella knee joint bandage is designed in accordance with the Genu knee joint bandage; according to claim 3, it additionally has in its front bandage part at least one clasp that stabilizes the first pad and runs in the longitudinal direction of the bandage, which is an integral part of the first pad or is located to the side of it. This clasp is elastic and is preferably inelastic in the longitudinal direction.

With a knee joint bandage designed in this way, the following knee indications can be effectively treated.

- Irritation and overload of the knee joint.

- Distortions and contusions.

- Joint effusions and swelling in osteoarthritis and arthritis.

- Myotendopathies.

- Weak ligaments.

- Patellar tendonitis.

- Tendency to luxation of the patella.

- Lateralization tendency of the patella.

- Chondropathia patellae.

The indication framework of "painful irritation of the knee joint" is very broad and ranges from soft tissue swelling after sports or work accidents to chronic complaints and femoropatellar dysplasia with a tendency to lateralization. The latter requires design features of a knee brace that go beyond the properties required to treat general knee complaints. Incorporating all of the active factors into one product would have a restrictive effect on the indication range: the brace becomes a special brace and would represent over-treatment in the case of non-specific knee pain, for example. It is therefore advantageous to use two bandages, namely the Genu knee joint bandage as a general basic product for overload symptoms, femoropatellar pain syndromes and for patellar tendonitis, while the patella knee joint bandage is the product based on this Genu knee joint bandage and is used for lateralization tendencies and chondropathic complaints. Both bandages, the Genu knee joint bandage and the patella knee joint bandage, build on each other.

Therefore, the effects and advantages of both supports are largely identical, although the patella knee joint support also has additional advantages.

The Genu and Patella knee joint support supports physiotherapy and relieves the knee joint and the patella. Rapid swelling reduction, pain relief

relief and improved function is achieved. In addition, intermittent compression is applied to the soft tissues of the joint and a deep massage is applied. Undesirable pressure on the patella and the underlying cartilage is avoided. The pressure on the patella is reduced, while its physiological sliding ability is maintained. The attachment of the hamstring muscles is relieved. Undesirable pressure on the nerves and vessels that run in the back of the knee is avoided. There are no negative effects on muscle activity. The bandage does not constrict and does not cause circulatory problems. The formation of folds in the back of the knee when the knee is bent is minimized. The bandage does not slip and a good fit is maintained even when moving. The bandage is very comfortable to wear because it does not chafe and is kind to the skin. The knee joint bandage also has the advantage that the function of the quadriceps tendon to pull the patella into its correct position is not impaired. In addition, the patella knee joint bandage guides the patella laterally, reducing lateral deviation.

The Genu knee joint bandage is a three-dimensional anatomically shaped two-stretch bandage that extends from the lower leg to the thigh and has a functional slight bending position of around 10° and is equipped with pressure-reducing edges. The bandage itself consists of two parts, with the front bandage part spanning 2/3 of the leg circumference. Above the knee joint there is an insert made of highly elastic wave knit that extends around the entire leg. The rear bandage part is sewn in with a pre-tensioned wave of the wave knit.

Spring rods incorporated into pockets above the side seams keep the bandage taut. The wave knit is closed over the patella. In the area above the kneecap there is a first pad, preferably horseshoe-shaped. The pad, which opens upwards, leaves the quadriceps tendon free. In the lower part, the profile of the pad is adapted to the tibial head and the course of the ligamentum patellae. This pad, which is arranged in the front part of the bandage, preferably contains a button-shaped friction core made of a material that has a higher degree of hardness than the material of the pad. This friction core is arranged infrapatellarly. One pad or two pads are sewn into the rear part of the bandage, which are elliptical or have other geometric shapes and which act on the attachment of the hamstring muscles. These two pads are placed approximately 1 cm above the knee joint space directly on the lateral seams by means of which the front part of the bandage is connected to the rear part of the bandage.

The patella knee joint bandage is also a three-dimensional, anatomically shaped, two-stretch bandage for the knee joint. The bandage extends from the lower leg to the thigh and has a functional, slight bending position of about 10° and is equipped with pressure-reducing edges. The bandage also consists of two parts, with the front part covering 2/3 of the leg circumference. Above the knee joint there is an insert made of highly elastic wave knit that extends around the entire leg. The rear part of the bandage is sewn in with a pre-tensioned wave. Spring rods incorporated into pockets above the side seams keep the bandage taut. The knit is

closed over the patella. In the area above the kneecap there is a first pad, preferably horseshoe-shaped. The pad, which is open at the top, leaves the quadriceps tendon free. In the lower part, the profile of the pad is adapted to the tibial head and the course of the ligamentum patellae. The pad used in the patella bandage can contain a button-shaped friction core made of a material whose degree of hardness is higher than the degree of hardness of the material from which the pad is made. This friction core is then arranged infrapatellarly. In addition, the pad of the patella knee joint bandage can have a component with different stretch properties. The first pad is connected laterally to a fan-shaped strip or to a clasp, which is preferably made of a springy-elastic material, but has no longitudinal elasticity. When the elastic elements in the bandage are lengthened during movement between extension and flexion, this strip or clasp straightens and exerts a centering force on the pad. Two elliptical pads can be sewn into the rear part of the patella knee joint bandage, which act on the attachment of the hamstring muscles. These two pads are placed about 1 cm above the knee joint gap, directly on the side seams.

Advantageous embodiments of the invention are characterized in the subclaims.

The design of the wave knit fabric used to make up the insert that is arranged in the bending area of the bandage is particularly advantageous. This wave knit fabric

has a relief in the form of a wave structure on at least one side. This wave structure is elastically pre-tensioned and stabilized by an underlying thread arrangement made of highly elastic yarn or thread, whereby the cover structure bulges out in a wave-like, preferably half-wave-like, manner when the wave knit is relaxed. If this surface structure is used in a bandage and is stressed perpendicular to the alignment of the transverse waves, which is the case, for example, when the bandaged joint is bent, then initially only the transverse waves are pulled flatter or smoother, without the cover structure being stretched or extended. Overstretching of the cover structure can be reliably excluded in this way, which at the same time prevents the appearance of wrinkles in the inner joint bend area, even after prolonged use of the bandage. The wave knit is therefore particularly suitable for use in bandages that are used for joints with a large freedom of movement or bending angle, as is the case, for example, with knee joint bandages. Particularly advantageous is the design according to which the wave knit has a wave structure of a cover structure formed on at least one side and aligned essentially perpendicular to the main direction of stretch, wherein this wave structure is elastically pre-tensioned and stabilized by an elastic thread arrangement incorporated into or located under this cover structure, which is connected to the cover structure at predetermined intervals and is shaped in such a way that the number of transverse waves is greatest where the greatest stretch path occurs due to the bending of the joint.

Such a wave knit allows the use of

relatively inelastic yarn for the cover structure, which creates the prerequisite for economical production of the wave knit. Furthermore, with the wave knit there is no danger of overstretching of the yarn used, as there is a high basic elasticity.

Embodiments of the invention are explained in more detail below with reference to the drawing.

Fig. 1 in a front view of a Genu knee joint bandage with a U-shaped pad with spring rods arranged in the rear part of the bandage and two elliptical pads,

Fig. 2 a rear view of the Genu knee brace,

Fig. 3 in a front view of a patella knee joint bandage with a U-shaped pad and with a pad centering clip arranged at a distance from this at the side and with spring rods arranged in the rear part of the bandage and two elliptical pads,

Fig. 4 a rear view of the patella knee joint brace,

Fig. 5 shows a front view of another embodiment of the patella knee joint bandage with a U-shaped pad and a pad centering clip arranged laterally therefrom,

Fig. 6 shows a front view of another embodiment of the patella knee joint bandage with a U-shaped

Pelotte and with a pelotte centering clip integrated into one of the pelotte legs,

Fig. 7 in a front view of the U-shaped pad with a pad centering clip integrated into one of its legs,

Fig. 8 in a front view of the U-shaped pad with a pad centering clip molded onto one of the pad legs,

Fig. 9 in a front view of a Genu knee joint bandage with a U-shaped pad with a friction core,

Fig. 10 in a front view a U-shaped pad with a friction core,

Fig. 11 in a front view the U-shaped pad,

Fig. 12 is a vertical section along line XII-XII in Fig. 11,

Fig. 13 is a vertical section along line XIII-XIII in Fig. 11,

Fig. 14 in a front view an elliptical pad,

Fig. 15 is a vertical section along line XV-XV in Fig. 14,

Fig. 16 in a front view two elliptical pads connected by a bridge,

Fig. 17 is a vertical section along line XVII-XVII in Fig. 16,

Fig. 18 in a front view a U-shaped pad with lateral elliptical pads connected to the pad via webs,

Fig. 19 is a vertical section along line XIX-XIX in Fig. 18,

Fig. 20 in a front view a patella knee joint bandage with a U-shaped pad and with two pad centering clips arranged laterally to it,

Fig. 21 shows a schematic view from the front of an insert made of a highly elastic wave knit arranged all around the bandage,

Fig. 22 shows a rear view of the insert made of the highly elastic wave knit,

Fig. 23 in a schematic representation the formation of the highly elastic wave knit in the front bandage part and in the rear bandage part of the knee joint bandage,

Fig. 24 is an enlarged section through the insert made of the wave knit fabric according to line XXIV-XXIV in Fig. 23,

Fig. 25 shows a schematically simplified representation of the principle of deformation of a fabric made of the wave knit,

Fig. 2 6 representations of knitting rows for clarification

a first embodiment of a method for producing the wave-knitted fabric,

Fig. 27 in a representation similar to Fig. 26 another knitting pattern for the wave knit,

Fig. 28 shows a side view of a friction core arranged in the U-shaped pad,

Fig. 29 a view of the human knee joint, Fig. 30 a cross-section of the right tibia.

Fig. 31 in a view from above a ring-shaped pad and

Fig. 32 is a vertical section along line XXXII-XXXII in Fig. 31.

The knee joint, shown in Fig. 29, is located in the middle of the "lower extremity" movement chain and is the largest joint in the human body. The upper joint body is a roller notched in the middle. Opposite this is a very flat joint surface formed only by the tibia. The menisci, two cartilage plates lying on the tibia joint surface, represent the sockets in which the roller of the upper joint body can move like a hinge. There is no bony guide for the knee joint. This function is taken over by other structures. The strong collateral ligaments serve as guide rails for the hinge movement. The short cruciate ligaments located inside the joint prevent the joint-forming bones from slipping backwards or forwards. In front of the joint lies

embedded in a tendon, the kneecap. It is the largest free bone and serves to improve the pulling effect of the lower leg extensor. The patella tendon is very sensitive.

In the knee joint shown in Fig. 29, 100 designates the vastus lateralis muscle, 102 the vasti lateralis tendon, 103 the vastus intermedius muscle, 104 the recto femoris muscle, 105 the vastus medialis muscle, 106 the vastus medialis obliquus muscle, 107 the patella, 108 the lateral patellofemoral ligament, 109 the medial patellofemoral ligament, 110 the laterally patellotibial ligament, 111 the medial patellotibial ligament and 112 the patellae ligament.

The stabilizers of the knee joint are divided into four functional units: the stabilizers of the medial and lateral complexes as well as the dorsal and ventral structures, whereby a distinction is made between static and dynamic stabilizers.

Fig. 30 shows the right tibia 120 in a cross-section. Here, 121 is the medial meniscus, 122 is the lateral meniscus, 123 is the ligamentum genus transversum, 124 is the ligamentum patellae, 125 is the ligamentum cruciatum anterius, 12 6 is the ligamentum cruciatum posterius, 127 is the ligamentum meniscofemorale posterius, 128 is the ligamentum collaterale mediale, 129 is the ligamentum collaterale laterale, 13 0 is the medial capsular ligament, 131 is the lateral capsular ligament, 132 is the ligamentum obliquum posterius, 13 3 is the ligamentum

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popliteum obliquum, 124 the ligamentum popliteum arcuatum, 135 the muscle semimembranosus, 136 the muscle popliteus, 137 the tractus iliotibialis and 138 the fat pad of Hoffa.

The bandage 10 for a knee joint shown in the drawing consists of an anatomically shaped tubular body 20 made of a fabric or knitted fabric with an all-round insert 30 made of a highly elastic wave knit 40. Above the seams connecting the rear bandage part 11 with the front bandage part 12, spring rods 13, 14 are incorporated into the tubular body material, which are designed to run in an arc shape in accordance with the anatomical shape of the tubular body 20, as shown in Figs. 2 and 4. These spring rods 13, 14 are designed to run straight; they only take on the arc shape later when the bandage is formed.

In the front bandage part 12 of the bandage 10 there is a first pad 50 made of a soft or soft-elastic material that is open at the top and leaves the quadriceps tendon free, whereby this pad 50 sits in the area above the kneecap when the bandage is applied. This pad 50 is U-shaped and is formed by the legs 51, 52 and the web 53 connecting the legs, whereby the pad 50 can also be V-shaped.

A second or a second and a third elliptical pad 60, 60', which acts on the attachment of the hamstring muscles and is also made of a soft or soft-elastic material, is inserted into the rear bandage part 11 of the bandage 10.

Fig. 1 and 2 show a bandage 10 which is designed as a Genu knee joint bandage 10a.

As a further embodiment of the bandage 10, according to Fig. 3 and 4, a patella knee joint bandage 10b is provided, which is based on the Genu knee joint bandage and differs from the Genu knee joint bandage 10a only in that at least one elastic clasp 70 is additionally arranged in the front bandage part 12, which stabilizes the pad 50 and runs in the longitudinal direction of the bandage, whereby this clasp 70 is an integral part of the pad 50 or is located to the side of it. This clasp 70 preferably has no longitudinal elasticity.

According to a first embodiment, the pad 50 in the front bandage part 12 has a horseshoe-shaped design with an arched course of the outer edges 50a, 50b of the two pad legs 51, 52 (Fig. 7, 10 and 11). The pad 50 has a flat base surface 54 on the outside; the cross section of the pad legs 51, 52 and the cross section in a partial area of the pad web 53 corresponds to a semicircle or a partial circle (Fig. 12 and 13). In the web 53 connecting the pad legs 51, 52 to one another, an internal recess 55 is provided in the middle for adaptation to the tibial head and to the course of the ligamentum patellae. The roughly rectangular or square recess 55 has lateral guides 56, 57 running in the longitudinal direction of the bandage. This recess 55 in the pad 50 prevents increased pressure on the patellar ligament, while this profiling of the pad 50 simultaneously causes a surface massage. The lateral guides 56, 57 serve to guide the

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Patellar ligament. It is important, however, that this depression 55 in the pad 50 not only leads to a reduction in pressure, but is also adapted to the contour of the tendon.

The pad 50 is made of felt, foam rubber, neoprene, rubber, a viscoelastic silicone rubber or an elastic, compressible, pressure-deformable silicone rubber or a material with the same elastic properties as natural rubber, silicone foam or the like.

The pad 50 can also be bag-shaped and filled with a gaseous or liquid medium.

The pad stabilization clip 70 is located adjacent to one of the two legs 51, 52 of the pad 50. The shape of the clip 70 corresponds to the shape of the outer leg edge 50a or 50b of the pad 50 (Fig.3). The clip 70 can be arranged at a distance from the leg 51 of the pad 50. A woven or knitted section 41 is then arranged between the leg 51 of the pad 50 and the clip 70 (Fig.3). However, it is also possible to arrange the clip 70 next to the leg 51 of the pad 50 without any gaps (Fig.5). In another embodiment, the clip 70 is molded onto the leg 51 of the pad 50 and is thus part of the pad 50 (Fig.6). The clasp 70 and the pad 50 are then formed as one piece, with the clasp 70 having a form elasticity corresponding to its effect.

The clasp 70 is guided through the leg 51 of the pad 50 according to Fig.7 and into the pad material

embedded. In the embodiment shown in Fig. 8, the clasp 70 is embedded in the leg 51 of the pad 50, in such a way that the clasp 70 protrudes from the pad leg 51 at both ends with a section 70a, 70b each.

The pad stabilization brace 70 is preferably made of a springy-elastic material in order to be able to adapt to all movements. The brace 70 is preferably made of a plastic with sufficient flexibility and a degree of hardness that is higher than the degree of hardness of the material from which the pad 50 is made. The brace 70 is inelastic in the longitudinal direction; however, it can also be elastic in the longitudinal direction.

A button-shaped friction core 80 is incorporated into the pad 50 and is made of a material that has a higher degree of hardness than the pad material. This friction core 80 is arranged in the middle of the web 53 of the pad 50 that connects the two legs 51, 52 (Fig. 9 and 10). The difference between the hardness of the pad 50 and the hardness of the friction core 80 is at least 10 Shore, preferably 20 Shore A. The material of the pad 50 can also have a hardness of less than 50 Shore A and the material of the friction core 80 can have a hardness of more than 50 Shore A. It is important that the friction core 80 is made of a material that is somewhat harder than the material of the pad 50.

While the pad 50 is made of a soft or soft-elastic material, preferably of a viscoelastic silicone rubber or an elastic, compressible, pressure-deformable silicone rubber, e.g. with a hardness

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of 40 Shore A, a silicone rubber with a hardness of 9 to 13 Shore A or a compressible silicone rubber that can be deformed by pressure and returns to its shape without elasticity, of the type of cold rubber that vulcanizes using the polyaddition process and that, in addition to being highly flexible, has a hardness of less than 4 Shore A, although silicone rubbers with a hardness of more than 4 Shore A can also be used, the friction core 80 consists of a hard or incompressible plastic. Such viscoelastic silicone rubbers used for the manufacture of the pad 50 or materials with the same elastic properties have the property of having a massaging effect when a bandage with such a pad 50 is applied due to the sliding movement triggered by mass displacement when pressure is applied or when movements occur in the contact area. For the manufacture of the Pelotte 50, a material should always be chosen that is viscoelastic and provides a massage due to its elastic properties.

Compared to the pad 50, the friction core 80 is made of a hard or incompressible plastic, with e.g. a hardness of over 50 Shore A and is therefore much harder than the pad 50, so that a targeted friction massage is achieved on specific pain points in the joint during movement. Natural or artificial rubber or hard rubber can be used as the material for the friction core 80. For example, a chloroprene polymer (trade name NEOPREN) with a hardness of 50 Shore A, a rubber-elastic, cross-linked polyurethane (trade name VULKOLLAN) with a hardness of 65 to 90 Shore A, a silicone rubber with a hardness of 60 Shore A, an ethylene-propylene

Diene rubber (EPDM) with a hardness of 80 Shore A or a copolymer with acrylonitrile (trade name PERBUNAN) with a hardness of 70 Shore A, and also a polyamide can be used. However, other plastics or natural material derivatives can also be used to manufacture the friction core 80. It is important that the friction core 80 has sufficient hardness to be able to exert the targeted friction massage on specific pain points. The friction core 80 can also be made of metal or wood.

The friction core 80 can be arranged in the pad 50 so that it can be replaced. For this purpose, the pad 50 is provided with a recess (not shown in the drawing) of approximately the size of the friction core 80, into which the friction core 80 is pressed by means of light pressure. The inner wall surface that defines the recess in the pad 50 preferably has a profile that allows engagement with the profile of the surrounding wall surface of the friction core 80 and since the pad material is elastic but the friction core 80 has a greater hardness than the pad material, the friction core 80 can be pressed into the recess, whereby during the pressing process the profile of the inner wall surface is compressed so that the friction core 80 can slide completely into the recess and due to the resilience of the material of the pad 50 the pad material is pressed into the edge profile of the friction core 80 so that it is held firmly in the pad 450. By appropriately deforming the pad 50 by applying strong external pressure, the friction core 80 can be pressed out of the pad 50. This makes it possible to use friction cores of different hardnesses.

In the case where pads 50 with replaceable friction cores 80 are used, the pad 80 is attached to the tubular body 20 of the bandage in such a way that the pad 50 can be removed.

The friction core 80 according to Fig. 28 with a circular, square, rectangular or other geometrical cross-section has in the area of its circumferential wall surface 81 a recess in the form of a groove 82, groove-shaped recesses, undercuts, serrations or the like, which serve to accommodate the pad material so that the friction core 80 is fixed in its position in the molded body of the pad 50. Preferably, the arrangement of the friction core 80 in the pad 50 is such that it lies just below the surface of the pad 50 in order to be able to exert a high pressure on the joint.

The friction core 80, which is made of a hard or incompressible material, is fixed in position in the material of the pad 50. The friction core 80 has a spherical cap-shaped surface 83 or a surface design, which corresponds in design and shape to the surface design of the pad 50 in the arrangement area of the friction core 80.

According to a further embodiment, the material of the friction core 80, which consists of a plastic, e.g. silicone rubber, is fused with the material of the pad 50 and permanently connected to its molded body. The friction core 80 can also be formed during the manufacture of the pad 50 by hardening the material of a section that is to form the subsequent friction core and therefore has a

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greater hardness than the soft material of the pad 50. In both cases, silicone rubber should preferably be used as the material.

The pad 50 can also be bag-shaped. This bag is then made of soft, elastic plastics. The interior of the bag is filled with a gaseous medium, such as air, or a liquid medium, such as a viscous silicone oil, water or the like. The friction core 80 is then fixed in position on the inner wall surface of the bag.

The Genu knee joint bandage 10a is provided with a friction core 80 arranged in its pad 50 as described above (Fig. 1 and 2), whereas the patella knee joint bandage 10b is provided with the pad 50, which can be designed with or without a friction core 80 (Fig. 3 and 4). The mode of action of the pad 50 is that of a pressure pad.

In the embodiment shown in Fig. 3 and 4, a pad stabilization clip 70 is arranged on the side of the pad 50. However, it is also possible to arrange a pad stabilization clip 70, 70' in the front bandage part 12 on both sides of the legs 51, 52 of the pad 50 (Fig. 20).

According to a further embodiment, the pads 60, 60' sewn into the rear bandage part 11 are made of the same material as the pad 50. In addition to an elliptical design, the pads 60, 60' can also have a different shape. Each of these two pads 60,

60' is designed as a bead-shaped body. Instead of two pads 60,60', only one pad 60 or 60' can be sewn into the rear part of the bandage.

The two pads 60, 60' in the rear bandage part 11 can be connected to one another via a web 61 (Fig. 16 and 17). It is also possible to connect the two pads 60, 60' in the rear bandage part 11 to the legs 51, 52 of the pad 50 via webs 58, 59 (Fig. 18 and 19). The webs 61 and 58, 59 connecting the pads 60, 60' to one another or to the pad 50 are thin-walled and made of the same material as the pads 50, 60, 60', so that these webs 61 and 58, 59 have a high degree of flexibility.

The rear bandage part 11 is sewn in with the pre-tensioned wave knit 40 (Fig. 1 and 2). The pad as well as the pads 60, 60' and the pad stabilization clip 7 0 are arranged in the area of the insert 3 0 made of the wave knit 40 integrated into the tubular body 2 0 of the bandage 10.

The wave knit 40 of the insert 30 has a larger number of waves 42 in the front bandage part 12 than in the rear bandage part 11. The guidance of the waves 42 of the wave knit 40 of the insert 30 starts from a smaller number of waves in the rear bandage part 11 to a division of the waves 42 into two wave groups 46, 46' running at a distance from one another in the front bandage part 12, wherein in the space 45 formed between the two wave groups 46, 46' in the front bandage part 12 a wedge-shaped

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End sections 47,47' end of wave group 46" is arranged (Fig. 21 and 22). When sewing the front bandage part 12 together with the rear bandage part II, the wave knit 40 with the smaller number of waves 42 is stretched while the wave knit in the front bandage part 12 is simultaneously contracted (Fig. 23). A special feature of the bandage 10 is that for the insert 30, which is provided where the highest alternating stretching stresses of the bandage occur, a special textile structure, namely the wave knit 40, is used, which is explained in more detail below. However, it is also possible to let the waves 42 of the wave knit 40 of the insert 30 in the front bandage part 12 run straight and parallel.

The strip-shaped representation of the insert 30 in Figs. 21 and 22 indicates that the wave-knitted fabric 40 forms a relief in this area, which is illustrated in the illustration according to Fig. 24. This relief is a wave structure that is formed on at least one side of the bandage - in the embodiment shown in the drawings on the side facing away from the body. A series of half-waves 218 are arranged one after the other with interposed nodes or node areas 220, which are created as follows:

A cover fabric 224 formed by stitches 222 is firmly connected in the area of individual stitches 222' to an elastic thread arrangement 226 on the underside of the cover fabric 224 in such a way that a row of stitches 222 of the cover fabric 224 - in the embodiment four - is connected by a longer stitch 228 of the underlying elastic

static thread arrangement 226. The meshes 222 between the node points or areas 220 are thereby bulged upwards, whereby the transverse waves 218 are pre-stressed and stabilized. By varying the number of bridged meshes 222 and/or the meshes 228, the deformation behavior and the permanent elasticity can be specifically influenced.

The deformation behavior of the wave-knitted fabric 40 formed in this way can be seen in detail in the illustration in Fig. 25. On the left-hand side, the wave-knitted fabric is shown in the unloaded state. The stitches are indicated by lines and the connection between the stitches by small circles.

The elastic yarn 226 provided on the underside bridges the knot areas 220, between which four stitches 222 of the cover knit 224 are formed.

Due to the pre-tensioning of the elastic thread arrangement 226, the stitches 222 are bulged out to form half-waves 218, whereby the relief structure is created. The half-waves 218 each have between two and twelve, preferably four, rows of stitches.

The right-hand side shows how the wave knit 40 behaves when subjected to a tensile force F. It can be seen that the elastic thread arrangement 226 is stretched between the node areas 220 without any additional stretching stress occurring in the area of the half waves 218, i.e. in the area of the stitches 222. The wave knit 40 can therefore lengthen by the dimension L before the stitches 222 of the cover knit 224 are subjected to tensile stress. This dimension L accordingly creates

an expansion reserve of the bandage knit compared to conventional textile fabrics.

The connection between the cover fabric 224 and the elastic thread arrangement 226 can be made in a variety of ways. It is also possible to select or create the connection in such a way that waves 42 are formed on both sides of the wave knit 40. The cover fabric 224 does not need to be single-surface. Due to the protruding structure of the wave knit 40, normal knitting yarn, such as cotton or polyamide yarn, can be used for the cover fabric despite providing a high degree of stretch elasticity. Higher elastic yarn, such as winding yarn, is preferably used for the elastic thread arrangement 226, whereby this elastic thread can also be plated in order to improve the wear resistance of the textile fabric or knitted fabric.

An inlay thread can also be incorporated into the stitches 222 of the cover knit 224 in order to achieve a compression effect of the bandage in this area of the wave-shaped relief structure.

Figures 26 and 27 show two ways in which the above-described wave knit 40 can be produced on automatic knitting machines. Two needle beds are used here, namely a first needle bed 260 and a second needle bed 262 with needles arranged at the same distance from one another. Several rows of stitches - four in the example shown - made of normal knitting yarn, such as cotton or polyamide yarn 264, are knitted on the first needle bed 260. Two rows of stitches are then knitted on both needle beds 260, 262.

knitted with elastic yarn, such as rubber or wrapping yarn 268, whereby this elastic yarn is preferably added with a plating thread 266. In the fifth knitting row, knitting is only carried out on selected needles 602,604,606,... etc. or 622,624,626,... etc. of both needle beds. The plating thread can be made of a polyamide HE thread. The illustration shows that the sixth row of stitches is again knitted on all needles of the two needle beds 260,262. However, this is not absolutely required.

This is followed by four rows of stitches with normal yarn on the first needle bed 260 and finally two further rows of stitches using elastic yarn, whereby the eleventh knitting row differs from the fifth knitting row in that the needles involved in the needle beds 260,262 are offset by one.

Fig. 27 shows a different pattern with a slightly different weave in the area of the later knitted knots 220. The knitting rows one to five and seven to eleven correspond to the knitting pattern according to Fig. 26. The only difference is the formation of the 6th and 12th knitting rows, so that a more detailed explanation of this figure does not appear necessary.

Deviating from the manufacturing process described above, it is also possible to first knit one or more rows of stitches from elastic yarn, such as wrapping yarn, on one needle bed and rows of stitches from normal knitting yarn, such as cotton or polyamide yarn, on the other needle bed, with one or more rows of stitches then being knitted with all or individual needles on both needle beds.

There is no restriction to the fact that the insert 30 consists of a previously described wave knit 40. The only decisive factor is that the textile fabric forming the insert has such a structure that an elastic thread arrangement either incorporated or connected to a textile cover structure according to a predetermined pattern gives the fabric such an internal pre-tension that at least on one side a wave-like relief is created, which can then be initially smoothed or smoothed out by external stress without already stressing the cover structure to stretch in this phase.

The insert 30 made of the wave-knitted fabric 40 prevents the formation of wrinkles or counteracts the formation of wrinkles, especially in the inner bending area of the applied bandage 10.

Preferably, the pad stabilizing clip 7 0 is led out of the insert 3 0 of the wave-knitted fabric 40 at both ends, with the free clip ends being sewn into the fabric or knitted fabric of the tubular body 20 of the bandage.

In order to achieve an almost seamless transition from the web area of the pad 50 to the bandage, the web of the pad 50 can be provided with a tongue-like shape that tapers towards the outer edge and is made of the pad material. It is also possible to have the outer edge area of the web taper in the web sections on both sides of the middle of the web. The outer edge of the pad web is thus designed to taper flat towards the outside. The free ends of the two legs of the pad can be widened like an elephant's foot, which improves the contact and effective area of the pad 50.

According to a second embodiment, the pad 150 arranged in the front bandage part 12 is ring-shaped and preferably has an oval shape or the shape of an ellipse. In the lower area, the two pad legs 51, 52 merge into a narrow, thin-walled pad section 152 in the form of a web-like depression 151, whereby the lateral edges 151a, 151b delimiting the web-like depression 151 run in a straight line or in the shape of a circular arc, as shown in Fig. 31, whereby lateral friction, ie friction on both sides of the tendon attachment, is achieved. This friction is further supported by the fact that the sections 151a', 151b ⁷ of the pad legs 51, 52 ending in the area of the lateral edges 151a, 151b have a bead-like design (Fig. 32). The pad 150 consists of the same materials as the pad 50. The pad 150 is attached to the front bandage part 12 by means of a fabric cut 160 made of a thin material attached to the inner wall so that a double wall is obtained. The pad 150 is then held in an immovable position in the space thus formed by a seam indicated at 161 which connects the cut 160 to the fabric of the bandage part 12 (Fig. 31).

Claims (1)

ffin sayings Bandage for the knee joint made of elastic bandage material in tubular form with a front bandage part (12) and a rear bandage part (11) and with at least one incorporated, longitudinally extending spring rod, characterized in that the bandage (10a) consists of an anatomically shaped tubular body (20) made of a woven or knitted fabric with an all-round insert (30) made of a highly elastic wave knit (40) and that in the front bandage part (12) there is arranged a pad (50) made of a soft or soft-elastic material which lies in the area above the kneecap when the bandage (10a) is applied, is open at the top and leaves the quadriceps tendon free. Bandage for the knee joint made of elastic bandage material in tubular form with a front bandage part (12) and a rear bandage part (11) and with at least one incorporated, longitudinally extending spring rod, characterized in that the bandage (10a) consists of an anatomically shaped tubular body (20) made of a fabric or knitted fabric with an all-round insert (30) made of a highly elastic wave knit (40) and that in the front bandage part (12) there is arranged an annular pad (150) made of a soft or soft-elastic material, which lies in the area above the kneecap when the bandage (10a) is applied, which is provided with a web-like depression (151) in the lower area to form a thin-walled pad section (152) in order to reduce pressure on the patellar ligament, whereby the lateral edges (151a, 151b) delimiting the web-like depression (151) are straight or in the shape of a circle. 3. Bandage for the knee joint made of an elastic bandage material in tubular form with a front bandage part (12) and a rear bandage part (11) and with at least one incorporated, longitudinally extending spring rod, characterized in that the bandage (10b) consists of an anatomically shaped tubular body (20) made of a woven or knitted fabric with an all-round insert (30) made of a highly elastic wave knit (40), and that in the front bandage part (12) a lying in the area above the kneecap when the bandage (10b) is applied, open at the top and leaving the quadriceps tendon free or ring-shaped pad (50; 150) made of a soft or soft-elastic material and at least one clasp (70) stabilizing the pad (50; 150) and running in the longitudinal direction of the bandage are arranged, the clasp (70) being an integral part of the Pelotte (50;150) or lying to the side of it. 4. Bandage for the knee joint made of elastic bandage material in tubular form with a front bandage part (12) and a rear bandage part (11) and with at least one incorporated, longitudinally extending spring rod, characterized in that the bandage (10a) consists of an anatomically shaped tubular body (20) made of a fabric or knitted fabric with an all-round insert (30) made of a highly elastic wave knit (40), that in the front bandage part (12) there is arranged a first, upwardly open or ring-shaped pad (50; 150) made of a soft or soft-elastic material, which lies in the area above the kneecap when the bandage (10a) is applied and leaves the quadriceps tendon free, and that in the rear bandage part (11) there is a second or a second and a third, the attachment of the ischiocrural A pad (60,60') made of a soft or soft-elastic material is used to support the muscles. 5. Bandage for the knee joint made of an elastic bandage material in tubular form with a front bandage part (12) and a rear bandage part (11) and with at least one incorporated, longitudinally extending spring rod, characterized in that the bandage (10b) consists of an anatomically shaped tubular body (20) made of a woven or knitted fabric with an all-round insert (30) made of a highly elastic wave-knitted fabric (40), that in the front bandage part (12) a first pad (50; 150) lying in the area above the kneecap when the bandage (10b) is applied, which is open at the top and leaves the quadriceps tendon free or is ring-shaped and made of a soft or soft-elastic material and at least one clasp (70) which stabilizes the first pad (50; 150) and runs in the longitudinal direction of the bandage, wherein the clasp (70) is an integral part of the first pelotte (50;150) or lying to the side of it, and that a second or a second and a third pelotte (60,60') made of a soft or soft-elastic material, which acts on the attachment of the hamstring muscles, is inserted into the rear bandage part (11). 6. Bandage according to one of claims 1 to 5, characterized in that the first pad (50/150) is U-shaped or V-shaped and preferably has a horseshoe-shaped design with an arcuate course of the outer wheels (50a, 50b) of the two pad legs (51, 52) or an oval shape, wherein the first pad (50; 150) has an external, flat base surface (54), a semicircular or partially circular leg cross-section and in which the pad legs (51,52) interconnecting web (53) has a central inner recess (55) with lateral guides (56,57) running in the longitudinal direction of the bandage for adaptation to the tibial head and to the course of the ligamentum patellae. 7. Bandage according to one of claims 3 and 5, characterized in that the pad stabilization clip (70) is located adjacent to one of the two pad legs (51, 52) of the first pad (50; 150) and has a shape corresponding to the shape of the outer leg edge (50a; 50b). 8. Bandage according to one of claims 3, 5 to 7, characterized in that the pad stabilizing clip (70) is arranged at a distance from the pad leg (51) of the two pad legs (51, 52) of the first pad (50; 150), wherein a fabric or knitted section (41) is optionally arranged between the pad leg (51) of the first pad (50; 150) and the pad stabilizing clip (70). 9. Bandage according to one of claims 3, 5 to 8, characterized in that the pad stabilizing clip (70) is arranged without a gap next to the pad leg (51) of the two pad legs (51, 52) of the first pad (50; 150). 10. Bandage according to one of claims 3, 5 to 8, characterized in that the pad stabilization clip (70) is molded onto the pad leg (51) of the two pad legs (51, 52) of the first pad (50; 150). 11. Bandage according to one of claims 3, 5 to 8, characterized in that the pad stabilization clip (70) is passed through one of the two pad legs (51, 52) of the first pad (50/150) and is embedded in the pad material. 12. Bandage according to one of claims 3, 5 to 8, characterized in that the pad stabilizing clip (70) is guided through one of the two pad legs (51, 52) of the first pad (50/150) and is embedded in the pad material, the pad stabilizing clip (70) being guided out of the pad leg (51) at both ends with a section (70a/70b). 13. Bandage according to one of claims 1 to 12, characterized in that the first pad (50/150) contains a button-shaped friction core (80) which is incorporated into the pad material and which consists of a material which has a higher degree of hardness than the degree of hardness of the pad material. 14. Bandage according to claim 13, characterized in that the difference between the hardness of the first pad (50/150) and the hardness of the friction core (80) is at least 10 Shore A, preferably 20 Shore A, the material of the first pad (50/150) having a hardness below 50 Shore A and the material of the friction core (80) having a hardness above 50 Shore A. 15. Bandage according to one of claims 13 to 14, characterized in that the friction core (80) for layer fixing in the first pad (50/150) in the region of its · I circumferential wall surface (81) has a groove-shaped recess, indentation, such as a groove, undercut, toothing or the like, (82) for receiving pad material. 16. Bandage according to one of claims 13 to 15, characterized in that the material of the friction core (80) is fused with the material of the first pad (50; 150) and is permanently connected to the pad material, wherein the friction core (80) and the first pad (50; 150) consist of plastics, in particular silicone rubber or the like. 17. Bandage according to one of claims 14 to 19, characterized in that the friction core (80) is obtained during the manufacture of the first pad (50; 150) by material hardening of a section of the first pad (50; 150), the friction core (80) and the first pad (50; 150) being made of plastics, in particular silicone rubbers or the like, of different degrees of hardness. 18. Bandage according to one of claims 1 to 17, characterized in that all pads (50; 150; 60, 60') are made of felt, foam rubber, neoprene, rubber, a viscoelastic silicone rubber or an elastic, compressible, pressure-deformable silicone rubber or a material with the same elastic properties, such as natural rubber, silicone rubber or the like. 19. Bandage according to one of claims 1 to 18, characterized in that the friction core (80) consists of a • · ·♦ incompressible!! plastic, such as a natural or synthetic rubber, hard rubber, chloroprene polymer, a rubber-elastic, cross-linked polyurethane, polyamide, metal, wood or similar. 20. Bandage according to one of claims 1 to 19, characterized in that in the first pad (50; 150) a recess is formed which receives the friction core (80), which is held in the recess releasably by means of a press or clamp fit. 21. Bandage according to one of claims 1 to 20, characterized in that in the front bandage part (12) on both sides of the pad legs (51, 52) of the first pad (50; 150) at least one pad stabilization clip (70, 70') is arranged. 22. Bandage according to one of claims 1 to 21, characterized in that the two pads (60, 60') in the rear bandage part (11) are connected to one another via a web (61), the two pads (60, 60') optionally being connected via webs (58, 59) to the pad legs (51, 52) of the first pad (50; 150). 23. Bandage according to one of claims 1 to 22, characterized in that the spring rods (13, 14) have an arcuate design. 24. Bandage according to one of claims 1 to 23, characterized in that the rear bandage part (11) is sewn in with pre-tensioned knitted fabric or wave knitted fabric (40). 25. Bandage according to one of claims 1 to 24, characterized in that the first pad (50; 150), the second and third pads (60, 60') and the pad stabilizing clip (70) are arranged in the region of the insert (30) made of the wave-knitted fabric (40). 26. Bandage according to one of claims 1 to 25, characterized in that the first pad (50; 150), the second and third pads (60, 60') and the pad stabilization clip (70) are arranged in pocket-shaped receptacles which are formed or sewn into the bandage (10). 27. Bandage according to one of claims 1 to 26, characterized in that the wave knit (40) of the insert (30) in the front bandage part (12) has a larger number of waves (42) than in the rear bandage part (11). 28. Bandage according to one of claims 1 to 27, characterized in that the waves (42) of the wave knit (40) of the insert (30) in the front bandage part (12) are straight and parallel. 29. Bandage according to one of claims 1 to 28, characterized in that the guidance of the waves (42) of the wave knit (40) of the insert (30) takes place from a small number of waves in the rear bandage part (11) to a division of the waves (42) into two wave groups running at a distance from one another (46, 46') in the front bandage part (12), whereby in the between the two wave groups (46, 46') a wave group (46") running out into wedge-shaped end sections (47, 47') is arranged. 30. Bandage according to one of claims 1 to 29, characterized in that when sewing the front bandage part (12) together with the rear bandage part (11), the wave knit (40) with the smaller number of waves in the rear bandage part (11) is pulled together by the wave knit in the front bandage part (12). 31. Bandage according to one of claims 1 to 30, characterized in that spring rods (13, 14) are incorporated into the tubular body material via the seams connecting the rear bandage part (11) to the front bandage part (12). 32. Bandage according to one of claims 3.5 to 31, characterized in that the pad stabilizing clip (70) is elastic. 33. Bandage according to one of claims 3.5 to 31, characterized in that the pad stabilization clip (70) is elastic and inelastic in the longitudinal direction. 34. Bandage according to one of claims 1 to 33, characterized in that the pad (60; 60') or the pads (60, 60') are elliptical or have another geometric shape. 35. Bandage according to one of claims 1 to 34, characterized in that the pads (60, 60') are combined to form a pad.