EP2616033A1 - Grappin pour rotule et appareil pour déplacer une rotule comprenant un tel grappin à rotule - Google Patents

Grappin pour rotule et appareil pour déplacer une rotule comprenant un tel grappin à rotule

Info

Publication number
EP2616033A1
EP2616033A1 EP11749075.5A EP11749075A EP2616033A1 EP 2616033 A1 EP2616033 A1 EP 2616033A1 EP 11749075 A EP11749075 A EP 11749075A EP 2616033 A1 EP2616033 A1 EP 2616033A1
Authority
EP
European Patent Office
Prior art keywords
patella
contact finger
units
patient
holding element
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP11749075.5A
Other languages
German (de)
English (en)
Other versions
EP2616033B1 (fr
EP2616033B8 (fr
Inventor
Agathe Koller-Hodac
Domenico Leonardo
Manuel Altmeyer
Silvio Walpen
Daniel Felder
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Gredig Georg Joeri
Original Assignee
HSR Hochschule fur Technik Rapperswil
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by HSR Hochschule fur Technik Rapperswil filed Critical HSR Hochschule fur Technik Rapperswil
Publication of EP2616033A1 publication Critical patent/EP2616033A1/fr
Publication of EP2616033B1 publication Critical patent/EP2616033B1/fr
Application granted granted Critical
Publication of EP2616033B8 publication Critical patent/EP2616033B8/fr
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G99/00—Subject matter not provided for in other groups of this subclass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/008—Apparatus for applying pressure or blows almost perpendicular to the body or limb axis, e.g. chiropractic devices for repositioning vertebrae, correcting deformation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/04—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with hydraulic or pneumatic drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G2203/00—General characteristics of devices
    • A61G2203/30—General characteristics of devices characterised by sensor means
    • A61G2203/46—General characteristics of devices characterised by sensor means for temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5071—Pressure sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2205/00—Devices for specific parts of the body
    • A61H2205/10—Leg
    • A61H2205/102—Knee
    • A61H2205/104—Patella

Definitions

  • the invention relates to a patella, a device for moving a patella and a method for adjusting a device for moving a patella according to the preambles of the independent claims.
  • a kneecap is also referred to as a patella.
  • the knee is the largest and most complex joint of the human body and it can be affected by both degenerative and traumatic diseases. With an increase in the aging population, a continuous increase in degenerative knee diseases was observed (Schabus, R. and Bosina, E., The knee - Diagnosis, Therapy and Rehabilitation, 2007, Springer Verlag), which usually lead to defects in the knee cartilage . Such defects in the knee cartilage have resulted in 1,026 knee replacements in Switzerland in 2006 and more than 500,000 complete knee replacements worldwide according to an estimate from 2004 (Agnesmür, J.D. and Lobenhofer, P., Endoprosthetics of the Knee Joint, Trauma Surgeon, 2004,
  • the patella or patella is the moving bone that lies in front of the knee joint and which is bound into a tendon that connects the quadriceps muscles with the lower leg bones.
  • Articular cartilage covers the back of the kneecap. The mobilization or movement of this knee region is extremely important in the rehabilitation process in order to prevent sticking of the knee and the knee joint.
  • rehabilitation therapy is to reduce possible swelling, to prevent further inflammation, to maintain or restore the mobility of the knee through a number of passive movement exercises, to maintain or restore the mobility of the patella and the strength of the knee
  • the kneecap is usually repeatedly deflected from its normal position. By deflecting it from the normal position, it is intended to prevent the patella from sticking to the inside of the knee in the sliding groove provided for the kneecap in the thighbone because of possible bleeding. Such sticking of the patella leads to a deterioration in the mobility of the knee, increased stiffness and instability of the knee joint and increased pain. The deflection from the normal position thus serves to maintain the mobility and mobility of the knee joint and the knee.
  • the physiotherapist usually move the patella by hand based on long experience. Manually moving the kneecap must be done several times a day for several days by the physiotherapist.
  • the patella is moved manually in a medial-lateral direction and in a cranial-caudal direction (Heckmann, TP, Noyes, FR, Barber-Westin, SD, Rehabilitation of Primary and Revision Anterior Cruciate Ligament Reconstruction, in: Noyes Knee Disorders Surgery, Rehabilitation , Clinical Outcomes, publisher: Noyes, FR, 2010, Saunders Elsevier, Philadephia; Stalzer, S., Atkins, J., Hagerman, G., Rehabilitation Principles, in: The Crucial Principles in Care of the Knee, published by: Feagin, JA Jr.
  • the patella When moving in the medial-lateral direction, the patella is moved from its center transversely to each side. When moving in a cranial-caudal direction, the patella is moved longitudinally up and down, ie towards the head and the opposite, lower body end.
  • the terms "longitudinal direction” and “transverse direction” refer to the leg of the patient.
  • the patients are instructed by the physiotherapist to move the kneecap manually even in the medial-lateral direction and in the cranial-caudal direction for several weeks, several times a day, even after discharge from the clinic or the rehabilitation center itself.
  • the patella is to be in this way until the sixth week after the operation two to three times a day for about 10 to 15 minutes
  • passive exercise devices For the mobilization of the knee joint in the longitudinal direction passive exercise devices can be used, which perform a continuous movement of the patella (so-called continuous passive motion - CPM). These passive motion devices are driven by an ex ternal ⁇ motor and move the leg in a controlled manner within a predefined diffraction of the knee joint, the muscles remain passively (US 5,333,604 A; Stalzer, S., Atkins, J., Hagerman , G., rehabilitation Principles, 'in: The Crucial Principles in Care of the Knee, Publisher: Feagin, JA Jr. and
  • the knee joint is bent automatically, thereby improving the mobility.
  • this device only indirectly helps to reduce the sticking of the kneecap.
  • the kneecap is namely only moved in the longitudinal direction, which does not correspond to the optimal movements that should be performed by the patella in the rehabilitation therapy.
  • the known passive motion devices contain no sensors and no control with which the movements of the knee and the patella could be monitored.
  • Manufacturer of such passive motion devices For example, Sutter in the USA, Chattanooga Group, Astromot, Danniger and Kinetec.
  • a patella gripper is also referred to as a patella gripper.
  • the inventive patella for a patella comprises a holding element and a contact finger device, wherein the contact finger device is arranged on the underside of the holding element.
  • the underside of the retaining element is the side facing the knee when the patella is used.
  • the upper side of the retaining element is the side opposite the underside.
  • the contact finger device comprises at least two contact finger units, which are arranged on opposite sides on the underside of the holding element, wherein the contact finger device is configured such that the patella can be moved by means of the contact finger units in cranial-caudal and medial-lateral direction.
  • the movement in the cranial-caudal direction and in the medial-lateral direction takes place successively, whereby the sequence is variable.
  • the movement in the cranial-caudal direction also includes a movement in the caudal-cranial direction.
  • the contact finger device comprises in the longitudinal direction two contact finger units arranged on opposite sides of the retaining element on opposite sides of the transverse axis of the retaining element. These contact finger units are adjustable in the longitudinal direction. They serve to move a kneecap in a cranial-caudal direction.
  • the longitudinal direction corresponds to the longitudinal direction of a leg of a patient.
  • the cranial-caudal direction is defined as the direction from the head to the opposite end of the body, ie, the feet, of a patient.
  • the contact finger device comprises two contact finger units provided in the transverse direction of the holding element, these contact finger units being arranged on opposite sides of the longitudinal axis of the holding element.
  • These contact finger units are adjustable in the transverse direction. They serve to move the kneecap in the medial-lateral direction.
  • the transverse direction corresponds to the transverse direction of a leg of a patient.
  • the medial-lateral direction encompasses the directions from the middle of the patella to its sides, ie laterally to the cranial-caudal direction.
  • the contact finger means is rotatably arranged on the holding element, so ⁇ that it about an axis perpendicular to the longitudinal axis of the support member and perpendicular to the transverse axis of the holding element, ie by a height axis and Z-axis, rotatable bar is in particular by 90 degrees.
  • the contact finger device comprises two contact finger units which are arranged on opposite sides on the underside of the holding element.
  • the contact finger units are preferably arranged in the starting position in the longitudinal direction on opposite sides of the transverse axis or in the transverse direction on opposite sides of the longitudinal axis of the retaining element. It can be provided on the upper side of the holding element, a handle for guiding the patella and / or for rotating the contact finger device. All contact finger units are preferably height-adjustable.
  • the contact finger units comprise one or more contact fingers.
  • the device according to the invention for moving a patella comprises a patella grasper according to the invention and a leg support device. Furthermore, one or more drive units for the movement of the
  • Fingertip units of the patella gripper are provided in the cranial-caudal (i.e., longitudinal) or medial-lateral (i.e., transverse) directions, and a control unit for controlling the one or more drive units. Under the motion of a
  • Kneecap is also understood as the mobilization of a kneecap.
  • the one or more drive units may move the contact finger units directly or indirectly through movement of the entire patellar scribe.
  • the inventive patella and the apparatus according to the invention for moving a patella can be used both in clinically monitored rehabilitation therapies as well as in unmonitored, performed by the patient rehabilitation therapies.
  • both the movement of the patella in the cranial-caudal direction and the movement in the medial-lateral direction can be achieved by means of the appropriately designed contact finger device, the healing process after a knee operation can be improved and if necessary also accelerated in comparison with conventional methods.
  • a mobilization of the knee joint often makes sense even before an operation, whereby the inventive knee disc gripper and the device according to the invention can also be used for this purpose.
  • the patella can be automatically adjusted to regular massive and repeatable way in the cranial-caudal direction and in the medial-lateral direction to be moved.
  • the movement of the kneecap thus no longer needs to be done by a physiotherapist.
  • the physiotherapist is thus relieved of this quite monotonous and time-consuming activity and thus costs can be saved in the rehabilitation therapy.
  • the device is set into a learning phase (also called a learning mode) by actuating an activation button provided on the device.
  • a learning phase also called a learning mode
  • the patella has been applied by a physiotherapist or the patient himself to the kneecap of the patient.
  • the inventive patella can also be applied by means of the control unit on a patella of a patient.
  • the position in which the patella is located after application represents the initial position or zero position of the patella gripper, which is preferably in the
  • Control unit is deposited, for example by pressing a provided on the patella gripper control element.
  • the movement of the patella can be in the direction to be learned, i. the movement in the direction to be learned next is only then released or unlocked.
  • the contact finger units are moved toward the patient's head in a cranial-caudal direction by a drive unit until the patient actuates the activation key again, the value of the force exerted on the patella at the time the activation key is actuated and / or. or the value of the maximum deflection of the
  • Patellar gripper or the contact finger units are stored directly or indirectly in the device (first cranial-caudal process step). Further, by means of the control unit, the contact finger units are moved via the drive unit in a cranial-caudal direction towards the patient's head opposite body end until the patient actuates the activation key, again the value of force exerted on the patella at the time the activation key is actuated or the value of the maximum deflection of the patella or of the contact finger units is stored directly or indirectly in the device (second cranial-caudal method step).
  • An "activation of an activation key” inter alia means both pressing the activation key and releasing the activation key held down.
  • the patella gripper is preferably returned to the zero position by means of the control unit. Thereafter, by means of the control unit, the contact finger units via the same or another drive unit in medial-lateral
  • the contact finger units are moved in the medial-lateral direction via the same drive unit as in the last method step from the initial position to the patient's right side of the body until the patient actuates the activation key, again the value at the time of Actuation of the activation button on the patella and / or the value of the maximum deflection of the knee bengreifers or the contact finger units directly or indirectly stored in the device (first mediallateral process step).
  • Direct storage of the exerted force is understood to mean the storage of the force actually measured by means of one or more force sensors.
  • Indirect storage of the applied force is understood as the storage of a measured quantity from which the applied force can be derived. This may, for example, to act by one or more pressure sensor units precisely measured ⁇ NEN pressure ((as fluidic pump in an embodiment the one or more drive units n)).
  • the movement of the contact finger units can be done directly (even without movement of the retaining element) or by movement of the patella.
  • Direct storage of the deflection of the patellar gripper or of the contact finger units is understood to mean the storage of the deflection actually measured by means of one or more linear sensor units (also referred to below as linear sensor units).
  • An indirect storage of this deflection is the storage of a measured quantity, from which the deflection can be derived. This may be, for example, a combination of the measured or the predetermined
  • Speed value for the fluidic pump and the measured time i.e., the time since the start of the displacement in a specific direction
  • the one or more antifac units as a fluidic pump (s)
  • the sequence of the first cranial-caudal procedural step, the second cranial-caudal procedural step, the first medial-lateral procedural step and the second medial-lateral procedural step is arbitrary in the method according to the invention, ie these method steps can be performed in any order.
  • a cranial caudal process step and a medial-lateral process step there is a rotation of the contact finger device by 90 degrees when the contact finger device contains only two opposite contact finger units and is rotatable.
  • the inventive method for adjusting the device according to the invention proceeds advantageously automatically or automatically, so that it can also be performed by the patient without the help of a physiotherapist.
  • the device and thus the rehabilitation therapy can be adapted to the healing process of a patient.
  • FIG. 1 is a perspective view of a first embodiment of an inventive patella with a view from above
  • FIG. 2 is a perspective view of a first embodiment of an inventive patella with view from below
  • FIG. 3 is a perspective view of a first embodiment of an inventive device for moving a kneecap
  • FIG. 4 is a further perspective view of a first embodiment of an inventive device for moving a patella with a schematically illustrated leg portion of a patient
  • 5 shows the illustration according to FIG. 4, wherein a first embodiment of the patella according to the invention is applied to the leg section of the patient
  • FIG. 6 shows a further perspective view of a first embodiment of an apparatus according to the invention for moving a kneecap with a leg section of a patient
  • Fig. 7 is a block diagram of a first embodiment of an inventive apparatus for loading movement ⁇ a patella
  • FIG. 8 is a schematic representation of the leg support device of a first embodiment of an inventive device for moving a kneecap with leg inserted
  • FIG. 9 is a flow chart illustrating the setting and operation of the first embodiment of the patellar movement apparatus according to the present invention.
  • FIG. 10 shows a graph of the measured force exerted by the first exemplary embodiment of the device according to the invention in a cranial-caudal direction as a function of time
  • FIG. 11 shows a graph of the measured force exerted by the first exemplary embodiment of the device according to the invention in a cranial-caudal direction and the measured displacement of the patella as a function of time
  • FIG. 12 is a perspective view of a second embodiment of a patella according to the invention, which is attached to a leg portion of a patient, and a leg holding device,
  • FIG. 13 is a perspective view of a second embodiment of an inventive patella with a view from below and 14 shows a block diagram of a second exemplary embodiment of an apparatus according to the invention for moving a kneecap.
  • like reference numerals designate like or equivalent components.
  • the patella gripper 1 comprises a handle 2, a holding element 3 and a contact finger device 4 with four contact finger units 4.1, 4.2.
  • the handle 2 is on the upper side of the holding element 3 and the contact finger device 4 is arranged on the underside of the holding element 3.
  • the handle 2 is preferably arranged centrally on the upper side of the holding element 3 and preferably screwed to the holding element 3.
  • Each contact finger unit 4.1, 4.2 is assigned an adjustment unit 5, which comprises guide rails 6 and a height adjustment unit 7.
  • the handle 2 is optional. It is also a guide of the patella 1 directly on the holding element 3 possible.
  • each contact finger unit 4.1 is arranged on the longitudinal axis 8 of the patellar gripper 1 (and thus of the holding element 3) in such a way that a respective contact finger unit 4.1 is arranged on each side of the transverse axis 9 of the patella 1 or the holding element 3. If the patella 1 is applied to a patella of a patient, the patella can be moved back and forth in a cranial-caudal direction via the contact finger units 4.1 by appropriate guidance / movement of the patella 1.
  • Each contact finger unit 4.1 preferably comprises two contact fingers 10, which can be attached to a knee disc attached condition to attack these.
  • the contact fingers 10 are arranged such that they are located on opposite sides of the longitudinal axis 8 of the patella 1 and retaining element 3. With two such arranged contact fingers 10 per contact finger unit 4.1, a particularly good fit of the patella 1 on a patella and a well-guided movement of the patella can be effected in a cranial-caudal direction.
  • each contact finger unit 4.1 when the contact finger unit 1 is applied to a leg of the patient, any scars which often run longitudinally and any swelling can be taken into account by positioning one contact finger 10 of each contact finger unit 4.1 on one side of the scar or the swelling positio - so that painful contact with the scar / swelling is avoided.
  • each contact finger unit 4.1 also have more or less than two contact fingers 10.
  • the patella gripper 1 is applied to a patella of a patient, the patella can be reciprocated in the medial-lateral direction via the contact finger units 4.2 by appropriate guidance / movement of the patella 1.
  • Each contact finger unit 4.2 preferably comprises a contact finger 10, which engages in attached to a patella state to this.
  • the contact fingers 10 are arranged such that they are located on the transverse axis 8 of the patella 1 or retaining element 3. This can cause a well-guided movement of the patella in the medial-lateral direction become.
  • each contact finger unit 4.2 also have more than one contact finger 10.
  • the ends of the contact fingers 10 farther from the support member 3 are preferably spherically shaped to allow patient-friendly contact with the patient's leg and knee.
  • the contact fingers 10 are preferably provided with protective hoods (not shown).
  • the protective covers are preferably made of silicone or a silicone-like material or include such.
  • the protective hoods are preferably glued to the ends of the contact fingers 10. The provision of such protective hoods can better avoid or at least reduce the pain and irritations which can arise due to the contact of the patient's leg with the knee disc gripper.
  • the contact finger units 4.1, 4.2 are preferably adjustably mounted on the holding element 3 in height via the height adjustment units 7 of the setting units 5 assigned to them. Further, the Kunststofffingerüen .1 preferably in the longitudinal direction and the contact finger units 4.2 preferably in the transverse direction on the guide rails 6 of their associated adjustment units 5 adjustably attached to the Garele- element 3, wherein the guide rails 6 of the contact finger units 4.1 in the longitudinal direction and the guide rails 6 of Contact finger units 4.2 extend in the transverse direction.
  • the guide rails 6 and the height adjustment units 7 can have latching points for different positions of the contact finger units 4.1, 4.2 in the longitudinal direction or in the transverse direction and in the height. Furthermore, the guide rails 6 are preferably each assigned a scaling or mass graduation 11.
  • the height adjustment units 7 can each be assigned a scaling or a mass division.
  • the adjusting units 5 By means of the adjusting units 5, the Po ⁇ sition of the contact fingers units 4.1, 4.2, and thus the contact fingers are manually adjusted 10 relative to the knee of the patient. Also, both the comparable Tikale as well as the horizontal position of the knee ticket ⁇ bengreifers 1 relative to the knee can be adjusted manually.
  • the manual positioning of the contact finger units 4.1, 4.2 is preferably carried out by a physiotherapist.
  • the initial distance between "the Grefingereinhei- th 4.1, 4.2 in the longitudinal and transverse directions are preferably adapted to the typical dimensions of knees of men, women or depending on the application of children, so the distances slightly beyond the extents of typical knees lengthwise - and lie in the transverse direction.
  • the holding element 3 is preferably configured diamond-shaped, with each tip of the diamond-shaped holding element 3 receiving a contact finger unit 4.1, 4.2 and its associated setting unit 5.
  • the edges of the diamond-shaped retaining element 3 are preferably arched inwardly for the more comfortable handling of the patella gripper 1 and can assume the function of a grip for moving the patella 1 as gripping surfaces.
  • the inventive patella 1 can be used manually by a physiotherapist or a patient in the context of rehabilitation therapy. However, it can also be used as part of a device 20 for automatic movement of a patella, as shown in Figures 3 to 7, wherein Figure 7 shows the block diagram of the device 20.
  • the device 20 preferably has an adapter 21 for connecting the patella 1.
  • the patella 21 is configured to receive the adapter 21.
  • the adapter 21 preferably comprises two vertically adjustable laterally and parallel juxtaposed, height-adjustable gripping arms 22.
  • the handle 2 is preferably removable from the holding element 3, so that the adapter 21 is inserted between the handle 2 and the holding element 3. can be brought, wherein the handle 2 after attaching the adapter 21 on the holding element 3, which for this be ⁇ preferably has corresponding latching elements, on the adapter 21 or again on the holding element 3 can be detachably fastened.
  • FIGS. 3 to 7 show a first exemplary embodiment 20 of an apparatus according to the invention for moving a kneecap.
  • the device 20 comprises a patella according to the first exemplary embodiment and a leg support device 23, which preferably has supports 35 for the lower leg and thigh of a patient.
  • the device 20 has an adjusting device 24, which serves, inter alia, the height adjustment of the patellar scribe 1 and in which the gripper arms 22 of the adapter 21 engage in such a way that they are adjustable in height, preferably latchable. By adjusting the height of the gripping arms 22 can be adjusted in height via the adapter 21 of the patella 1 and lowered in this way on a knee of a patient.
  • the adjusting device 24 is preferably pivotable about a transversely extending transverse axis and preferably also about a longitudinal axis extending in the longitudinal direction, so that the position of the patella 1 on the knee disc can be optimized, depending on the position of the leg in the leg holding device 23.
  • the inventive Knee cap device 20 can be used for both right and left legs.
  • Transport device 20 preferably has a locking mechanism, so that the adjustment device 24 and the patella 1 are fixed.
  • the device 20 furthermore has a first drive unit 25 for the movement of the patella gripper 1 in a cranial-caudal direction, ie in the longitudinal direction, a second drive unit 26 for the movement of the patellar gripper 1 in the medial-lateral direction, ie in the transverse direction, and a control unit 27 for control and preferably for controlling the first drive unit 25 and the second anti-collision unit 26 (see FIG. 7).
  • the first drive unit 25, the second drive unit 26 and the control unit 27 are preferably housed in a common housing 48 for protection.
  • a battery (not shown) is preferably used, so that the device 20 can be easily transported.
  • the battery is preferably also in the housing 48. However, it can also be provided in addition to or as an alternative to the power supply, a connection for a building power system.
  • the first and second drive units 25, 26 control the movement and position of the patella 1 over the movement / position of the adjustment device 2.
  • FIG. 4 shows the device 20 according to the invention for moving a kneecap with a schematic representation of a leg section 49 of a patient, wherein the leg section 49 encompasses the knee 30 of the patient and the patella 1 is shown at a height away from the leg section 49.
  • the device 20 shown in FIG. 5 corresponds to the device 20 in FIG. 4, with the patella gripper 1 now being lowered onto the knee 30 by means of the adjustment device 24 and acting on it.
  • FIG. 6 corresponds to the representation in FIG. 5, wherein a real leg 38 with a knee 39 is now illustrated, to which the patella 1 attacks.
  • FIG. 7 shows a block diagram of the device 20 according to the invention for moving a patella, which comprises a patella according to the first exemplary embodiment.
  • the control unit 27 controls the cranial-caudal movement or the movement in the longitudinal direction of the patellar scribe 1 and thus the patella of a patient via the first drive unit 25 when the patella 1 engages the patella. Furthermore, the control unit 27 controls via the second drive unit 26, the medial-lateral movement or movement in the transverse direction of the patella gripper 1, and thus in the applied state of the patella of a Pa ⁇ tienten.
  • the first and the second drive unit 25, 26 each have a motor 28, in particular a Elect ⁇ romotor (preferably a DC motor) and a linear guide unit 29, the linear Füh ⁇ approximation unit 29 of the first drive unit 25 the knee ⁇ disk gripper 1 in the longitudinal direction and the linear guide unit 29 of the second drive unit 26 moves the patella 1 in the transverse direction.
  • a transmission unit 30, in particular a transmission is preferably provided, wherein the transmission unit 30 may comprise a clutch.
  • the motors 28 are preceded by a respective power electronics unit 31, via which the control unit 27 controls the motors 28.
  • the power electronics units 31 may include power amplifiers. Further, various sensors are preferably provided, which will be discussed below.
  • the first and second drive units 25, 26 are operated in such a way that they grip the patella 1 in accordance with a Cartesian coordinate system in the X and Y directions, i. in longitudinal and transversal direction or in cranial-caudal and medial-lateral direction.
  • a corresponding linear sensor unit 32 For measuring the linear movement or for the deflection of the patellar gripper 1 in the cranial-caudal and in the medial-lateral direction, a corresponding linear sensor unit 32, in particular a linear potentiometer, is provided for each direction, which measures the extent of the position change at the respective linear guide unit 29 and therefore measures the position / deflection of the patellar gripper in the longitudinal or in the transverse direction and transmits the measured values to the control unit 27.
  • the linear sensor units 32 are also referred to as position sensor units.
  • each motor 28 is associated with a coder or encoder 33 which measures the position of the motor shaft and transmits the respective power electronics unit 31 and / or the control unit 27.
  • the control unit 27 controls the patellar gripper 1 via the first and the second drive units 25, 26.
  • Position limit switches are preferably provided. If a position limit switch is moved by a linear guide unit 29 when the patella 1 is moved, this is detected by the control unit 27 as reaching the maximum permissible deflection and the patella 1 is moved back to the zero position by the control unit 27 for safety reasons.
  • force sensors 34 are provided which measure the force exerted on the patella 1 and transmit the measured force to the control unit 27. Depending on the measured force, the control unit 27 also regulates the patella 1 via corresponding activation of the first and the second drive unit 25, 26.
  • the force sensors 34 are preferably attached to or integrated in the adapter 21 and comprise strain gauges or are designed as such.
  • the force sensors 34 may alternatively or additionally be arranged in the contact finger units 4.1, 4.2.
  • the motor currents are preferably monitored by means of the control unit 27 by corresponding current sensors (not shown) associated with the motors 28 in order to prevent unpleasant shocks of the patella 1 to the kneecap of a patient.
  • the measurement of the motor currents represents a measurement redundant to the force measurement, which serves to protect the patient.
  • the device 20 is preferably a temperature sensor (not shown) integrated to measure the temperature in the device for safety reasons, so that overheating can be detected.
  • a temperature sensor (not shown) integrated to measure the temperature in the device for safety reasons, so that overheating can be detected.
  • the provision of sensors for different quantities results in a redundant measuring system, which guarantees the safety of the patient and offers several monitoring options for the entire healing process of the patient.
  • the control unit 27 By means of the force sensors 34, the linear sensor units 32, the position limit switches not shown, the current sensors, not shown, the temperature sensor and the monitoring and evaluation of these fed back, measured values by the control unit 27, the safety of the use of the device 20 for the Patients are assured.
  • the tolerable limit values for the measured values or quantities, in particular for the measured force and the measured position change / deflection, depend on the respective patient and are therefore preferably determined before the actual rehabilitation therapy as part of a learning phase and stored in the device 20.
  • the control unit 27 initiates a reversal of movement of the patella 1, so that the patella 1 is moved back to the initial position.
  • the control unit 27 changes to a safety mode in which the device 20 is automatically shut down by the control unit 27 and the linear guide units 29 are replaced by one of The control unit 27 caused decoupling of the motors 28 of the mechanical parts of the transmission units 30 are free to move, so that the patella 1 is free to move, the respective coupling of the transmission units 30 is preferably designed magnetically.
  • FIG. 8 shows the leg support device 23 of the device 20, which has two supports 35, one support 35 being able to receive one thigh and the other support 35 a lower leg of a patient.
  • the leg-holding device 23 is suitable both for the reception of a left and a right leg.
  • straps 36 are used, which are attached to the supports 35.
  • the leg 38 should be either in an extended or slightly bent state. Even a bending of the leg 38 of more than 20 degrees may impede the mobility of the patella, since the kneecap is usually already in the thigh groove at such an angle.
  • the leg-holding device 23 is designed or connected to the housing 48 of the device 20 in such a way that it can be tilted so that the patient has a can take a comfortable position.
  • the leg holding device 23 is also so mounted on the housing 48 that it is adjustable in height in order to increase the comfort for the patien ⁇ th.
  • the leg holding device 23 is configured such that the angular position of the supports 35 can be changed to each other, which leads to a change ⁇ tion of the knee flexion.
  • the supports 35 are connected to each other via a corresponding hinge 37.
  • the flexion of the knee can be defined by the angle ⁇ indicated in FIG.
  • the adjustability of the leg support device 23 allows the device 20 to be adjustable with respect to various leg morphologies and knee pathologies.
  • the device 20 is preferably operated via an external user interface (not shown) such as a laptop. Via the external user interface, the device 20 can be controlled and the rehabilitation therapy performed by the device on the knee of a patient can be displayed and monitored. For this purpose, for example, the application program Labview installed on the external user interface can be used. In the external user interface, different therapy phases can be stored for activation.
  • the device 20 preferably has a corresponding interface (not shown) such as a serial interface, eg a USB interface (USB: Universal Serial Bus), so that only one cable for the connection of the external user interface with the device 20 is needed.
  • the device can also communicate by means of radio transmission, for example according to the Bluetooth protocol with an external user interface.
  • the user interface can also be integrated in the device 20 and provided on the outside of the housing 48.
  • the application of the device 20 according to the invention for the movement of a patella is preferably carried out in two successive phases.
  • the first phase the device 20, the deflections / displacements or movements of the patella are taught.
  • This first phase represents a learning phase in which the device is set up for or calibrated for a particular patient.
  • the second phase the device 20 then performs the learned or set movement of the patella.
  • the first phase or the learning phase is on
  • this learning phase only has to be repeated after its initial implementation if parameters of the rehabilitation therapy have changed between two therapy sessions.
  • the learning phase can be performed manually or automatically or automatically by the device 20.
  • the Phy ⁇ siotherapeut moves the patella gripper 1, to move the knee ticket ⁇ be in cranial-caudal direction upwards and downwards and in the medial-lateral direction from inside to outside, and back.
  • the physiotherapist decides which maximum movements / deflections or displacements of the patella do not cause any pain in the patient.
  • the physiotherapist in the device 20 stores or stores the force / deflection values corresponding to these maximum movements / deflections or displacements, in particular by pressing corresponding keys on the patellar gripper 1.
  • the force / deflection values can also be transmitted via an internal or external user interface be deposited in the device 20.
  • the stored force / deflection values are then evaluated in the subsequent second phase, the actual therapy phase with successive therapy sessions. advises 20 used for the movement of the patella of the respective patient by means of the patella 1.
  • the device 20 moves the patellar gripper 1 - e.g. after pressing an activation button provided on the device 20 for the activation of the learning phase - automatically gently and slowly, preferably in 2-millimeter increments, first in a cranial-caudal direction and then off and then in the medial-lateral direction first to the one and then to the other side, until the patient begins to feel pain, and signals this to the device 20, for example, by releasing or repressing the activation button or by actuating a corresponding further activation button so that the learning movement in the learning phase is interrupted and the patella 1 is interrupted by the control unit 27 is moved back to its initial position.
  • the kneecap can be moved only in the medial-lateral direction and then in a cranial-caudal direction.
  • the patella 1 is preferably first moved back to its initial position.
  • the device 20 may also be configured to process patient acoustic signals, e.g. at the loud word "stop" the learning phase interrupts.
  • the force / displacement values or deflection values that are present when the learning phase is interrupted are stored in the device 20 via the force sensors 34 and / or the linear sensor units 32. They may be re-uploaded at any time and several times and will be used as values for the movement of the patella of the device 20 in the later second phase during the therapy sessions so that the learning phase need not be performed at each therapy session, resulting in a time saving.
  • the automatic implementation of the learning phase offers in particular for the patient's own therapies that he performs in his home. During the first phase, he can easily assume a relaxed and comfortable position.
  • the amplitude of the displacement / displacement of the patella is gradually increased, up to the values stored for the deflections and / or the forces in the respective direction (cranial-caudal or medial-lateral), so that pain-free treatment can be ensured.
  • the physiotherapist can set parameters of rehabilitation therapy, for example by means of the application program Labview. the duration of each therapy session / treatment in minutes and the cycle rate, i. the number of up and down movements in cranial-caudal
  • the control unit 27 For a change from the cranial-caudal to the medial-lateral direction of the patellar scribe 1 is preferably returned by the control unit 27 in the middle position (initial position), which also represents the initial position or zero position of the patella 1. Since the second phase is fully automatic, it is completely repeatable and comprehensible, even by the patient himself.
  • the applied forces / displacements or deflections are preferably generated by the device 20 and / or the external user interface by the force sensors 34 and / or the recorded linear sensor units 32 so that not only the result of each therapy session in particular graphically displayed and evaluated on the user interface and / or the device 20, but also therapy results of several therapy sessions over a longer period of time can be compared. In this way, healing progress can be recorded and monitored.
  • the learning phase and the second phase are separate for the cranial-caudal direction and for the medial-lateral
  • a first step 40 the device 20 or a user, for example a physiotherapist, of the device 20 checks whether the values for the movement of the patella are set in the medial-lateral direction. If this is not the case, then in step 41 the first phase, ie the learning phase, for the medial-lateral direction is performed either manually or automatically. After completion of the learning phase, the second phase for the medial-lateral direction begins in step 42, in which the force / deflection values stored in the learning phase are used by the control unit 27 to control the patella 1 and thus to move the patella in the medial-lateral direction become. The displacement / deflection of the patella in the medial-lateral direction takes place according to a predetermined cycle rate.
  • step 43 it is checked whether the cycle rate is reached. If this is the case, then in step 44 either automatically or by the user checks whether the values for the movement of the patella are set in a cranial-caudal direction. If this is not the case, the learning phase for the cranial-caudal direction runs either manually or automatically in step 45. After completion of the learning phase, the second phase will ent ⁇ speaking carried out step 42 for the cranial-caudal direction in step 46th In step 47, the number of shifts / deflections of the patella in the cranial-caudal direction is monitored (corresponding to step 43) and at the predetermined cycles It ⁇ range rate, the therapy session is terminated.
  • the steps 44, 45, 46, 47 for the cranial-caudal direction and then the steps 40, 41, 42, 43 for the medialleral direction can be performed. Furthermore, it is also possible to check whether the values for the movements are set in the medial-lateral direction and in the cranial-caudal direction (Steps 40 and 44) and, depending on the result of the examination, the learning phases can be carried out for both directions ( Steps 41 and 45) and only after completion of both learning phases, the second, actual therapy phases can be carried out for both directions (steps 42, 43 and 46, 47). In a change from cranial-caudal to medial-lateral
  • the patella 1 is preferably returned by the control unit 27 first in the middle position (initial position).
  • FIG. 10 shows an exemplary course of the force applied by the device 20 for movement / deflection of the patella in a cranial-caudal direction during a therapy session over time.
  • the force values gradually increase.
  • the control unit 27 reduces the amplitude of the force and thus the deflection automatically.
  • the power of ranks according to the deflection and direction of deflection ie, cranial-caudal upward toward the patient's head, or down toward the patient's feet). The greater the deflection of the knee disc, the greater the force applied.
  • FIG. 10 shows exemplary courses of the measured force values (dashed curve) and deflection values (solid curve) during a learning phase in the cranial-caudal direction, within which the maximum permissible force (the limit value for the force) is determined beforehand as 20 Newton and in the device 20 had been deposited.
  • the displacement of the patella by means of the patella 1 of the device 20 uniformly and steadily toward the head of the patient to 8 millimeters (-8 millimeters from the initial position or zero position of the patella 1) and then in the direction opposite to the head Body end increased to 8 mm.
  • the measured force values oscillate between about -15 Newton (towards the end opposite the head) and about 10 Newton (towards the head).
  • an external force is applied to the kneecap via the operating surface and the control unit 27 by means of the patella 1, which exceeds the predetermined limit of 20 Newton, to check whether the monitoring of the force values for limit value overruns.
  • the deflection and the force are automatically and directly reduced by the device 20 with the aid of the control unit 27 when the applied force exceeds the stored limit value.
  • the patella 1 is automatically and immediately moved by the control unit 27 back to its initial position. After this takes place automatic reduction of the deflection and the force of the device 20, a new learning phase is started, in which the applied force again is gradually increased.
  • the measurement of the applied force by means of the force sensors 34 and the feedback of the measured force values to the control unit 27 ensure painless treatment of the patient.
  • Exceeding a current limit for the Mo ⁇ torströme the drive units 25, 26 are automatically and immediately deactivated by the control unit 27 to set the speed reference values for the motors 28 to zero and sets comparable linear guide units 29 in the freewheel.
  • FIGS. 12 and 13 show a second exemplary embodiment 51 of a patellar gripper according to the invention with which a patella can be moved.
  • the patella 51 comprises a holding element 53, on the underside of a contact finger device 54 is arranged.
  • the contact finger device 54 comprises two contact finger units 54. 1 arranged on opposite sides on the underside of the holding element 53 and comprising at least one, preferably two, contact fingers 55 each. To the contact fingers 55 and possibly provided protective hoods for this applies to the first embodiment 1 of the invention according to the present patella above.
  • the contact finger device 54 and thus the
  • Contact finger units 54.1 are rotatably mounted on the holding member 53 so that the contact finger units 54.1 move from a position in the longitudinal direction on opposite sides of the transverse axis of the holding member 53 (to move the kneecap in the cranial-caudal direction or in the longitudinal direction) to a position in the transverse direction opposite sides of the longitudinal axis of the support member 53 (for movement of the patella in the medial-lateral direction or in the transverse direction) can be moved and vice versa.
  • the contact finger device 54 is preferably rotatable by at least 90 degrees.
  • the holding element 53 has Preferably, at least one, preferably two circular arc ⁇ shaped openings 56.
  • a corresponding number of handles 52 is provided for Dre ⁇ hen the contact finger means 54, wherein the one or more handles 52 connected to the contact fingers 54, and preferably a handle 52 via an orifice 56 with the Contact finger device 54 is connected.
  • Each contact finger unit 54.1 is associated with a fluidic actuator 59, the term being intended to include both "pneumatic” and “hydraulic” fluidly.
  • they are pneumatic actuators.
  • Each fluidic actuator 59 may be, for example, a fluid fillable pad, with each pad having a plurality (preferably three) sequentially, i. sequentially, may comprise arranged fillable chambers 59.1.
  • the fluidic actuators 59 are preferably arranged between the respective contact finger unit 54.1 and the edge of the holding element 53 and act on the respective contact finger unit 54.1. Each contact finger unit 54.1 is thus applied to a fluidic actuator 59.
  • the fluidic actuators 59 are preferably driven or filled with fluid via a fluidic pump 58, the fluidic pump 58 being part of a second exemplary embodiment 60 of a device for moving a patella according to the invention.
  • the device 60 according to the invention is shown as a block diagram in FIG.
  • FIG. 12 shows, in addition to the patella 51, the leg support 63 of the device 60 according to the invention, with the patella 51 being mounted on a leg splint 64 of the leg support 63, which leg splint 64 can be applied to the top of a leg.
  • the leg splint 64 preferably has an opening for the knee above which the patella 51 is disposed, and seats 65 and 66 may be present for the thigh and the lower leg, to de ⁇ nen thigh and lower leg. Be ⁇ vorzugtdeem the angle between the shots can be adjusted and changed 65 66 /, which leads to changes in underlying knee flexion.
  • the patient's leg can be bent for the therapeutic movement of the patella, or be stretched again.
  • tethers 67 which form part of the leg holding device 63rd Figure 12 shows the patella 51 for better illustration spaced from the leg 49 of the patient.
  • the patella 51 preferably has an adjustment device 57 by means of which the height of the patella 51 can be adjusted in relation to the knee.
  • the adjustment device 57 - and thus the patella 51 firmly connected to it - is preferably pivotable about the transverse axis, so that the position / position of the patella 51 on the kneecap of the patient can be optimized.
  • the patella 51 and the device 60 can be used for both right and left kneecaps or legs.
  • the receptacles 65, 66 of the leg support device 63 are preferably folded down or folded down below the patella 51.
  • the kneecap can be mobilized by means of the contact finger units 54. 1 both in the cranial-caudal direction and in the medial-lateral direction.
  • the contact finger units 54.1 are correspondingly moved by means of the fluidic actuators 59, for which the fluidic actuators 59 are actuated by a fluidic pump 58, one of the fluidic actuators 59 depending on the direction of movement (or not) Fluid is filled.
  • the contact finger device 54 of the patellar gripper 51 can be rotated so that the contact finger units 54.1 via the fluidic actuators 59 firstly in a cranial-caudal or caudal-cranial direction (ie in the longitudinal direction back and forth) and secondly in the medial-lateral direction ( so in the transverse direction) are movable back and forth so that the patella can be mobilized in the appropriate direction.
  • the one or more contact fingers 55 of the contact finger units 5 .1 forward the force introduced via the fluidic actuators 59 in a targeted manner onto the kneecap.
  • FIG. 14 shows a block diagram of the device 60 according to the invention for moving a kneecap.
  • the device 60 comprises a control unit 67 for controlling the drive unit 68 formed by the fluidic pump 58 and the fluidic actuators 59 68 for the contact finger units 54.1, wherein the control unit 67 and the fluidic pump 58 for protection preferably in a separate housing, not shown are housed.
  • the fluidic pump 58 is connected via valves 69 to the fluidic actuators 59, which also form part of the drive unit 68.
  • the valves 69 and the fluidic pump 58 are controlled via the power electronics unit (s) 70 by the control unit 67.
  • the control unit 67 controls the movement of the patella over the control of the fluidic pump 58, which then depending on the desired direction of movement fluid into one of the fluidic actuators 59 promotes, by means of prior rotation of the contact ⁇ finger device 54 by 90 degrees, the movement of the knee ⁇ slice can be done in the longitudinal direction or in the transverse direction.
  • this pressure exerts pressure on the associated con ⁇ tact finger unit 54.1 and moves them (and thus the kneecap) in the desired direction.
  • Pressure sensor units 71 are preferably provided, which in particular measure the pressure exerted by the fluidic actuators 59 and transmit the measured pressure value to a pressure regulator 72, which compares the measured pressure value with a stored desired pressure value and in particular via a corresponding signal to the control unit 67 the target pressure value einre- gel.
  • the sensors described in the context of the patella 1 and the gripper device 20 or sensor units or at least some thereof may be provided.
  • the power supply of the device 60 may be as described above for the device 20. The same applies to the operation or an external user interface of the device 20.
  • linear sensor units / linear sensor units 73 are preferably provided which measure the deflection of the contact finger units 54.1 and transmit the measured values to the control unit 67.
  • a movement of the patella 1 is provided by means of a fluidic pump and fluidic actuators be, as with respect to the second embodiment 51 of an inventive .
  • Patellar gripper and the second embodiment 60 of a device for moving a patella according to Figures 12 to 14 are provided. Accordingly may comprise a linear guide unit by the kneecap gripper 51 and the device 60 to be one or more drive units for the con tact ⁇ 54.1 finger units are provided, each egg ⁇ NEN motor, in particular an electric motor, and.
  • the device 20 may include a leg support device as shown in FIG.
  • the device 60 may include a leg support device as shown in FIG.
  • the patellar 51 and the device 60 are rotated 90.degree.
  • the direction of movement of the kneecap from longitudinal to transverse direction or vice versa.

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  • Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Epidemiology (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Rehabilitation Tools (AREA)

Abstract

L'invention concerne un grappin à rotule pour une rotule dotée d'un élément de retenue (3 ; 53) et d'un dispositif de doigt de contact (4 ; 54), le dispositif de doigt de contact (4 ; 54) étant disposé sur le côté inférieur de l'élément de retenue (3 ; 53), le dispositif de doigt de contact (4 ; 54) comprenant au moins deux unités de doigt de contact (4.1, 4.2; 54.1) qui sont disposées sur des côtés opposés de l'élément de retenue (3 ; 53), et le dispositif de doigt de contact (4 ; 54) étant conçu de telle sorte que la rotule peut être déplacée au moyen des unités de doigt de contact (4.1, 4.2; 54.1) dans les directions crânio-caudale et dans la direction médio-latérale. L'invention concerne également un appareil (20 ; 60) doté d'un tel grappin pour rotule (1 ; 51).
EP11749075.5A 2010-09-16 2011-08-08 Grappin pour rotule et appareil pour déplacer une rotule comprenant un tel grappin à rotule Active EP2616033B8 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH01509/10A CH703815A1 (de) 2010-09-16 2010-09-16 Kniescheibengreifer, Gerät zum Bewegen einer Kniescheibe und Verfahren zum Einstellen des Geräts zum Bewegen einer Kniescheibe.
PCT/CH2011/000177 WO2012034239A1 (fr) 2010-09-16 2011-08-08 Grappin pour rotule et appareil pour déplacer une rotule comprenant un tel grappin à rotule

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EP2616033A1 true EP2616033A1 (fr) 2013-07-24
EP2616033B1 EP2616033B1 (fr) 2020-02-05
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Publication number Publication date
US20130233323A1 (en) 2013-09-12
EP2616033B1 (fr) 2020-02-05
EP2616033B8 (fr) 2020-04-15
WO2012034239A1 (fr) 2012-03-22
CH703815A1 (de) 2012-03-30
US10188574B2 (en) 2019-01-29

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