IL264910A - Dynamic synovial joint brace - Google Patents

Description

DYNAMIC SYNOVIAL JOINT BRACE FIELD OF THE INVENTION The present invention relates, in some embodiments thereof to a joint brace which includes stationary and moving parts that allow to mimic the natural joint motion while preventing an undesirable and/or dangerous movement of the joint. In some embodiments, the brace allows a plantarflexion and a dorsiflexion motions while restricting eversion and inversion and/or abduction and adduction motions. In some embodiments, the brace preserves the natural instantaneous center of rotation (ICR) motion of a joint while movement.

BACKGROUND OF THE INVENTION Joint injuries, such as ankle injuries, are among the most common orthopedic injuries. Those injuries are most common among athletes, old people, and combat soldiers. Traditional treatment includes application of pressure to the injured area to reduce swelling and prevention of movement of the ankle in order to prevent undesirous and harmful motions. The most recent acceptable treatment regime however refers to continuous exercise as soon as possible after the injury. It is therefore desirable to provide an orthopedic device or orthosis which allows movement of the injured joint while restricting mobility in unwanted directions.

Typical joint braces and support structures include elements connecting the joint while applying pressure in an attempt to control the joint's movement. Various orthotic braces include an upper and lower portions hingedly connected at the ankle bone position allowing the brace to rotate backwards and forwards.

U.S. Patent 8641654 discloses, “a hinged ankle brace having a semi-rigid ankle cuff and a semi-rigid foot bed rotatably connected by a medial hinge and a lateral hinge provides enhanced stability and support to a wearer's ankle. The medial hinge of the ankle brace may be higher than the lateral hinge to accurately replicate the bending motion of an ankle. The ankle brace also includes ratchetably interconnected semi-rigid straps. These semi-rigid straps provide a semi-rigid structure encircling the ankle of a wearer for enhanced support. The ratchet mechanism may include a curved window that enables angular adjustment of the ratcheting straps. The ankle brace may also include a soft inner liner and a soft outer sleeve. The outer sleeve is configured to 1 provide compression to the semi-rigid shell, which in turn provides additional compression to the ankle. The semi-rigid foot bed may include posterior extensions that cup and support the wearer's heel, and a posterior cut-out portion that receives the wearer's heel.” U.S. Patent 9770357 discloses “an ankle brace that has a stirrup with a flat bottom portion and a first and second upright leg. Each of the first and second upright legs has an upper end and a lower end, the upper end having a circular opening therethrough and the lower end attached to the flat bottom portion. First and second pivot legs, each having a circular opening therethrough, are removably and rotatably connected to the first and second upright legs, respectively. First and second leg extensions are removably connected to the first and second pivot legs, respectively.

When connected, the circular openings in the pivot legs overlap the respective circular openings in the upright legs, and each pivot leg is rotatable about an axis through and perpendicular to the pivot leg circular opening. The circular openings in the first and second upright legs are positioned and sufficiently large to allow at least a portion of the malleolus bone of an ankle to protrude therethrough.

U.S. Patent 4938777 discloses an ankle orthosis device which comprises a foot receiving cup or shoe which is integrated with or to which is rigidly attached a force transmitting rib which has an inverted Y-shape. At the proximal end of the Y is slidably attached to the rib for securing the device to the lower leg near the distal end of the tibia.

U.S. Patent 4936295 discloses a support bar pivotally attached to a high-top shoe, with the upper end of the bar well above the ankle and the lower end of the bar just below the foot. The upper end of the bar is fixed about centrally of the leg, while the lower end of the bar is fixed just forward of the heel.

Some braces attempt to allow other forms of motion. For example, U.S. Patent 5242379 discloses an ankle brace for limiting flexing and pivoting movement of the ankle joint. The brace includes a soft resilient sock and a pair of brace panels positioned and retained over the sock on opposite sides of the ankle and foot. Each panel is formed by a pair of brace sections hinged together by a floating pivot axis hinge. The hinge includes a pair of juxtaposed hinge plates adapted to pivot and slide with respect to each other. One of the plates is secured to the ankle section of the brace and the other is secured to the foot section of the brace. 2 The braces and panels thereof attempt to allow a circular motion of the ankle, hence are based on a floating pivot axis.

U.S. Patent 6409695 discloses an ankle-foot orthotic which includes a lower leg shell attachable to the lower leg of the wearer inside of the wearer's trousers, a foot shell held in place inside the wearer's shoe, by the shoe itself, and a pair of mechanical joints attaching the lower leg shell to the foot shell. The mechanical joints are pivotally attached to the foot shell.

The mechanical joint merely allows a linear vertical motion while restricting rotational motion of the joint.

U.S. Patent 9398970 discloses a lightweight therapeutic ankle foot orthosis designed for increasing the range of motion and correcting alignment of the foot and ankle. The orthosis creates a variable load stretch at the ankle to prevent contracture and shortening of the heel cord.

The above braces fail to mimic the actual movement of the joint. Hence, not only such braces fail to promote healing of an injured joint but may otherwise be harmful due to limited natural motion of the joint. In the case of the ankle, movement while walking includes change in position of the ankle's joint center (a.k.a, Instantaneous Center of Rotation; ICR, or Instantaneous Axis of Rotation; IAR). Namely, walking is a complex motion that includes rotational as well as translational movements of the ICR.

The axis of rotation of the ankle joint was studied by Lundberg, A. et al. (The journal of bone and joint surgery 71B, pp. 94-99, 1989). In their study, the researchers discovered that the talo-crural joint axis may alter considerably during the arc of motion.

Recent studies have demonstrated progress in further revealing the kinematic and biomechanics properties of synovial joints.

Kelly N. Saln et al., (Appl Bionics Biomech. 2016; 2016: 5985137) presented a new model for simulating aspects of in vivo foot ankle mechanisms. A 2D testing method was established to determine the location of the IAR of the ankle joint under simulated stance phase conditions in a human cadaveric model. The study shed light as to the range of motion and differences between dorsiflexion and plantarflexion. 3 V. Pinskerova et al., (Does the femur roll-back with flexion? J. Bone Joint Surg [Br] 2004;86-B:925-31) illustrated a different pattern of movement in the knee joint between the lateral and medial sides of the knee.

In view of the foregoing, there is a need for novel joint braces that allow the actual natural movement of the joint and restrict undesirous and harmful motions such as inversion and eversion. The herein provided brace attempts to fulfill such requirements.

SUMMARY OF THE INVENTION It is an object of the invention to provide a joint brace that allows the actual, naturally occurring variable combined rotational and translational motion of the joint.

It is an object of the invention to provide a joint brace that maintains the natural spatial momentary axis of rotation of the joint.

It is an object of the invention to provide a joint brace that restricts undesirous motions of the joint, such as abduction and adduction movements in the transverse plane and eversion and inversion movements in the frontal plane.

It is an object of the invention to provide a joint brace that allows full range of plantarflexion and a dorsiflexion motions in the sagittal plane and limits excess range of such motions and/or dangerous and harmful motions. The herein disclosed brace and method allows such attributes and provide an efficient, comfortable and supportive joint brace.

An aspect of the invention pertains to a brace for a synovial joint comprising: a first limb retainer element for attachment to a first limb portion; a second limb retainer element for attachment to a second limb portion; and a transmission mechanism movably connecting the first retainer to the second retainer at the medial and lateral sides of the joint, the transmission mechanism allows a rotational movement and further a translational movement along a length between the first retainer and the second retainer, thereby allowing a momentary spatial center of rotation movement of the synovial joint during plantarflexion and dorsiflexion.

In one or more embodiments, the invention provides a brace for a synovial joint, the brace comprising: a first limb retainer element for attachment to a first limb portion; a second limb retainer element for attachment to a second limb portion; and 4 a linkage movably connecting the first retainer to the second retainer, the linkage allows a rotational movement and further a /or translational movement along a sloped length between the first retainer and the second retainer, thereby allowing a momentary spatial center of rotation movement of the synovial joint during plantarflexion and dorsiflexion.

In one or more embodiments, the transmission mechanism or linkage allows a one-dimensional translation movement between the first retainer and the second retainer.

In one or more embodiments, the transmission mechanism or linkage allows, a back and forth dorsiflexion and plantarflexion via a path of the sloped linkage. In one or more embodiments, the slope downwardly inclines towards an anterior side of the foot.

In one or more embodiments, the transmission mechanism disposed adjacent the instantaneous center of rotation of a joint of a subject.

In one or more embodiments, the transmission mechanism disposed in a first linkage at the medial side of the joint, movably connecting the first retainer to the second retainer at the medial side, and in a second linkage disposed at the lateral side of the joint and movably connecting the first retainer to the second retainer at the lateral side.

In one or more embodiments, the slope defines an angle in a range of about 2 to about 40 degrees between a longitudinal length of the first limb retainer and the slope or longitudinal axis of the transmission mechanism. In one or more embodiments, the slope defines an angle in a range of about 2 to about 30 degrees between a longitudinal length of the first limb retainer and the slope or longitudinal axis of the transmission mechanism. In one or more embodiments, the slope defines an angle in a range of about 5 to about 20 degrees between a longitudinal length of the first limb retainer and the slope or longitudinal axis of the transmission mechanism. In one or more embodiments, the slope defines an angle in a range of about 2 to about 10 degrees between a longitudinal length of the first limb retainer and the slope or longitudinal axis of the transmission mechanism.

In one or more embodiments, the linkage comprises an intermediate element comprising a hinge and/or a conforming element, the hinge and/or conforming element allow the rotational and translational movement of the limb retainer elements with respect to each other.

In one or more embodiments, the conforming element includes a slot, and the hinge includes a pin, the slot allowing accommodating therein the pin such to provide the movement of rotation and translation when the pin and/or slot move with respect to each other.

In one or more embodiments, the slot is moveable about the pin.

In one or more embodiments, the slot includes a track, allowing a sliding movement of the pin and slot with respect to each other.

In one or more embodiments, the slot has a slope defining an angle in a range of about 2 to about 40 degrees between a longitudinal length of the first limb retainer or vertical axis and the slope or longitudinal axis of the slot. In one or more embodiments, the slot has a slope in a range of about 5 to about 20 degrees between a longitudinal length of the first limb retainer and the slope or longitudinal axis of the slot.

In one or more embodiments, the slot has a length of between about 10 mm and about 30 mm.

In one or more embodiments, the slot has a length of between about 15 mm and about 25 mm.

In one or more embodiments, the slot has a width of between about 5 mm and about 15 mm.

In one or more embodiments, the pin disposed about the middle of the slot during the foot flat step in the gait cycle of a subject.

In one or more embodiments, the transmission mechanism or linkage includes a sloped spring allowing translational movement along the sloped length between the first retainer and the second retainer.

In one or more embodiments, the first retainer is configured to retain a tibia and the second retainer is configured to retain a foot.

In one or more embodiments, the brace allows plantarflexion and a dorsiflexion motions in the sagittal plane.

In one or more embodiments, the brace restricts abduction and adduction movements in the transverse plane, and/or eversion and inversion movements in the frontal plane. 6 In one or more embodiments, the brace is having a first limb retainer, a second limb retainer and a linkage moveably connecting the first and second limb retainers at both the lateral and medial sides of a joint.

In one or more embodiments, the first and second limb retainers are synchronized in their rotational and translational movements.

In one or more embodiments, the brace further comprising a fixature member for fixating the first and/or second limb retainer to a limb portion.

In one or more embodiments, the fixature element is selected from an adhesive, a glue, a magnet, a high friction element providing a high friction between the limb portion and the brace, or a combination thereof.

In one or more embodiments, the brace further comprising a synchronizing element that allows synchronization of the rotational and/or translational movement between the medial and lateral sides of the joint.

In one or more embodiments, the first limb retainer element, the second limb retainer element, and/or the linkage manufactured from a rigid or semi-rigid material.

In one or more embodiments, the intermediate element is attached to the second retainer and is moveable about the first retainer.

In one or more embodiments, the intermediate element is integrally attached to the second retainer forming a single piece of material.

In one or more embodiments, the intermediate element is attached to the first retainer and is moveable about the second retainer.

In one or more embodiments, the intermediate element is integrally attached to the first retainer forming a single piece of material.

In one or more embodiments, the brace includes a conforming element including 2 pins in 2 slots. In one or more embodiments, the first retainer has an axis and the translation is not parallel to the axis.

In yet a further aspect, the present invention provides a brace for a synovial joint comprising: a first limb retainer element for attachment to a first limb portion; a second limb retainer element for attachment to a second limb portion; a first linkage disposed at the medial side of the joint and movably connecting the first retainer to the second retainer at the medial side; and 7 a second linkage disposed at the lateral side of the joint and movably connecting the first retainer to the second retainer at the lateral side; wherein the first linkage allows a rotational movement and the second linkage allows a rotational and translational movement between the first retainer and the second retainer, thereby allowing a momentary spatial center of rotation movement of the synovial joint.

In one or more embodiments, the first retainer is configured to retain a femur and the second retainer is configured to retain a tibia.

In one or more embodiments, the linkage comprises a pin and an intermediate element having a slot, the slot allowing accommodating therein the pin such to provide the movement of rotation and/or translation when the pin and/or slot move with respect to each other.

In one or more embodiments, the pin protrudes from the first limb retainer and fixedly attached thereto.

In one or more embodiments, the slot in the lateral side has a length of between about 10 mm and about 30 mm.

In one or more embodiments, the brace further comprising a fixature member for fixating the first and/or second limb retainer to a limb portion.

In one or more embodiments, the fixature element is selected from an adhesive, a glue, a magnet, a high friction element providing a high friction between the limb portion and the brace, or a combination thereof.

In one or more embodiments, the intermediate element is attached to the second retainer and is moveable about the first retainer.

In one or more embodiments, the intermediate element is integrally attached to the second retainer forming a single piece of material.

In one or more embodiments, the slot in the lateral side is substantially horizontal.

In one or more embodiments, the slot in the lateral side is substantially wider than the slot in the medial side.

In one or more embodiments, the slot in the lateral side translates backwards and forward about a central axis of rotation.

In one or more embodiments, the slot in the medial side is substantially rounded.

In one or more embodiments, the slot in the medial side has a diameter which is larger than the diameter of the pin in about 0.05 mm and up to about 5 mm. 8 In one or more embodiments, the pin disposed about the middle of the slot during the foot flat step in the gait cycle of a subject.

Unless otherwise defined, all technical and/or scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the invention pertains. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of embodiments of the invention, exemplary methods and/or materials are described below. In case of conflict, the patent specification, including definitions, will control. In addition, the materials, methods, and examples are illustrative only and are not intended to be necessarily limiting.

BRIEF DESCRIPTION OF THE DRAWINGS Some embodiments of the invention are herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of embodiments of the invention. In this regard, the description taken with the drawings makes apparent to those skilled in the art how embodiments of the invention may be practiced.

In the drawings: FIG. 1A is a is a block diagram illustrating a joint brace in accordance with embodiments of the current invention.

FIG. 1B is a is a block diagram illustrating an ankle brace in accordance with an embodiment of the current invention.

FIG. 2 is a flow chart of a limitation of movement of a joint in accordance with an embodiment of the current invention.

FIG. 3 is an exemplary illustration of an ankle brace positioned on a boot, in accordance with an embodiment of the current invention.

FIG. 4 is an exploded view illustrating the elements of the ankle brace of FIG. 3, in accordance with an embodiment of the current invention.

FIG. 5 is a cut view of an exemplary brace with a screw for linking a pin to a retainer element, in accordance with an embodiment of the current invention.

FIG. 6 is a cut view of an exemplary brace with a bearing element enclosing a pin, in accordance with an embodiment of the current invention. 9 FIG. 7A is a front view illustration of an exemplary knee brace, in accordance with an embodiment of the current invention.

FIG. 7B is a top cut view of a knee and a knee's brace, in accordance with an embodiment of the current invention.

FIG. 8 illustrates an exemplary knee brace having a knee fixature element, in accordance with an embodiment of the current invention.

FIG. 9 illustrates an exemplary ankle brace having a shoe/ankle fixature element, in accordance with an embodiment of the current invention.

FIGs. 10A – 10E illustrate an installed ankle brace with movements of a pin along a slot while walking, in accordance with an embodiment of the current invention.

DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION The present invention, in some embodiments thereof, relates to support and/or an orthopedic brace to prevent and/or treat a joint injury and, more particularly, but not exclusively, to an ankle brace that allows improved movement. In some embodiments, the brace is easy to carry in a first aid kit.

The present invention relates to a compact brace that provides a support to a synovial joint (e.g., an ankle joint or a knee joint). The brace is particularly useful for supporting a synovial joint following dislocation and/or during rehabilitation process.

In some embodiments, the brace is designed to allow a plantarflexion and a dorsiflexion motions in the sagittal plane. In some embodiments, the brace is designed to restrict eversion and inversion motions in the coronal plane and/or adduction and abduction motions in the transverse plane. Advantageously, the brace is designed to allow the dynamic and natural momentary instantaneous center of rotation (ICR) movement of the joint during walking.

The brace further advantageously affords the following attributes: allows a patient to continue walking after a joint injury (e.g., an ankle sprain), provides an improved rehabilitation of an injured joint by utilizing a transmission mechanism that allows the natural ICR movement of the joint.

Some brace solutions ignore the biomechanical spatial instantaneous center of rotation movement of a synovial joint and mainly focus on allowing a rotational movement and on restricting eversion and inversion motions. Other brace solutions attempt to allow dorsiflexion and plantarflexion movement but rely on inadequate and controversial biomechanical analysis of the instantaneous center of rotation. For example, some prior art braces attempt to allow dorsiflexion and plantarflexion movements but permit a range of movement which is wider than the actual range of dorsiflexion and plantarflexion. Such braces may include a floating hinge mechanism which is not restricted to the actual required motions. Yet other prior art braces fail to synchronize motions at the medial and lateral sides of a joint. Such braces fail to mimic the actual movement of the joint and may even cause damage to the wearer.

The current joint brace and method of using same overcomes the shortcomings of prior art braces and provides a brace which supports the actual spatial instantaneous center of rotation movement of a joint. To this end, the inventors of the invention have devised and prepared a brace with a unique and inventive transmission mechanism. The invention is based in part on allowing a full range of movement of a joint during the dorsiflexion and plantar flexion movements of the ankle. Further, the transmission mechanism affords an orientation and position of the range of movements which allow the ICR movement during walking.

In one or more embodiments, the transmission mechanism is moveable along a length. In one or more embodiments, the transmission mechanism extends and/or allows movement along a length of the range of movement of the dorsiflexion and plantar flexion. In one or more embodiments, the length is between about 15 mm and about 45 mm. For example, between about 15 mm and about 25 mm. In one or more embodiments, the transmission mechanism allows movement along a slope of between about 7 and about 15. The herein disclosed brace includes a transmission mechanism that affords rotational and translational movements along such slope. In one or more embodiments, the transmission mechanism is disposed adjacent and moveable along the ICR. In one or more embodiments, the transmission mechanism is non-floating. In one or more embodiments, the transmission mechanism is synchronized in movement between the medial and lateral sides of the joint in a human body.

In view of the above, the current brace support includes a transmission mechanism that allows the natural movement of the joint and specifically mimics the motion of the instantaneous center of rotation.

An aspect of some embodiments of the current invention relates to a joint support brace with a unique movement mechanism that combines spatial rotation and 11 translation movements of the joint. The movement mechanism includes, in one embodiment, a moving hinge. For example, the hinge may connect between two limb portions allowing a relative rotation of the limb portions around the hinge. Optionally, the hinge is movably attached to one of the limb portions. For example, the hinge may translate with respect to one of the limb portions. For example, translation may be one dimensional and/or along a fixed path. For example, the path may be linear and/or curvilinear. Alternatively, or additionally, movement of the hinge with respect to a limb may include rotation around an axis that is not parallel to the axis of the hinge.

In one or more embodiments, the brace is compact, optionally disposable. In one or more embodiments, the brace may comprise two parts, a first limb retaining element embraces the tibia and a second limb retaining element embraces the foot. In one or more embodiments a linkage connects the first limb retaining element and the second limb retaining element. The linkage allows movement of the limb retaining elements. And covers the full range of motion during the dorsi and plantar flexion.

In one or more embodiments, the limb retaining element includes a pin and the foot retaining element includes a slot. In one or more embodiments, the limb retaining element includes a slot and the foot retaining element includes a pin. Optionally, the slot disposed along a length in a third intermediate element connecting the first and second elements via the slot and pin that resides in the slot. In one or more embodiments, a hinge with a pin and a slot is obtained which disposed adjacent the center of the ankle and in which the pin can move along the slot or the slot moveable about the pin.

Optionally, two linkage elements disposed at opposing sides of the joint, i.e., the lateral and medial resulting in a motion of sliding movements and a rotation along the sagittal plane.

Various materials for the brace are contemplated. Advantageously, the material of one or more elements of the brace is a rigid or semi rigid, thereby assisting in limiting undesirous movements. Non-limiting embodiments include a carbon fiber, i.e., Kevlar carbon fiber-based materials.

Optionally, the carbon-based elements are connected with Kevlar fabric, enabling the parts comprising the brace to fold flexibly.

Optionally, the brace includes one or more straps, e.g., Velcro straps for tightening and stabilizing the various parts of the brace. 12 Before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not necessarily limited in its application to the details of construction and the arrangement of the components and/or methods set forth in the following description and/or illustrated in the drawings and/or the Examples. The invention is capable of other embodiments or of being practiced or carried out in various ways.

Referring now to the drawings, Figure 1A is a block diagram illustrating a joint brace in accordance with embodiments of the current invention. In some embodiments, a brace includes a linkage 105a between two limb retainers 102a, 108a.

For example, the linkage 105a may include a transmission mechanism in the form of a hinge 106a and/or a conforming element 104a. Alternative non-limiting examples of the transmission mechanisms include a spring.

For example, the linkage 105a allows a specific range of movement that is more complex than simple rotation and/or translation. For example, the brace is limiting undesired movements.

In some embodiments, a brace for a biological joint (synovial joint) is configured to allow a complex natural joint movement while preventing an undesirable and/or dangerous movement. For example, some joints may include bones rotating around multiple axes and/or sliding and rotating simultaneously. It may be undesirable to limit the joint to a simple movement (e.g., a rotation) of a simple mechanical hinge, which would limit the movement of a user and/or inhibit healing. Nevertheless, it may be desirable in some embodiments to limit unwanted movement. Optionally, a linkage 105a includes moving elements leading to a specific range of movement. For example, a sliding conforming element 104a may be added to a hinge 106a, giving a combination of one-dimensional translation and/or rotation along a translating axis.

For example, such an embodiment may include a part rotating around a sliding pin.

Alternatively, or additionally, such an embodiment may include a hinge moving within a part. Alternatively, or additionally, the linkage may include two hinges with non-parallel axes. Alternatively, or additionally, the linkage may include two hinges with parallel axes. In some embodiments, the two hinges are aligned along a momentary axis following the joint momentary center of rotation. In some embodiments, the linkage may include two different pin sizes in two different slot sizes. 13 In one or more embodiments, the linkage allows translation along a length of about 10 mm and 30 mm. For example, depending on the age and/or weight, and/or height of the wearer, the linkage allows translation along a length of about 15 mm and about 25 mm, or about 18 mm and about 23 mm. In one or more embodiments, the linkage allows translation along a sloped plane. In one or more embodiments, the sloped plane inclines towards the anterior side of the body. In one or more embodiments, the sloped plane inclines towards the posterior side of the body. In one or more embodiments, the slope is within the range of about 5 and about 15. For example, about 5 and about 12, or about 7 and about 10. In an exemplary embodiment, the slope is 7, 7.5, 8, 8.5, 9, 9.5, or 10. In one or more embodiments, the linkage allows a horizontal translation movement. In one or more embodiments, the linkage allows a translation movement which may vary depending on the synovial joint to be treated. In an exemplary embodiment, the synovial joint is an ankle and the linkage allows translation along a sloped plane, wherein the sloped plane inclines towards the anterior side of the body. In yet another exemplary embodiment, the synovial joint is a knee joint and the linkage allows a horizontal translation movement.

In one or more embodiments, the linkage disposed in both medial and lateral sides of the brace. In one or more embodiments, the linkage in the medial and lateral sides of the brace is similar, optionally identical. In one or more embodiments, the linkage in the medial and lateral sides of the brace is non-identical demonstrating different structure, and/or features.

Optionally, the brace will fit into a package. For example, the brace will fit into a package having a length, width and/or depth ranging between 1 to 10 and/or 10 to 30 cm and/or 30 to 50 cm. Optionally the brace will weigh less than 500 g and/or less than 800 grams and/or less than 2000 grams. In some embodiments, these conditions enable the continuation of the marching/walking process (defining requirements of the fixture) while locking two movements in both planes, in order to minimize the injury and allow the continuation of the marching/walking process.

Figure 1B is a block diagram illustrating an ankle brace in accordance with an embodiment of the current invention. For example, an ankle brace may include an upper retainer 102b, for example, to hold to a tibia. For example, an ankle brace may include a lower retainer 108b for example to hold to a foot and/or a shoe. The 14 retainers 102b, 108b are optionally connected by a linkage 105b. For example, linkage 105b may include a hinge 106b and/or a conforming element 104b.

Optionally, the conforming element 104b allows the hinge 106b to follow circular or rotational movements of the foot. Optionally, the conforming element 104b allows the hinge 106b to follow non-circular or non-rotational movements of the foot.

Optionally, the conforming element 104b allows the hinge 106b to follow circular or rotational and translational movements of the foot. For example, the hinge 106b may include a pin and/or the conforming element 104b may include a slot that allows rotation and/or translation of the pin in respect to one of the retainers 102b, 108b. In some embodiments, a linkage 105b may include a forcing element 114, for example a flexible element and/or an elastic element and/or a flexible and/or an adhesive and/or a magnetic element. For example, a spring may force a tibial retainer 102b upward away from a foot retainer 108b. For example, a forcing element 114 may include an element that forces the hinge 106b towards the plantar flexion and/or some other position.

In some embodiments, each retaining element may include a rigid, or semi-rigid element 110a, 110b and/or a tightening element 112a, 112b. For example, the rigid/semi-rigid element 110a, 110b may include molded plastic element fit to a tibia and/or a foot and/or a shoe. Optionally, the tightening element 112a, 112b may include one or more straps and/or fasteners, for example a fastener may include a threaded tightening element for example a clamp. Optionally a retaining element may include a shock absorbing element and/or padding. In some embodiments, a retainer may include a fixature element with a high friction surface that attaches to clothes and/or anatomical features (shown for example in FIGs. 8-9). Further suitable fixature elements include, for example, a magnet.

In the case of an ankle (e.g. the Tibia talus joint), for example, the position of the center of rotation between the foot and the tibia may appear to move with respect to the tibia during walking movement. For example, the apparent location of the pivot of the joint may result from the structure of the joint which may have the shape of a spatial curve that causes momentary axis of rotation at any relative angle between two bones and/or sliding movement between various bones of the foot. An ankle linkage may include for example, a pin rotating and/or sliding in a slot. Optionally, pins may be mounted symmetrically on both sides (medial and lateral) of a fixture allowing movement on the sagittal plane. Alternatively, or additionally, the system may include a flexible and/or elastic element to carry part of the load on the joint and/or to add a forcing to a position of the joint. In some embodiments, a linkage may include a forcing element and/or a limiting guide (for example a piston and/or locking mechanism and/or a guide rail). In some embodiments, a hinge 106a and/or a conforming element 104a may be synchronized. For example, a pin may have a non- round cross section and/or a slot may have a non-uniform width, such that as the pin moves down the slot it is forced to rotate to particular angle and/or as the pin rotates to a particular angle it is forced to move to a particular position along the slot.

In some embodiments, an ankle brace is designed to prevent movement in the directions of adduction (motion towards the center of the body) and abduction (motion away from the midline), which is performed in the transverse plane and/or the inversion and eversion (twist in/out) movement in the frontal plane. Optionally, the brace allows movement substantially only in the directions of the dorsiflexion and plantarflexion that is executed in the sagittal plane. For example, the brace may allow a range of motion of up to 75° degrees, 70°, or 65°. For example, the brace may allow vertical motion to angles of up to 35° degrees, up to 30° degrees, up to 25° degrees or up to 20° degrees during dorsiflexion. For example, the brace may allow vertical motion to angles ranging between 0° to 35°, 0° to 30°, 0° to 25°, or 0° to 20° degrees during dorsiflexion. For example, the brace may allow motion to angles ranging between 10° to 35°, 20°- 30° and/or between 22° to 28° degrees and/or between 15° to 34° degrees and/or between 10° to 20° degrees during dorsiflexion. The brace may allow motion to angle of up to 55° degrees during plantarflexion. The brace may allow motion to angle of up to 50° degrees, up to 45° degrees, up to 40° degrees, or up to 35° degrees during plantarflexion. The brace may allow motion to angles ranging between 30°-55° and/or between 37°-45° and/or between 30°-50° during plantarflexion. For example, the brace may enable between 25 to 100%, between 45 to 55% and/or between 35 to 45% and/or between 25 to 35%, between 50 to 100%, between 60 to 100%, between 70 to 100%, between 80 to 100%, or between 90 to 100% of motion in compare to a normal joint. Optionally, an axis of rotation may translate with respect to a foot and/or a tibia of the user. For example, range of movement (ROM) of the translation may be up to 5 cm. For example, range of movement (ROM) of the translation may be up to 4 cm, 3 cm, 2.5 cm, 2.4 cm, 2.3 cm, 16 2.2 cm, or 2.1 cm. For example, range of movement (ROM) of the translation may range between 0.1 to 2.5 cm and/or between 0.5 to 2.5 cm, and/or between 1 to 2.5 cm, between 0.5 to 1 cm and/or between 0.1 to 0.5 cm and/or between 2.5 to 5 cm.

The range of rotation in flexion may range between 3 to 20 degrees and/or between 20 to 50 degrees and/or between 50 to 85 degrees. In addition, the brace optionally takes into account the variable rotation center of the ankle using a transmission mechanism between its parts.

Figure 2 is a flow chart of a limitation of movement of a joint in accordance with an embodiment of the current invention. In some embodiments, a brace may be used to protect a joint. Optionally, the brace may inhibit damaging movements 218 of the joint (inversion and/or eversion). In some embodiments, the brace will allow limited movement 222 and/or 220 of a joint. In some embodiments, a conformal movement 222 may be allowed. In some embodiments, a natural joint movement 220 is allowed.

In some embodiments, the conformal movement 222 is limited to natural joint movement 220, or vice versa.

In some embodiments, movement in a safe direction may be allowed 220 freely.

For example, 100% of safe natural movement. Alternatively, or additionally, allowed movement 220 may be limited for example between 70 to 90% of the limits of natural safe movement and/or between 40 to 70% and/or between 10 to 40%. In some embodiments, support may be included for allowed movements 220. For example, a forcing element may support movements in one or another direction and/or restrict or limit unsafe or undesired movements.

In some embodiments, movements may be synchronized, for example an allowed movement 220 is synchronized to a conforming movement 222.

In some embodiments, an allowed movement 220 may include rotation of parts of a limb around a joint. Optionally conformal movement 222 may include movement of the center of rotation 220 with respect to part of the limb. For example, for an ankle, a tibia may be allowed 220 to rotate around an ankle with respect to a foot. Optionally a conformal movement 222 may include a translation of the center of the rotation with respect to the tibia. For example, various movements that may be prevented 218 and/or allowed 220, 222 are described herein above.

Figures 3-4 and 10 illustrate an ankle brace 301 positioned on a boot 324 in accordance with an embodiment of the current invention. In some embodiments, the 17 brace 301 includes linkage 305 movably connecting a shoe retainer 308 to a tibia/calf retainer 302. Optionally the linkage 305 includes a transmission mechanism in the form of a hinge and/or a conforming element. For example, linkage 305 includes duel pins 306 (e.g. one on each side of boot 324) fixed to tibia/calf retainer 302 which rotate and/or translate in slots 304 fixed to shoe retainer 308 (e.g. one on each side of boot 324).In some embodiments, an intermediate element 326 is fixed to shoe retainer 308 and movably connected via linkage 305 to tibia/calf retainer 302. For example, attachment of intermediate element 326 to shoe retainer 308 is by screws, bolts and/or rivets passing through holes 328. Optionally, intermediate element 326 is provided when integrally connected to shoe retainer 308 such that intermediate element 326 and shoe retainer 308 are provided as a single unified piece of material. Optionally each tibia/calf retainer 302, intermediate element 326 and/or shoe retainer 308 are fastened to boot 324 via straps passing through strap holes 312a, 312b, 312c and 312d, respectively. Alternatively, or additionally an elastic tightening element and/or a threaded tightener and/or a pin and/or a friction element and/or an adhesive may hold the brace to a shoe and/or clothing and/or a limb of the user.

In some embodiments, the tight connection between intermediate element 326 and calf retainer 302 inhibits movement in the direction of adduction-abduction of the foot, which is performed in the transverse plane and/or the inversion-eversion movement in the frontal plane. Optionally, rotation of intermediate element 326 around pin 306 allows dorsiflexion and/or plantarflexion that is executed in the sagittal plane and/or translation of pin 306 inside slot 304 helps conform the rotation around pin 306 to the complex movement of the ankle. Optionally, a stiffening element and/or synchronization element may be included to increase the resistance to twisting and/or inversion-eversion movements. For example, the stiffening element and/or synchronization element may further assist in maintaining an even and synchronized translation of one pin in a slot on one side of the boot with translation of a second pin in a second slot for example on the opposite side of the boot. Optionally, a stiffening element connects intermediate elements 326 on opposite sides of boot 324. For example, the stiffening element may be rigid and/or elastic (e.g. holding intermediate elements 326 tightly to tibia/calf retainer 302). Optional ranges of movement may for example be as described in regard to the preceding figures 18 In some embodiments, the axis of rotation of the hinge (e.g. pins 306) are fixed with respect to tibia/calf retaining element 302 and/or move with respect to foot retaining element 308. Alternatively, or additionally, the axis of rotation of the hinge may be fixed with respect to a foot retaining element 308 and/or move with respect to tibia/calf retaining element 302. Alternatively, or additionally, the axis of rotation of the hinge may move with respect to both a foot retaining element 308 and/or a calf retaining element 302. Optionally a gap 327 is formed between tibia retaining element 302 and intermediate element 326 to allow a certain degree of movement or free movement of the pin 306 or movement of slot 304 about pin 306 and/or minimize the friction between tibia/calf retaining element 302 and intermediate element 326.

Optionally, gap 327 is formed when tibia/calf retaining element 302 and intermediate element 326 have a different thickness (e.g., tibia retaining element 302 is thinner than intermediate element 326). For example, the gap 327 may be at least about 0.01 mm. Optionally, the gap is up to about 10 mm. For example, the gap 327 is between about 0.01 mm and 10 mm, between about 0.01 mm and 8 mm, between about 0.01 mm and 7 mm, between about 0.01 mm and 6 mm, between about 0.01 mm and 5 mm, between about 0.01 mm and 4 mm, between about 0.1 mm and 10 mm, between about 1 mm and 10 mm, or between about 1.5 mm and 10 mm. To allow free rotational movement of pin 306, the slot 304 may have a diameter that is slightly larger than the diameter of pin 306. For example, slot 304 has a diameter which is larger than the diameter of the pin 306 in about 0.05 mm and up to about 5 mm.

In some embodiments, a forcing element, for example an elastic element may be added to take some of the force off of the joint and/or to bias the linkage to one position or another. Alternatively, or additionally, a synchronized element may be added to synchronize different movements. For example, a slot and/or a pin may have a non-uniform cross section such that as the pin slide down the slot, it is forced to rotate to a certain angle (or range of angles) according to its position along the slot.

Optionally, a desirable synchronization of rotation and translation may be similar to that described in the description of preceding figures. In some embodiments, there may be a resistance to movement (for example pin 306 may be tight in slot 304 to create frictional resistance to rotation and/or translation and/or an interference element such as a ridge and/or elastic resistance may be added). In some embodiments, the resistance may be adjustable (for example a screw may tighten a friction element 19 between slot 304 and pin 306). In some embodiments, a range of movement (ROM) may be adjustable. For example, there may be an adjustable element blocking a part of slot 304 to limit translation of pin 306 and/or rotation of pin may be limited by protrusions on the pin and/or slot. The limiting elements may optionally be adjustable by a user.

Referring now to FIG. 4, slot 304 of intermediate element 326 enables rotation of pin 306. Slot 304 of intermediate element 326 further enables movement of pin 306 along an axis Y of the slot. In one or more embodiments, the length "b" of slot 304 is sloped. In one or more embodiments, the length "b" of slot 304 has a slope inclining towards the anterior portion of the foot. In one or more embodiments, the length "b" of slot 304 is between about 5 mm and up to about 40 mm. For example, between about 10 mm and about 35 mm, between about 10 mm and about 30 mm, between about 15 mm and about 35 mm, between about 15 mm and about 30 mm, between about 15 mm and about 25 mm, or between about 15 mm and about 21 mm, between about 21 mm and about 25 mm. In one embodiment, the length b of slot 304 is about 21 mm. In one or more embodiments, the width "a" of slot 304 is between about 0.1 mm and up to about 10 mm. For example, between about 0.5 mm and about 10 mm, between about 0.1 mm and about 5 mm, or between about 0.5 mm and about 5 mm.

In one or more embodiments, an angle α resides between a vertical axis X of the tibia and a longitudinal axis Y of the slot. In one or more embodiments, angle α is up to about 40°. For example, angle α is up to about 35°, up to about 30°, up to about 25°, up to about 20°, up to about 15°, up to about 12°, up to about 10°, or up to about 8. In one or more embodiments, angle α is at least about 2°. For example, angle α is at least about 5°. As described above one or more strap holes 312c may be disposed to allow fastening intermediate element 326 to boot 324 via straps passing through strap holes 312c.

Optionally, one or more strap holes 312c and dedicated straps (shown for example in FIG. 10) may be disposed to allow fastening a lateral intermediate element 326 to a medial intermediate element 326. Optionally, the straps allow the movement and further synchronization of opposing intermediate element 326 positioned on the medial and lateral sides of the leg. The attachment of intermediate element 326 to shoe retainer 308 may be via screws, bolts and/or rivets passing through holes 328 and complementary holes 330.

Optionally, tibia/calf retainer 302 has an elongated U shape structure allowing a posterior encircling of the tibia. Pin 306 protrudes from an outer surface of retainer 302 and constitutes part thereof.

Optionally, one or more strap holes 312a and 312b and dedicated straps (shown for example in FIG. 10) may be disposed in retainer 302 to allow fastening two sides (i.e., medial and lateral) of the retainer 302.

Shoe retainer 308 may have a stirrup-like structure, allowing stabilized positioning and holding of the foot. Optionally, shoe retainer 308 is connected to intermediate element 326, optionally via screws, bolts and/or rivets passing through holes 328 and complementary holes 330. Nevertheless, alternative attachment means are further contemplated and applicable. Optionally, shoe retainer 308 is integrally connected to intermediate element 326, forming a unified piece material or element.

Optionally, one or more strap holes 312d and dedicated straps (shown for example in FIG. 10) may be disposed in retainer 308 to allow fastening two sides (i.e., medial and lateral) of the retainer 308.

Referring now to FIG. 5 an embodiment of connecting pin 406 to a retaining element 402 is shown. In some embodiments, pin 406 is fixedly attached, to retaining element 402 via a screw, or a pin locking element 429. In some embodiments, retaining element 402 is stationary. In some embodiments, the pin 406 may be attached to or integrally manufactured with retaining element 402. As described above, pin 406 is moveable along slot 404 provided in intermediate element 426.

Alternatively, or additionality, pin 406 is stationary and intermediate element 426 is moveable about pin 406.

An alternative attachment mechanism of pin 507 is shown in FIG. 6. Here, pin 506 is a press fit pin and includes shoulders and a bearing element 507 moveable along rail/slot 504. In some embodiments, the pin 506 is integrally manufactured with retaining element 502 and the pin is a press fit pin and includes shoulders and a bearing element 507. None limiting examples of connecting pin 506 to retaining element 502 include a glue, an ultrasound welding or any other suitable means.

FIGs. 7A – 7B illustrate yet another exemplary knee brace 601 which includes at opposing sides of the knee, a retaining element 602a and 602b disposed in conjunction with a femur. The brace 601 further includes a tibia retaining element 608a and 608b disposed in conjunction with the tibia. Intermediate elements 626a and 21 626b are provided, connecting between the femur retaining elements 602a and 602b and the tibia retaining elements 608a and 608b. In one or more embodiments, the intermediate elements 626a and 626b each include a slot 604a and 604b, respectively.

Optionally, slots 604a and 604b are similar in size and/or shape. Alternatively, slots 604a and 604b are different in size and/or shape. In one embodiment, slot 604a allows rotation and/or translation movement of pin 606a and/or intermediate element 626a.

In accordance with this embodiment, slot 604a is longitudinal, optionally, horizontal, optionally oblique. In one embodiment, slot 604b allows rotation movement of pin 606b and/or intermediate element 626b. In accordance with this embodiment, slot 604b is rounded. The brace 601 therefore optionally allows rotation movement at the medial M side and rotation and translation movement at the lateral L side of the knee 600. To allow free rotational movement of pin 606b, the slot 604b may have a diameter that is slightly larger than the diameter of pin 604b. For example, slot 604b has a diameter which is larger than the diameter of the pin in about 0.05 mm and up to about 5 mm. FIG. 7B is a cross section view of the knee 600 and brace 601. As shown, slot 604a is larger than slot 606b and allows translation as well as rotation movement of the lateral side of knee 600. Optionally, the translation movement is about slot 604a and creates X1 and X2 angles about a center of rotation Z. Optionally, X1 angle is bigger, smaller or equal to X2 angle.

Referring now to FIG. 8, a schematic knee fixature element 709 providing high friction, including low or high modulus adhesive or glue, a magnet, etc., to enable to fixate retaining element 702 to the knee. The fixature element 709 allows for the stationary property of retaining element 702. In such a way, intermediate element having a slot (not shown) is moveable relative to pin 706, determining the path of ankle rotation.

FIG. 9 illustrates a shoe/ankle fixature 809 in the form of a velcro having shoe adhesive portion 809b which attaches a retaining element 802 via adhesive portion 809a. The fixature element 809 allows for the stationary property of retaining element 802. In such a way, intermediate element having a slot (not shown) is moveable relative to pin 806, determining the path of ankle rotation.

FIGs. 10A – 10E illustrate a knee brace and the dynamic positions of a pin 306 with respect to a slot 304 during the various steps of the gait cycle. At FIG. 10A, the heel strikes the ground (a.k.a., "the heel strike" step of the gait cycle). The pin 306 is 22 disposed at the top of the slot 304 (i.e., progress in the slot is about 0%). In FIG. 10B, the foot is in a flat position (a.k.a, the "foot flat" step of the gait cycle), the pin 306 is at the middle of the slot 304 (i.e., progress in the slot is about 50%). In FIG. 10C, a gait step known as the "mid stance" is shown, the pin 306 begins to descend downwardly in the slot 304 (i.e., progress in the slot is about 90%), due to a weight load of the subject that is being transferred from the contralateral leg (not shown). In a further step of the gait cycle in which the heel of the contralateral leg is off the ground (not shown), the pin 306 may reach up to about 100% progress in slot 304. At FIG. 10D, during the "toe off" step of the gait cycle, the pin 306 is at the top of the slot (i.e., progress along the slot is about 0%). At FIG. 10E, a gait step known as the "mid swing", the pin is near the top most part of the slot, and the progress in slot is about %.

Each of the following terms: 'includes', 'including', 'has', 'having', 'comprises', and 'comprising', and, their linguistic, as used herein, means 'including, but not limited to', and is to be taken as specifying the stated component(s), feature(s), characteristic(s), parameter(s), integer(s), or step(s), and does not preclude addition of one or more additional component(s), feature(s), characteristic(s), parameter(s), integer(s), step(s), or groups thereof. Each of these terms is considered equivalent in meaning to the phrase 'consisting essentially of'.

Each of the phrases 'consisting of' and 'consists of', as used herein, means 'including and limited to'.

The term 'method', as used herein, refers to steps, procedures, manners, means, or/and techniques, for accomplishing a given task including, but not limited to, those steps, procedures, manners, means, or/and techniques, either known to, or readily developed from known steps, procedures, manners, means, or/and techniques, by practitioners in the relevant field(s) of the disclosed invention.

Throughout this disclosure, a numerical value of a parameter, feature, characteristic, object, or dimension, may be stated or described in terms of a numerical range format. Such a numerical range format, as used herein, illustrates implementation of some exemplary embodiments of the invention, and does not inflexibly limit the scope of the exemplary embodiments of the invention.

Accordingly, a stated or described numerical range also refers to, and encompasses, all possible sub-ranges and individual numerical values (where a numerical value may be 23 expressed as a whole, integral, or fractional number) within that stated or described numerical range. For example, a stated or described numerical range 'from 1 to 6' also refers to, and encompasses, all possible sub-ranges, such as 'from 1 to 3', 'from 1 to 4', 'from 1 to 5', 'from 2 to 4', 'from 2 to 6', 'from 3 to 6', etc., and individual numerical values, such as '1', '1.3', '2', '2.8', '3', '3.5', '4', '4.6', '5', '5.2', and '6', within the stated or described numerical range of 'from 1 to 6'. This applies regardless of the numerical breadth, extent, or size, of the stated or described numerical range.

Moreover, for stating or describing a numerical range, the phrase 'in a range of between about a first numerical value and about a second numerical value', is considered equivalent to, and meaning the same as, the phrase 'in a range of from about a first numerical value to about a second numerical value', and, thus, the two equivalently meaning phrases may be used interchangeably.

The term 'about', is some embodiments, refers to ±30 % of the stated numerical value. In further embodiments, the term refers to ±20 % of the stated numerical value.

In yet further embodiments, the term refers to ±10 % of the stated numerical value.

It is to be fully understood that certain aspects, characteristics, and features, of the invention, which are, for clarity, illustratively described and presented in the context or format of a plurality of separate embodiments, may also be illustratively described and presented in any suitable combination or sub-combination in the context or format of a single embodiment. Conversely, various aspects, characteristics, and features, of the invention which are illustratively described and presented in combination or sub combination in the context or format of a single embodiment, may also be illustratively described and presented in the context or format of a plurality of separate embodiments.

Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications, and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications, and variations that fall within the spirit and broad scope of the appended claims.

All publications, patents, and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by 24 reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention. To the extent that section headings are used, they should not be construed as necessarily limiting.

Claims (34)

:

1. A brace for a synovial joint comprising: a first limb retainer element for attachment to a first limb portion; a second limb retainer element for attachment to a second limb portion; and a transmission mechanism movably connecting said first retainer element to said 5 second retainer element at the medial and lateral sides of the joint, said transmission mechanism at each of the medial and lateral sides includes a hinge comprising a pin fixedly attached to the first retainer element or to the second retainer element and disposed within a single sloped slot that downwardly inclines towards an anterior side of a subject, the hinge configured to allow a rotational movement and further a 10 translational movement along a length of the sloped slot, thereby allowing a momentary spatial center of rotation movement of the joint during plantarflexion and dorsiflexion.

2. The brace of claim 1, wherein the transmission mechanism is disposed 15 adjacent the instantaneous center of rotation of a joint of a subject.

3. The brace of claim 1 or 2, wherein said transmission mechanism comprises an intermediate element comprising said hinge, the hinge and intermediate element allow the rotational and translational movement of the limb retainer elements with respect to 20 each other.

4. The brace of any one of claims 1-3, wherein said sloped slot defines an angle in a range of about 2 to about 40 degrees between a longitudinal length of the first limb retainer element and the slope. 25

5. The brace of any one of claims 1-4, wherein said length of said slot is between about 10 mm and about 45 mm.

6. The brace of claim 5, wherein said length of said slot is between about 15 mm 30 and about 25 mm. 26 264910/4

7. The brace of any one of claims 1-6, wherein said slot has a width of between about 5 mm and about 20 mm.

8. The brace of any one of claims 1-7, wherein in use said pin is disposed about 5 the middle of the slot during a foot flat step in a gait cycle of a subject.

9. The brace of any one of claims 1-8, wherein said transmission mechanism further includes a sloped spring allowing translational movement along a length thereof. 10

10. The brace of any one of claims 1-9, wherein said first retainer element is configured to retain a tibia and said second retainer element is configured to retain a foot. 15

11. The brace of any one of claims 1-10, configured to allow plantarflexion and dorsiflexion motions in a sagittal plane of a subject.

12. The brace of any one of claims 1-11, configured to restrict abduction and adduction movements in a transverse plane, and/or eversion and inversion movements 20 in a frontal plane of a subject.

13. The brace of claim 1, wherein the transmission mechanisms allow synchronized movements between the medial and lateral sides of the joint. 25

14. The brace of any one of claims 1-13, further comprising a fixature element for fixating the first and/or second limb retainer element to a limb portion.

15. The brace of claim 14, wherein the fixature element is selected from an adhesive, a glue, a magnet, a high friction element providing a high friction between 30 the limb portion and the brace, or a combination thereof. 27 264910/4

16. The brace of any one of claims 3-15, wherein the first limb retainer element, the second limb retainer element, and/or the intermediate element are manufactured from a rigid or semi-rigid material. 5

17. The brace of any one of claims 3-16, wherein the intermediate element is attached to said second retainer element and is moveable about said first retainer element.

18. The brace of claim 17, wherein the intermediate element is integrally attached 10 to said second retainer element forming a single piece of material.

19. The brace of any one of claims 3-16, wherein the intermediate element is attached to said first retainer element and is moveable about said second retainer element. 15

20. The brace of claim 19, wherein the intermediate element is integrally attached to said first retainer element forming a single piece of material.

21. A brace for a synovial joint comprising: 20 a first limb retainer element for attachment to a first limb portion; a second limb retainer element for attachment to a second limb portion; and a transmission mechanism movably connecting said first retainer element to said second retainer element at the medial and lateral sides of the joint, said transmission mechanism at the medial side includes a pin fixedly attached to the first 25 retainer element or to the second retainer element and disposed within a rounded slot such to allow a rotational movement between the first retainer element and the second retainer element at said medial side, said transmission mechanism at the lateral side includes a hinge comprising a pin fixedly attached to the first retainer element or to the second retainer element and disposed within a single longitudinal slot such to 30 allow a rotational movement and further a translational movement along a length of the slot between the first retainer element and the second retainer element at the lateral side, thereby allowing a momentary spatial center of rotation movement of the knee joint. 28 264910/4

22. The brace of claim 21, wherein said first retainer element is configured to retain a femur and said second retainer element is configured to retain a tibia.

23. The brace of claim 21 or 22, wherein the transmission mechanism at the 5 medial side of the joint further comprises a first intermediate element movably connecting said first retainer element to said second retainer element at said medial side, and wherein the transmission mechanism at the lateral side of the joint further comprises a second intermediate element movably connecting said first retainer element to said second retainer element at said lateral side. 10

24. The brace of any one of claims 21 -23, wherein said pin protrudes from said first limb retainer element and fixedly attached thereto.

25. The brace of any one of claims 21-24, wherein the length of the slot in the 15 lateral side is between about 10 mm and about 30 mm.

26. The brace of any one of claims 21 -25, further comprising a fixature element for fixating the first and/or second limb retainer element to a limb portion. 20

27. The brace of claim 26, wherein the fixature element is selected from an adhesive, a glue, a magnet, a high friction element providing a high friction between the limb portion and the brace, or a combination thereof.

28. The brace of any one of claims 23-27, wherein the intermediate element is 25 attached to said second retainer element and is moveable about said first retainer element.

29. The brace of claim 28, wherein the intermediate element is integrally attached to said second retainer element forming a single piece of material. 30

30. The brace of any one of claims 21-29, wherein the slot in the lateral side is substantially horizontal. 29 264910/4

31. The brace of any one of claims 21-30, wherein the slot in the lateral side has a length being substantially larger than a diameter of the rounded slot in the medial side. 5

32. The brace of any one of claims 21-31, wherein the slot in the lateral side translates backwards and forward about a central axis of rotation.

33. The brace of any one of claims 21-32, wherein the rounded slot in the medial side has a diameter which is larger than the diameter of the pin in about 0.05 mm and 10 up to about 5 mm.

34. The brace of any one of claims 21-33, wherein said pin is disposed about the middle of the slot during the foot flat step in a gait cycle of a subject. 30