JP2010119646A - Knee joint brace - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a brace for retaining a knee joint which is unstable due to force pushing an upper end of a tibia forward or backward relative to a lower end of a femur because of damage to anterior and posterior cruciate ligaments or loose cruciate ligaments caused by knee osteoarthritis. <P>SOLUTION: A belt or a corset attached to a lower thigh is connected to a belt or a brace of a corset attached to the femur as a supporting base by a mechanism which uses a rod, a hinge, and a rod-shaped or curved, resilient material bowing only in the front-back direction alone or combines them. Then, force in the direction opposite to the direction in which the knee joint is unstable is applied to an upper part of the lower thigh by the belt or the corset attached to the lower thigh. Interference between the knee joint brace and a lower limb is reduced by performing processing to bend a part of the brace corresponding to between the femur and the lower thigh of or a brace part of the corset, the rod, the hinge, the resilient material, or the like along the curvature of the knee joint of the physiological valgus or the like of the knee joint as shown in a curve for bending processing of the brace. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

The present invention relates to a knee joint orthosis used for treating a knee joint disorder and holding the knee joint during exercise.

The knee joint is one of the joints that are prone to injury in the human body, such as knee osteoarthritis, meniscus injury, collateral ligament injury, cruciate ligament injury, etc. due to trauma or aging.
For this reason, many knee joint orthoses have been devised for the treatment of damaged knee joints and for holding the joints during exercise.

There is a knee joint assist device that assists joint motion by faithfully reproducing the complicated movement of the knee joint with a conventional knee joint orthosis.
Knee joint auxiliary device

In addition, there is a brace that corrects the knee joint varusally or valgus for the treatment of knee osteoarthritis.
Knee orthosis having sagittal adjustment part of special table 2002-525171

In the sense that the knee joint assisting device shown in Patent Document 1 smoothly moves the joint surface on the tibia side from the lower part of the joint surface on the femur side to the rear part during exercise of the knee joint, and obtains an accurate hinge motion. Seems to be effective.

The knee orthosis having the sagittal adjustment part shown in Patent Document 2 is to perform valgus correction on the varus knee commonly seen in osteoarthritis of the knee, in the sense that the decompression inside the knee joint is measured, It seems to be effective.

In particular, the knee brace having a sagittal adjustment part is a structure extending from the thigh to the lower leg, using a hinge for the knee joint part, and the direction of the force to be applied differs from the present invention, Since a force in a certain direction is to be applied to the relationship of the knee joint, there are some which are close in structure and function as compared with the present invention.

The cruciate ligament includes an anterior cruciate ligament and a posterior cruciate ligament. In the knee joint, the posterior cruciate ligament is tensioned against the force with which the upper end of the tibia (14) is pushed backward against the lower end of the femur (13). Conversely, the anterior cruciate ligament has tension against the force pushed forward. In other words, the cruciate ligament has tension against the force that shears the knee joint in the front-rear direction.

If the posterior cruciate ligament of the cruciate ligament is damaged, the upper end of the tibia (14) can be pushed backward against the lower end of the femur (13). If the anterior cruciate ligament is damaged, the tibia It becomes possible to pull out the upper end of the front. This is medically known as a withdrawal sign. (In the explanation of the withdrawal sign, for the sake of convenience, it was written as “pushing backward / pulling forward”, but this is synonymous with “pushing backward / pushing forward”.)

However, the conventional knee joint orthosis mentioned above, which has a sagittal adjuster, and the knee joint assist device correct in the varus and valgus directions and faithfully reproduce the complicated movement of the knee joint. However, due to the damage of the cruciate ligament, the upper end of the tibia (14) could not be effectively held by the knee joint which became unstable with respect to the force pushed forward or backward.

As shown in FIG. 11, when the knee joint is observed from the front, the axis of the tibia (Db) is about the axis of the femur (Da), as shown in FIG. The lower end of the femur (13) is said to be bulging at the femoral medial condyle (13i) and the femoral lateral condyle (13o), and the tibia ( The upper end of 14) bulges at the medial tibial condyle (14i) and the lateral tibial condyle (14o), respectively. And the radius (15) has adhered to the outer side of a tibia, and when it observes from the front-back direction, the knee joint part is curving. This is called the physiological curvature of the knee joint.

Since the knee joint orthosis similar to the present invention is intended to exert a dynamic or static forcing force on the knee joint, it usually has a highly rigid structure. If the outline is straight, it can be considered that the lower limbs and the brace interfere with each other, causing problems such as pain and discomfort when worn.

As a means of solving the problems related to the knee joint that has become unstable due to damage to the anterior and posterior cruciate ligaments, a force opposite to that applied to the knee joint can be applied by the brace. The most direct.

A specific example for holding a knee joint that has become unstable due to the force of the anterior or posterior cruciate ligament being damaged and the tibia (14) being pushed forward or backward against the lower end of the femur (13). As a means, depending on the stress acting at the time of bending and stretching of the knee joint, a rigid rigid rod or hinge that does not flex easily, or a rod-like or curved elastic material that flexes only in the front-rear direction (hereinafter referred to as “elastic material” 18) ”), the direction of the force that causes the knee joint to become unstable with the belt or corset attached to the lower leg using the thigh as the support base by connecting the belt or corset attached to the thigh and the lower leg. Is to apply a force in the opposite direction.

Further, since it has a sturdy structure that does not easily bend in this manner, as a measure for improving the wearing feeling, a brace extending from the thigh to the lower leg is used as a bending curve of the brace shown in FIG. As shown in 8), the bending of the knee joint according to the physiological curvature of the knee joint, which forms the physiological valgus of the knee joint, and the medial and lateral condyles of the femur (13) and the tibia (14). By applying, interference with the brace can be reduced.

When the posterior cruciate ligament is damaged, the knee joint is unstable with respect to the force with which the upper end of the tibia (14) is pushed backward relative to the lower end of the femur (13). The upper end of the tibia (14) can be pushed backward.

In this case, by attaching the knee joint orthosis of the present invention to the lower limb, the lower upper leg rear belt (3a) applies a force (Aa) for pushing the upper part of the lower leg forward. The lower leg lower belt (4b) applies a force (Bb) that pushes the lower leg lower. As a result, the force (Aa) that pushes the upper part of the lower leg forward becomes more effective, and the knee joint that has become unstable with respect to the force that pushes the lower end of the tibia (14) backward relative to the femur (13). Can be held.

Moreover, in the damage of the anterior cruciate ligament, it is unstable with respect to the force by which the upper end of the tibia (14) is pushed forward with respect to the lower end of the femur (13).

In this case, the lower leg upper belt (3b) applies a force (Ab) that pushes the upper lower leg backward.
Then, the lower leg lower belt (4a) applies a force (Ba) for pushing the lower part of the lower leg forward.
As a result, the force (Ab) for pushing the upper part of the lower leg backward becomes more effective, and the knee joint that is unstable with respect to the force for pushing the upper end of the tibia (14) forward is applied to the femur (13). Can hold.

In addition to damage to the cruciate ligament itself, loosening of the cruciate ligament may cause instability of the knee joint. That is, the joint space, which is the joint gap, becomes narrow due to wear and deformation of the knee joint due to osteoarthritis of the knee, and loosening occurs when the start and stop portions of the cruciate ligament approach each other.

When the knee joint is bent, a force to further flex the knee joint is brought about by the body weight. Therefore, in the knee joint in which the cruciate ligament has loosened, the lower end of the femur (13) is the upper end of the tibia (14). A force that tries to slide down the top works.

When this is seen relatively, it means that the force by which the upper end of the tibia (14) is pushed backward is applied to the lower end of the femur (13).

For instability of the knee joint caused by loosening of the cruciate ligament caused by such knee osteoarthritis, by using a brace for posterior cruciate ligament damage described later, By applying a force to push the tibia (14) forward, the unstable knee joint can be held.

Regarding the problem of improving the feeling of wearing, a rod or corset extending from the thigh to the lower leg, or a knee hinge (7) or an elastic material (18) is used for the physiological valgus of the knee joint, the femoral medial condyle (13i), and the thigh. In accordance with the physiological curvature of the knee joint created by the lateral bone condyle (13o) and the bulging of the medial tibial condyle (14i) and the lateral tibial condyle (14o), it is bent into the brace as shown by the bending curve (8) of the brace. By applying the processing, it is possible to reduce pain and discomfort at the time of wearing due to the orthosis interfering with the lower limbs.

The best mode for carrying out the present invention is a knee joint holding device for posterior cruciate ligament injury, and this structure will be described with reference to FIG.

The thigh side rod (5) supported by the upper thigh belt (1) and the lower thigh belt (2) is connected to the crus side rod (6) by the knee hinge (7). And the outside is a paired structure. The crus side rod (6) has a structure in which a crus upper rear belt (3a) and a crus lower front belt (4b) are attached.

In the structure of the best mode for carrying out the present invention, when the knee joint is stretched, the force that pushes the upper part of the lower leg forward (Aa) works most strongly, and as the knee joint flexion angle increases, The power tends to weaken.

In order to improve this, when the knee joint is bent by providing the rotation shaft of the knee hinge below the position (F) where the knee joint bends in the structure of the best mode for carrying out the invention described above. In addition, it was devised to add a mechanical structure that prevents the force (Aa) that pushes the upper part of the lower leg forward from weakening.

A mechanical structure added to the best mode for carrying out the present invention will be described with reference to FIG.
In a state where the knee joint is extended, when the lower limb is viewed from the side, the axis line (Ea) of the thigh passes through the position (F) where the knee joint bends, passes through the axis line (Eb) of the crus, A straight line up to I).

The axis line (Ha) of the thigh orthosis passes through the position of the rotation axis (G) of the knee hinge provided below, passes through the axis line (Hb) of the lower leg orthosis, and reaches the sole (I). It is still a straight line.

From the thigh axis (Ea) via the position (F) where the knee joint bends to the sole (I), the axis of rotation of the knee hinge provided below the axis (Ha) of the thigh brace (G) ), Or the axis extending to the sole (I) through the rotation axis (G2) of the knee hinge provided above, is drawn separately in the front and rear for easy understanding, but actually overlaps Is.
In the case of the best mode for carrying out the present invention, the rotation axis (G) of the knee hinge provided below is routed, and the rotation axis (G2) of the knee hinge provided above is irrelevant. .

When the knee joint is bent, it is bent at the bending position (F) of the knee joint, so that the sole (I) is moved to the moved sole (I2), and the lower leg axis (Eb) is the lower leg axis (Eb2). Move to).

In the best mode for carrying out the present invention, the knee hinge (7) is provided below the bending position (F) of the knee joint in order to apply a force (Aa) for pushing the upper part of the lower leg forward. Therefore, the axis (Hb) of the lower leg brace that is bent at the position of the rotation axis (G) of the knee hinge provided below has a smaller movement amount than the axis (Eb2) of the moved lower leg, and the axis of the moved lower leg (Eb2). ) An axis appears in front of it. This is defined as the axis (Hb2) of the lower leg orthosis that appears forward.

In this way, when the knee joint is extended, the lower leg axis (Eb) and the lower leg brace axis (Hb), which are running in parallel, have two axes with angles in the knee joint flexion state. Become.

Since the brace and the lower leg are actually bound by a belt, the two axes have a mechanism that attracts each other and a force (Aa) that pushes the upper part of the lower leg forward works.

As described above, when the mechanical structure is added to the first embodiment, the bending portion (Rs) of the orthosis indicated by the oblique lines is provided on the thigh in order to provide the rotation axis of the hinge below the position (F) at which the knee joint bends. It will be applied to the side rod (5).

The best mode for carrying out the invention of the present invention will be described with reference to FIG.

In the knee joint holding device mounting method of the present invention, the upper thigh belt (1) is arranged so that the knee hinge (7) comes to the position (F) where the knee joint bends and the lower and right legs are sandwiched between the inner and outer rods. Further, the lower thigh belt (2) is attached to the thigh, and the lower upper leg rear belt (3a) and the lower lower leg front belt (4b) are attached to the lower leg while the knee joint is extended.

In such a state where the knee joint holding device is attached to the lower limb, the force that pushes the upper part of the lower leg forward (Aa) is applied as the upper lower leg belt (3a) is tightened more strongly, and the lower lower leg front belt (4b) Push the lower part of the lower leg backward.
Thereby, the knee joint which became unstable with respect to the force by which the tibia (14) is pushed back can be hold | maintained with respect to the femur (13).

FIG. 3 is a front view in which the best mode for carrying out the invention is attached to a lower limb. The position (F) at which the knee joint bends shown in this figure is the axis seen from the front.

Example 1 is a knee joint holding device for anterior cruciate ligament injury. This will be described with reference to FIG.

In the anterior cruciate ligament injury, the knee joint is unstable due to the force with which the upper end of the tibia (14) is pushed forward relative to the lower end of the femur (13).

In order to hold this, a force (Ab) for pushing the upper end of the tibia (14) backward is applied. Therefore, the belt attached to the upper part of the lower leg is provided in the front, and the belt attached to the lower part of the lower leg is provided in the rear. These belts are referred to as an upper lower leg front belt (3b) and a lower lower leg rear belt (4a), respectively.

In the case of Example 1, when the knee joint is bent, the force (Ab) for pushing the upper part of the lower leg shown in FIG. 10 backward is not weakened, so that the knee joint is bent above the position (F). The rotation axis of the knee hinge will be provided. The rotation axis of the knee hinge is the rotation axis (G2) of the knee hinge provided above.

In order to provide the rotation axis of the knee hinge above the position where the knee joint bends (F), the slanted portion of the bending portion (Rs) of the orthosis according to the physiological curvature of the knee joint is applied to the crus rod side. Yes.

As a result, when the knee joint is bent, the axis of the lower leg orthosis appears behind the lower leg axis (Eb2) bent at the position (F) at which the knee joint bends. This axis is taken as the axis (Hb3) of the lower leg brace that appears rearward.

Since the brace attached to the lower leg and the lower leg are bound by a belt, the bent lower leg axis (Eb2) and the lower leg orthotic axis (Hb3) are pulled toward each other, pushing the upper part of the lower leg backward This is a mechanism in which force (Ab) works.

An embodiment in which the belt attached to the thigh and the lower thigh is changed to a corset type will be described with reference to FIG.

FIG. 5 shows a knee joint holding device for posterior cruciate ligament injury. This means that the upper thigh belt (1) and the lower thigh belt (2) are made into one thigh corset (9), and the belt attached to the upper part of the lower leg and the belt attached to the lower part of the lower leg are also made into one lower thigh corset (10). It has been changed.

The thigh corset (9) and the thigh corset (10) are connected by a rod and a knee hinge (7) in the same manner as the belt type, and the thigh corset (10) has an arrow ( It is a movable structure as in (C).

In this corset-type knee joint holding device, the thigh-side rod (5) can be eliminated and the thigh corset (9) and the crus-side rod (6) can be directly connected by a hinge (7).

FIG. 6 shows an example in which the corset-type knee joint holding device of Example 2 is attached to the lower limb.

After attaching the thigh corset (9) and the crus corset (10) to the lower limbs, by tightening the adjustment belt (11) of the crus corset, a force (Aa) that pushes the upper part of the crus forward can be applied. It is a structure which can hold | maintain the knee joint which became unstable with respect to the bone (13) by the force by which the upper end of the tibia (14) is pushed back.

When changing the type of Example 2 to a device for damaging the anterior cruciate ligament, the front and back of the lower leg corset (10) are attached in the reverse direction, and the adjustment belt (11) of the lower leg corset is moved forward from the rear. Relocated to Then, by tightening the adjustment belt (11) of the lower leg corset from the front, a force (Ab) for pushing the upper part of the lower leg backward can be applied.

A structure that strengthens the force (Aa) that pushes the upper part of the lower leg forward when the knee joint is bent will be described with reference to FIG. 7 using a mechanism different from the mechanical structure depicted in FIG.

This is a device for posterior cruciate ligament injuries. The lower end of the thigh rod (5) protrudes longer than the knee hinge (7), and the lower back of the thigh upper belt ( 3a) is attached.

In this structure, when the knee hinge (7) is bent, the lower end of the thigh side rod (5) protrudes forward from the long axis of the lower leg side rod (6), so the lower leg attached to the lower end of the thigh side rod (5) The upper rear belt (3) applies a force (Aa) that pushes the upper part of the lower leg forward.

In this structure, the greater the angle at which the knee joint bends, the stronger the force (Aa) that pushes the upper part of the lower leg forward, so the degree of freedom of flexion of the knee joint decreases.

On the other hand, since the increase in the knee joint flexion angle directly reflects the force (Aa) for pushing the upper part of the lower leg forward, this structure can be used if the knee joint flexion angle is small. Is suitable.

The structure of the third embodiment can apply a force (Aa) for pushing the upper part of the lower leg forward even if the lower leg lower belt (4) and the lower leg side rod (6) are eliminated.

Although not shown in the drawing, when the structure of the type of Example 3 is applied to an anterior cruciate ligament injury orthosis, the upper end of the crus rod (6) protrudes longer than the knee hinge (7). The lower thigh belt (2) is attached to the upper end of the lower leg side rod (6). And let the belt attached to the upper part of a lower leg be the lower leg upper front belt (3b) of the type attached from the front. Thus, when the knee joint is bent, the lower thigh belt (2) generates a force that pushes the lower leg side rod (6) backward, so that a force (Ab) that pushes backward is applied to the upper part of the lower leg.

Example 4 is a device for posterior cruciate ligament injury, and is a device that considers the usage situation where the angle at which the knee joint bends is large. This will be described with reference to FIG.

The link plate (17) is interposed between the thigh-side rod (5) and the crus-side rod (6), and the upper part of the link plate is connected to the thigh-side rod (5) by a knee hinge (7). A spring (16) was attached so as to repel the bending of the joint.

The knee hinge (7) between the thigh rod (5) and the link plate (17) corresponds to the bending position (F) of the knee joint, and the lower part of the link plate (17) The knee hinge (7) is connected to the crus rod (6).

This type of brace is characterized by a structure in which knee hinges (7) are provided on the upper and lower sides across the link plate (17), and the force with which the spring (16) bends the upper knee hinge (7). Because of the repulsive structure, when the knee joint is bent, the lower knee hinge (7) without the spring first bends, and the upper lower leg belt (3a) moves the upper part of the lower leg indicated by the arrow forward. This is a mechanism for applying a pressing force (Aa).

When the knee joint is further bent, the upper knee hinge (7) bends due to the extension of the spring (16), and thus a force (Aa) that pushes the upper part of the lower leg forward is applied while maintaining the degree of freedom of the knee joint. Thereby, it is possible to hold the knee joint which has become unstable due to the force pushing the upper end of the tibia (14) backward relative to the lower end of the femur (13).

A brace having a structure using an elastic material (18) instead of the knee hinge (7) will be described with reference to FIG.

The elastic material (18) is preferably a rod-shaped or curved steel, reinforced plastic, or the like, and is bent in the front-rear direction and not in the horizontal direction. The upper part of the lower leg, which is a feature of the present invention, is used. It has repulsive force that can apply forward pushing force (Aa).

The orthosis of Example 5 has a structure in which an elastic material (18) is attached between a thigh-side rod (5) and a crus-side rod (6), and an upper crus rear belt (3a) is attached in the middle.

When the knee joint is bent, the elastic material (18) bends forward, whereby the lower leg upper rear belt (3a) is pulled forward, and a force (Aa) for pushing the upper part of the lower leg forward is applied, and the femur (13 The upper end of the tibia (14) can hold the knee joint that has become unstable due to the force pushed backward.

In Example 5, the lower leg belt (3) and the lower leg side rod (6) are eliminated, and the elastic material (18) is cut at the lower part of the lower leg upper belt (3a) attachment position. It is possible to apply a force (Aa) that pushes forward.

Even the elastic material (18) is a highly rigid material that can only bend in the front-rear direction in response to knee flexion. Thus, it is desirable to bend the elastic material (18) like the bending curve (8) of the brace.

It is a perspective view which shows the best form for implementing this invention. 1 is a side view showing the best mode for carrying out the present invention. 1 is a front view of a right foot orthosis showing the best mode for carrying out the present invention. It is a perspective view which shows Example 1 of this invention. It is a perspective view which shows Example 2 of this invention. It is the attachment figure of the side surface of Example 2 of this invention. It is the mounting | wearing figure of the side which shows the structure of Example 3 of this invention. It is a side view showing the structure of Example 4 of the present invention. It is the side mounting | wearing figure which shows the structure of Example 5 of this invention, (a) is a figure showing the expansion state of the knee joint, (b) is the figure showing the bending state of the knee joint. It is the side view of the leg which showed the positional relationship of the tibia with respect to the femur, and the direction of applied force with the arrow. It is a front view of the right foot showing the axis of femur and tibia showing the physiological valgus of the knee joint and the bending curve (8) of the brace. The best mode for carrying out the invention and the mechanical structure added to the first and second embodiments, where the rotation axis (G) of the knee hinge is below or above the position (F) at which the knee joint bends FIG.

Explanation of symbols

1, upper thigh belt 2, lower thigh belt 3a, upper lower leg rear belt 3b, upper lower leg front belt 4, lower lower leg belt 4a, lower lower leg rear belt 4b, lower lower leg front belt 5, thigh side rod 6, lower leg side rod 7 , Knee hinge 8, brace bending curve 9, femoral corset 10, lower leg corset 11, lower leg corset adjustment belt 12, lower leg hinge 13, femur 13i, femoral medial condyle 13o, femoral lateral condyle 14, tibial 14i , Tibial medial condyle 14o, lateral tibial condyle 15, rib 16, spring 17, link plate 18, elastic material Aa, force to push upper part of lower leg forward (indicated by arrow)
Ab, force to push the upper lower leg backward (indicated by arrow)
Ba, force to push the lower leg forward (indicated by arrows)
Bb, force to push the lower leg lower back (indicated by arrow)
C, arrow indicating movement of the lower leg corset Da, femoral axis Db, tibial axis Ea, thigh axis Eb, lower leg axis Eb2, moved lower leg axis F, knee joint bending position G , The rotation axis G2 of the knee hinge provided below, the rotation axis Ha of the knee hinge provided above, the axis line Hb of the thigh orthosis, the axis line Hb2 of the crus orthosis, the axis line Hb3 of the crus orthosis appearing forward, and appearing backward Lower limb orthosis axis I, sole 12, sole movement point Rs, orthotic bending section (hatched area)

Claims (2)

It relates to a knee joint orthosis that has a structure in which a belt or corset to be attached to the thigh and lower leg is connected by a rod, hinge, rod-shaped or curved elastic material (hereinafter referred to as “elastic material (17)”). The force that pushes the upper part of the lower leg forward by the belt or corset attached to the lower leg through the rod or hinge, or the rod-shaped or curved elastic material (17), using the belt or corset attached to the thigh as the support base ( Aa) or a force pushing backward (Ab) is applied.
Thereby, the force which pushes the upper end of a tibia (14) to the front or back is given with respect to the lower end of a femur (13), The knee joint holding | maintenance apparatus characterized by the above-mentioned.   The present invention relates to a knee joint orthosis having the structure of claim 1, wherein a rod, a corset, a hinge, or an elastic material (17) of the orthosis extending from the thigh to the lower leg is indicated by a bending curve (8) of the orthosis. A knee joint holding device that reduces the interference between the brace and the lower limb by bending the brace according to the curvature of the knee joint such as physiological valgus.

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