US20170281388A9 - Anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error - Google Patents
Anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error Download PDFInfo
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- US20170281388A9 US20170281388A9 US15/061,379 US201615061379A US2017281388A9 US 20170281388 A9 US20170281388 A9 US 20170281388A9 US 201615061379 A US201615061379 A US 201615061379A US 2017281388 A9 US2017281388 A9 US 2017281388A9
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- proximal
- distal
- band
- cable
- hinge mechanism
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F5/0123—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the knees
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F2005/0132—Additional features of the articulation
- A61F2005/0165—Additional features of the articulation with limits of movement
- A61F2005/0167—Additional features of the articulation with limits of movement adjustable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F2005/0132—Additional features of the articulation
- A61F2005/0172—Additional features of the articulation with cushions
- A61F2005/0176—Additional features of the articulation with cushions supporting the patella
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0073—Force-limiting means
Definitions
- This invention relates to anatomical braces in general, and more particularly to anatomical braces for dynamically stabilizing the patella during knee articulation so as to address patella tracking error.
- the knee joint is formed at the convergence of the femur and the tibia.
- the patella also known as the knee cap
- the patella and the femur together form another joint, i.e., the patello-femoral joint.
- the posterior side of the patella (formed as a ridge) engages the anterior side of the femur (formed as a groove).
- the patella ridge rides in the femoral groove as the knee articulates.
- the patella moves from distal (in flexion) to proximal (in extension).
- patella tracking error Many people suffer from improper tracking of the patella relative to the femur. More particularly, many people suffer from “patella tracking error” where the patella fails to track properly along the femur as the knee articulates. In many cases, with patella tracking error, the patella improperly tracks laterally as the knee moves from flexion to extension, and/or the patella fails to track proximally as the knee moves from flexion to extension. Less severe forms of patella tracking error can cause pain in the joint. More severe forms of patella tracking error can lead to cartilage damage and arthritis of the knee.
- anatomical brace disclosed in U.S. Pat. No. 6,551,264 is a significant improvement over prior art anatomical braces, it nonetheless suffers from a significant design limitation, i.e., it can impose only lateral-to-medial forces on the patella as the knee moves from flexion to extension, and is unable to impose distal-to-proximal forces (or diagonal forces) on the patella as the knee moves from flexion to extension.
- the anatomical brace disclosed in U.S. Pat. No. 6,551,264 is only partially successful in dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- the anatomical brace disclosed in U.S. Pat. No. 6,551,264 tends to be relatively heavy and intrusive, inasmuch as it uses a so-called “double hinge construction” in which hinge mechanisms are disposed on both the lateral and medial sides of the knee joint, and includes a substantial body of fabric on the posterior side of the knee which impedes full flexion of the knee (e.g., due to bunching in the back of the brace).
- anatomical brace disclosed in U.S. Pat. No. 6,551,264 can migrate during use, inasmuch as it uses only a single strap to secure the anatomical brace to the calf of the patient and uses only a single strap to secure the anatomical brace to the thigh of the patient.
- one object of the present invention is to provide a novel anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors, wherein the anatomical brace is configured to apply distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension.
- Another object of the present invention is to provide a novel anatomical brace which is relatively lightweight and non-intrusive, by eliminating the so-called “double hinge construction”, and by avoiding the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace).
- Yet another object of the present invention is to provide a novel anatomical brace which is more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient.
- Another object of the present invention is to provide a novel anatomical brace which relaxes the forces applied to the patella during knee flexion so that the novel anatomical brace is not “too tight” around the kneecap during knee flexion.
- the present invention comprises the provision and use of a novel anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- the novel anatomical brace is configured to apply distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension.
- novel anatomical brace is configured to be relatively lightweight and non-intrusive, by eliminating the so-called “double hinge construction”, and by avoiding the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace).
- novel anatomical brace is configured to be more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient.
- novel anatomical brace is configured to relax the forces applied to the patella during knee flexion so that the novel anatomical brace is not “too tight” around the kneecap during knee flexion.
- anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error, said anatomical brace comprising:
- a brace body comprising:
- a hinge mechanism comprising a distal segment, a proximal segment and a pivot for pivotally connecting said distal segment and said proximal segment, said distal segment of said hinge mechanism being connected to said distal band and said proximal segment of said hinge mechanism being connected to said proximal band;
- a second cable guide mounted to said proximal segment of said hinge mechanism
- a cable having a first end and a second end
- said first end of said cable being mounted to said distal segment of said hinge mechanism, said second end of said cable being mounted to at least one of said distal band and said lateral connector, and said cable being routed proximally along said distal segment of said hinge mechanism, through said first cable guide, proximally along said proximal segment of said hinge mechanism, through said second cable guide, laterally along said proximal band, distally along said lateral connector and through said third cable guide;
- said anatomical brace when said anatomical brace is mounted to the knee of a patient so that said distal band is secured to the calf of the patient, said proximal band is secured to the thigh of the patient and the patella of the patient is received in said central opening of said brace body, and when the knee thereafter moves to full extension, said cable is tensioned, whereby to apply a proximal/medial force to the patella of the patient, and when the knee thereafter moves to full flexion, said cable is relaxed, so that the proximal/medial force is released.
- a method for dynamically stabilizing the patella during knee articulation so as to address patella tracking error comprising:
- an anatomical brace comprising:
- FIG. 1 is a schematic view showing the novel anatomical brace of the present invention from the medial side, with the knee in full flexion;
- FIG. 2 is a schematic view showing the novel anatomical brace of the present invention from the anterior side, with the knee in full flexion;
- FIG. 3 is a schematic view showing the novel anatomical brace of the present invention from the lateral side, with the knee in full flexion;
- FIG. 4 is a schematic view showing the novel anatomical brace of the present invention from the medial side, with the knee in full extension;
- FIG. 5 is a schematic view showing the novel anatomical brace of the present invention from the anterior side, with the knee in full extension;
- FIG. 6 is a schematic view showing the novel anatomical brace of the present invention from the lateral side, with the knee in full extension;
- FIG. 7 is a schematic view showing the front (anterior) side of the novel anatomical brace of the present invention, with the anatomical brace laid out flat on a surface;
- FIG. 8 is a schematic view showing the rear (posterior) side of the novel anatomical brace of the present invention, with the anatomical brace laid out flat on a surface;
- FIGS. 9-12 are schematic views showing operation of the novel anatomical brace as the knee moves from flexion to extension;
- FIGS. 13 and 14 are schematic views showing operation of the novel anatomical brace as the knee moves from extension to flexion;
- FIG. 15 is a schematic view showing another form of the novel anatomical brace of the present invention.
- FIG. 16 is a schematic view showing still another form of the novel anatomical brace of the present invention.
- FIG. 17 is a schematic view showing one form of a cover which may be positioned over the novel anatomical brace during use.
- the present invention comprises the provision and use of a novel anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- the novel anatomical brace is configured to apply distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension.
- novel anatomical brace is configured to be relatively lightweight and non-intrusive, by eliminating the so-called “double hinge construction”, and by avoiding the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace).
- novel anatomical brace is configured to be more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient.
- novel anatomical brace is configured to relax the forces applied to the patella during knee flexion so that the novel anatomical brace is not “too tight” around the kneecap during knee flexion.
- Anatomical brace 5 for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- Anatomical brace 5 generally comprises a brace body 10 comprising a distal band 15 having a first end 20 and a second end 25 , a proximal band 30 having a first end 35 and a second end 40 , a medial connector 45 having a distal end 50 and a proximal end 55 , and a lateral connector 60 having a distal end 65 and a proximal end 70 .
- Brace body 10 is flexible, and is preferably formed out of a flexible sheet material such as a woven fabric, a synthetic rubber, etc. In one preferred form of the invention, brace body 10 is formed out of neoprene or a neoprene blend.
- One half 75 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the front (anterior) side of first end 20 of distal band 15 and the other half 80 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the rear (posterior) side of second end 25 of distal band 15 , such that distal band 15 can be wrapped about the calf of a patient and secured in place.
- a hook-and-mesh e.g, Velcro®
- One half 85 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the front (anterior) side of first end 35 of proximal band 30 and the other half 90 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the rear (posterior) side of second end 40 of proximal band 30 , such that proximal band 30 can be wrapped about the thigh of a patient and secured in place.
- a hook-and-mesh e.g., Velcro®
- a pair of distal straps 95 are secured to distal band 15 at their first ends 100 .
- One half 110 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the front (anterior) side of each of first ends 100 of distal straps 95 and the other half 115 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the rear (posterior) side of each of second ends 105 of distal straps 95 , such that distal straps 95 can be wrapped over distal band 15 and secured in place after distal band 15 has been secured to the calf of a patient.
- a hook-and-mesh e.g, Velcro®
- a proximal strap 120 having a first end 125 and a second end 130 , is secured to proximal band 30 at its first end 125 .
- One half 135 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the front (anterior) side of first end 125 of proximal strap 120 and the other half 140 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the rear (posterior) side of second end 130 of proximal strap 120 , such that proximal strap 120 can be wrapped over proximal band 30 and secured in place after proximal band 30 has been secured to the thigh of a patient.
- a hook-and-mesh e.g., Velcro®
- Central opening 72 of brace body 10 is sized to receive the patella of a patient, as will hereinafter be discussed.
- a hinge mechanism 145 is mounted over medial connector 45 and secured to distal band 15 and proximal band 30 . More particularly, hinge mechanism 145 comprises a distal segment 150 and a proximal segment 155 , with distal segment 150 being connected to proximal segment 155 at a pivot 160 . Distal segment 150 of hinge mechanism 145 is secured to distal band 15 and proximal segment 155 of hinge mechanism 145 is secured to proximal band 30 . Distal segment 150 of hinge mechanism 145 , and proximal segment 155 of hinge mechanism 145 , are each relatively stiff, and are preferably formed out of a lightweight metal, or a plastic, or a carbon fiber, etc.
- Pivot 160 of hinge mechanism 145 is relatively frictionless (i.e., it is easily articulated) and is preferably formed as an assembly comprising a central disc-shaped body to which both distal segment 150 and proximal segment 155 are pivotally attached.
- pivot 160 can comprise a simple “rivet pivot” or “screw pivot” of the sort well known in the art.
- a first cable guide (e.g., a pivot guide) 162 is mounted to the portion of pivot 160 which faces posteriorly when anatomical brace 5 is secured to the knee of a patient (for purposes of the present disclosure, first cable guide 162 is sometimes hereinafter referred to as being mounted to “the posterior portion of pivot 160 ”, and/or to “the posterior side of pivot 160 ”, etc.).
- a second cable guide (e.g., a guide pulley) 165 is adjustably mounted to proximal segment 155 of hinge mechanism 145 . More particularly, second cable guide (e.g., guide pulley) 165 is mounted to proximal segment 155 of hinge mechanism 145 so that the distance between second cable guide (e.g., guide pulley) 165 and pivot 160 may be adjusted by the user. In one preferred form of the invention, second cable guide (e.g., guide pulley) 165 is adjustably mounted to proximal segment 155 of hinge mechanism 145 , e.g., using a screw and a plurality of holes.
- a third cable guide (e.g., a brace tunnel) 167 is formed on lateral connector 60 .
- third cable guide 167 comprises a brace tunnel
- the brace tunnel may be formed out of the same material as brace body 10 , or the brace tunnel may be formed out of a different material than brace body 10 .
- a cable 170 extends between distal segment 150 of hinge mechanism 145 and a distal lateral portion of brace body 10 of anatomical brace 5 . More particularly, cable 170 comprises a first end 182 which is adjustably secured to distal segment 150 of hinge 145 , and a second end 183 which is adjustably secured to a lateral portion of distal band 15 , with the intermediate portion of cable 170 extending proximally along distal segment 150 of hinge mechanism 150 , through first cable guide (e.g., pivot guide) 162 , proximally along proximal segment 155 of hinge mechanism 150 , through second cable guide (e.g., guide pulley) 165 , laterally along proximal band 30 , distally along lateral connector 60 , and then through third cable guide (e.g., brace tunnel) 167 .
- first cable guide e.g., pivot guide
- proximal segment 155 of hinge mechanism 150 proximally along proximal segment 155 of hinge mechanism 150
- first cable guide 162 which is positioned on the posterior side of pivot 160 so as to keep first end 182 of cable 170 toward the posterior side of pivot 160 .
- first cable guide 162 e.g., pivot guide
- cable 170 is able to release tension when the knee flexes and increase tension when the knee extends. This is a significant improvement in the art.
- the present invention provides a hinged knee brace (i.e., a patellofemoral knee brace) with a cable system where the cable passes along the length of the hinge and posteriorly to the hinge pivot. This unique design allows for tightening of the cable (therefore resulting in the application of pressure to the kneecap) during knee extension and loosening of the cable (therefore resulting in releasing pressure from the kneecap) during flexion.
- second end 183 of cable 170 passes through third cable guide (e.g., brace tunnel) 167 positioned on lateral connector 60 so as to stabilize second end 183 of cable 170 laterally of the patella, and second end 183 of cable 170 is secured to a lateral portion of distal band 15 .
- cable 170 is able to apply lateral-to-medial, and distal-to-proximal, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension.
- first end 182 of cable 170 is adjustably mounted to distal segment 150 of hinge mechanism 145 such that the position of first end 182 of cable 170 can be adjusted relative to distal segment 150 of hinge mechanism 145 , whereby to change the angle, direction and/or tension of cable 170 , in order to accommodate the patient's anatomy.
- first end 182 of cable 170 is adjustably mounted to distal segment 150 of hinge mechanism 145 using a screw and a plurality of holes.
- second end 183 of cable 170 is adjustably mounted to distal band 15 of brace body 10 such that the position of second end 183 of cable 170 can be adjusted relative to distal band 15 of brace body 10 , whereby to change the angle, direction and/or tension of cable 170 , in order to accommodate the patient's anatomy.
- second end 183 of cable 170 is adjustably mounted to distal band 15 using a hook-and-mesh (e.g., Velcro®) fastener.
- one half 184 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to second end 183 of cable 170 and the other half of a hook-and-mesh (e.g., Velcro®) fastener is provided by the element 75 previously described.
- a hook-and-mesh e.g., Velcro®
- second cable guide (e.g., guide pulley) 165 is adjustably mounted to proximal segment 155 of hinge mechanism 145 such that the position of second cable guide (e.g., guide pulley) 165 on proximal segment 155 of hinge mechanism 145 can be adjusted, whereby to change the angle, direction and/or tension of cable 170 , in order to accommodate the patient's anatomy.
- first end 182 of cable 170 is formed out of a relatively inelastic material such as stainless steel and second end 183 of cable 170 is formed out of an elastomeric material (e.g., rubber, a rubber substitute, an elastic weave, etc.).
- first end 182 of cable 170 is substantially unstretchable while second end 175 of cable 170 can elongate to some (i.e., a limited) extent.
- second end 183 of cable 170 out of an elastomeric material has several significant advantages. First, it is convenient for the healthcare professional during fitting of anatomical brace 5 , since it minimizes the need for cable sizing and eliminates concerns about excessive or inadequate cable lengths. Second, it eliminates concerns about cable bunching when the knee is in flexion (i.e., when the knee is bent), since the elastomeric nature of the cable takes up excess cable length when tension on the cable is relaxed. Third, the elastomeric nature of the cable is able to accommodate the patient's anatomy during extension (i.e., knee straightening), and eliminates the concern that the limit of the cable will be reached before the leg is in full extension.
- second end 183 of cable 170 is preferably elastic to some (i.e., a limited) extent, it is not so elastic as to prevent cable 170 and brace body 10 from applying forces to the patella during flexion of the knee.
- the elastomeric nature of second end 183 of the tensioned cable 170 pulls the tibia towards the femur, whereby to provide (through the patella tendon) distal-to-proximal forces on the patella (which reduces the load on the patella tendon, thereby making anatomical brace 5 useful for patients with patella tendonitis).
- anatomical brace 5 is first secured to the patient by positioning brace body 10 over the knee so that central opening 72 of brace body 10 receives the patella of the patient and makes a relatively close fit about the distal and lateral portions of the patella, placing medial connector 45 over the medial portion of the knee, and placing lateral connector 60 over the lateral portion of the knee; and by fitting distal band 15 about the calf of the patient and making it fast with hook-and-mesh (e.g, Velcro®) fastener 75 , 80 , and fitting proximal band 30 about the thigh of the patient and making it fast with hook-and-mesh (e.g., Velcro®) fastener 85 , 90 .
- hook-and-mesh e.g, Velcro®
- distal straps 95 are tightened about distal band 15 using hook-and-mesh (e.g., Velcro®) fasteners 110 , 115
- proximal strap 120 is tightened about proximal band 30 using hook-and-mesh (e.g, Velcro®) fastener 135 , 140 .
- hook-and-mesh e.g., Velcro®
- brace body 10 By positioning brace body 10 so that central opening 72 of brace body 10 receives the patella of the patient, brace body 10 and cable 170 of anatomical brace 5 will surround the patella of the patient.
- hinge mechanism 145 will extend along the medial portion of the knee, and the rear of the knee is left substantially uncovered by anatomical brace 5 .
- cable 170 has its first end 182 adjustably secured to distal segment 150 of hinge mechanism 145 .
- first cable guide e.g., pivot guide
- second cable guide e.g., guide pulley
- third cable guide e.g., brace tunnel
- the cable passes posterior to pivot 160 and alongside, and substantially engages, the lateral portions of the patella, and terminates distal to the patella.
- brace body 10 of anatomical brace 5 proximally and medially (i.e., in a proximal/medial diagonal direction).
- This proximal/medial force is applied to (i) the patella of the patient via brace body 10 (inasmuch as central opening 72 of brace body 10 receives the patella of the patient and makes a relatively close fit about the distal and lateral portions of the patella), and (ii) the tibia of the patient (inasmuch as distal band 15 or brace body 10 is secured to the upper calf of the patient, and hence the tibia of the patient, and the second end 183 of cable 170 is anchored to distal band 15 ), which force is in turn transferred to the patella via the patella tendon. See FIGS. 9-12 .
- anatomical brace 5 when the knee articulates from flexion to extension (see FIGS. 9-12 ), anatomical brace 5 applies distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) on the patella, whereby to correct for patella tracking errors, and when the knee articulates from extension to flexion (see FIGS. 13 and 14 ), anatomical brace 5 relaxes the forces applied to the patella.
- the use of a guided cable system that allows the anatomical brace to engage the patella with distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) during knee extension, and relax those forces during knee flexion is a unique feature not found in the prior art and which is highly advantageous over the anatomical braces of the prior art. This is made possible by the use of the unique guided cable system of the present invention, where the cable passes along the length of the hinge mechanism and posteriorly to the hinge pivot.
- cable 170 can stretch (to some extent) when the cable is tensioned during knee extension (i.e., during knee straightening), and cable 170 can contract (to some extent) when the cable is relaxed during knee flexion (i.e., during knee bending).
- second end 183 of cable 170 out of an elastomeric material provides increased convenience for the healthcare professional during fitting of anatomical brace 5 , since it minimizes the need for cable sizing and eliminates concerns about excessive or inadequate cable lengths; (ii) eliminates concerns about cable bunching when the knee is in flexion (i.e., when the knee is bent), since the elastomeric nature of the cable takes up excess cable length when tension on the cable is relaxed; (iii) accommodates the patient's anatomy during extension (i.e., knee straightening), and eliminates the concern that the limit of the cable will be reached before the leg is in full extension; (of course, it will also be appreciated that while second end 183 of cable 170 is preferably elastic to some extent, it is not so elastic as to prevent cable 170 and brace body 10 from applying forces to the patella during flexion of the knee); and (iv) during knee extension, the elastomeric nature of second end 183 of the tensioned cable
- anatomical brace 5 is relatively lightweight and non-intrusive, since it utilizes a single-hinge construction and avoids a so-called “double hinge construction”, and avoids the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace).
- the present invention provides a light weight and low profile brace that, among other things, prevents bunching in the back of the brace and tightness when the knee is bent.
- anatomical brace 5 is more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient.
- anatomical brace 5 is configured to relax the forces applied to the patella during knee flexion so that anatomical brace 5 is not “too tight” around the kneecap during knee flexion.
- first end 182 of cable 170 is adjustably mounted to distal segment 150 of hinge mechanism 145 such that the position of first end 182 of cable 170 can be adjusted relative to distal segment 150 of hinge mechanism 145 , whereby to change the angle, direction and/or tension of cable 170 , in order to accommodate the patient's anatomy; and it was noted that in one preferred form of the invention, first end 182 of cable 170 is adjustably mounted to distal segment 150 of hinge mechanism 145 using a screw and a plurality of holes.
- many other mounting mechanisms may be utilized if desired. By way of example but not limitation, and looking now at FIG.
- first end 182 of cable 170 may adjustably mounted to distal segment 150 of hinge mechanism 145 by providing a rail 200 on distal segment 150 of hinge mechanism 145 , and by mounting first end 182 of cable 170 to a rider 205 which is slidably mounted to rail 200 , with a fixation element (e.g., a set screw, not shown) being used to lock rider 205 in place at a desired position along rail 200 .
- a fixation element e.g., a set screw, not shown
- second cable guide (e.g., guide pulley) 165 is adjustably mounted to proximal segment 155 of hinge mechanism 145 such that the position of second cable guide (e.g., guide pulley) 165 can be adjusted relative to proximal segment 155 of hinge mechanism 145 , whereby to change the angle, direction and/or tension of cable 170 , in order to accommodate the patient's anatomy; and it was noted that in one preferred form of the invention, second cable guide (e.g., guide pulley) 165 is adjustably mounted to proximal segment 155 of hinge mechanism 145 using a screw and a plurality of holes.
- second cable guide (e.g., guide pulley) 165 may adjustably mounted to proximal segment 155 of hinge mechanism 145 by providing a rail 210 on proximal segment 155 of hinge mechanism 145 , and by mounting second cable guide (e.g., guide pulley) 165 to a rider 215 which is slidably mounted to rail 210 , with a fixation element (e.g., a set screw, not shown) being used to lock rider 215 in place at a desired position along rail 210 .
- a fixation element e.g., a set screw, not shown
- FIG. 16 shows another form of the novel anatomical brace of the present invention.
- This form of the invention is generally similar to the construction shown in FIG. 15 , except that various components of the hinge mechanism are formed with a lighter weight construction.
- second end 183 of cable 170 is adjustably mounted to distal band 15 of brace body 10 such that the position of second end 183 of cable 170 can be adjusted relative to distal band 15 of brace body 10 , whereby to change the angle, direction and/or tension of cable 170 , in order to accommodate the patient's anatomy; and it was noted that in one preferred form of the invention, second end 183 of cable 170 is adjustably mounted to distal band 15 of brace body 10 using a hook-and-mesh (e.g. Velcro®) fastener.
- a hook-and-mesh e.g. Velcro®
- first cable guide 162 may be a pivot guide
- second cable guide 165 may be a guide pulley
- third cable guide 167 may be a brace tunnel; however, it should also be appreciated that other elements (e.g., rings, eyelets, tubes, etc.) may be used to form first cable guide 162 , second cable guide 165 and/or third cable guide 167 (i.e., essentially any structure capable of guiding cable 170 in a manner consistent with the present invention).
- first cable guide e.g., guide pulley
- second cable guide e.g., guide pulley
- third cable guide e.g., brace tunnel
- an elastic sleeve 220 may be provided for selectively covering novel anatomical brace 5 , with the elastic sleeve 220 being pulled up over the anatomical brace during use.
- an overlying covering or panel may be permanently (or temporarily) attached to anatomical brace 5 (e.g., to portions of brace body 10 ), with the covering or panel able to be laid open (e.g., folded back) when it is necessary to access the operative elements of the anatomical brace (e.g., to adjust the disposition of cable 170 ) and the covering or panel being closable (e.g., laid back over the operative elements and secured in place) when the anatomical brace is in use.
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Abstract
Description
- This patent application claims benefit of pending prior U.S. Provisional Patent Application Ser. No. 62/127,919, filed Mar. 4, 2015 by Andrew M. Blecher, M.D. for ANATOMICAL BRACE FOR DYNAMICALLY STABILIZING THE PATELLA DURING KNEE ARTICULATION SO AS TO ADDRESS PATELLA TRACKING ERROR (Attorney's Docket No. BLECHER-1 PROV), which patent application is hereby incorporated herein by reference.
- This invention relates to anatomical braces in general, and more particularly to anatomical braces for dynamically stabilizing the patella during knee articulation so as to address patella tracking error.
- The knee joint is formed at the convergence of the femur and the tibia. The patella (also known as the knee cap) sits on the anterior side of the knee joint, at the base of the femur. The patella and the femur together form another joint, i.e., the patello-femoral joint. At the patello-femoral joint, the posterior side of the patella (formed as a ridge) engages the anterior side of the femur (formed as a groove). With a properly functioning patello-femoral joint, the patella ridge rides in the femoral groove as the knee articulates. Among other things, with a properly functioning patello-femoral joint, the patella moves from distal (in flexion) to proximal (in extension).
- Many people suffer from improper tracking of the patella relative to the femur. More particularly, many people suffer from “patella tracking error” where the patella fails to track properly along the femur as the knee articulates. In many cases, with patella tracking error, the patella improperly tracks laterally as the knee moves from flexion to extension, and/or the patella fails to track proximally as the knee moves from flexion to extension. Less severe forms of patella tracking error can cause pain in the joint. More severe forms of patella tracking error can lead to cartilage damage and arthritis of the knee.
- As a result, a recognized need exists for effective treatment of patella tracking errors.
- In U.S. Pat. No. 6,551,264, issued Apr. 22, 2003 to Cawley et al. for ORTHOSIS FOR DYNAMICALLY STABILIZING THE PATELLO-FEMORAL JOINT, there is disclosed an anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- While the anatomical brace disclosed in U.S. Pat. No. 6,551,264 is a significant improvement over prior art anatomical braces, it nonetheless suffers from a significant design limitation, i.e., it can impose only lateral-to-medial forces on the patella as the knee moves from flexion to extension, and is unable to impose distal-to-proximal forces (or diagonal forces) on the patella as the knee moves from flexion to extension. As a result, the anatomical brace disclosed in U.S. Pat. No. 6,551,264 is only partially successful in dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- In addition, the anatomical brace disclosed in U.S. Pat. No. 6,551,264 also suffers from several additional design limitations.
- Among other things, the anatomical brace disclosed in U.S. Pat. No. 6,551,264 tends to be relatively heavy and intrusive, inasmuch as it uses a so-called “double hinge construction” in which hinge mechanisms are disposed on both the lateral and medial sides of the knee joint, and includes a substantial body of fabric on the posterior side of the knee which impedes full flexion of the knee (e.g., due to bunching in the back of the brace).
- Furthermore, the anatomical brace disclosed in U.S. Pat. No. 6,551,264 can migrate during use, inasmuch as it uses only a single strap to secure the anatomical brace to the calf of the patient and uses only a single strap to secure the anatomical brace to the thigh of the patient.
- And it should also be appreciated that the anatomical brace disclosed in U.S. Pat. No. 6,551,264 suffers from the fact that it does not adequately relax the forces applied around the kneecap during knee flexion, and hence the anatomical brace disclosed in U.S. Pat. No. 6,551,264 is “too tight” around the kneecap during knee flexion.
- As a result, one object of the present invention is to provide a novel anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors, wherein the anatomical brace is configured to apply distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension.
- And another object of the present invention is to provide a novel anatomical brace which is relatively lightweight and non-intrusive, by eliminating the so-called “double hinge construction”, and by avoiding the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace).
- And another object of the present invention is to provide a novel anatomical brace which is more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient.
- And another object of the present invention is to provide a novel anatomical brace which relaxes the forces applied to the patella during knee flexion so that the novel anatomical brace is not “too tight” around the kneecap during knee flexion.
- These and other objects are addressed by the present invention, which comprises the provision and use of a novel anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- Among other things, the novel anatomical brace is configured to apply distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension.
- And the novel anatomical brace is configured to be relatively lightweight and non-intrusive, by eliminating the so-called “double hinge construction”, and by avoiding the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace).
- And the novel anatomical brace is configured to be more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient.
- And the novel anatomical brace is configured to relax the forces applied to the patella during knee flexion so that the novel anatomical brace is not “too tight” around the kneecap during knee flexion.
- In one preferred form of the invention, there is provided an anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error, said anatomical brace comprising:
- a brace body comprising:
-
- a distal band having a first end, a second end and a fastener for securing together said first end of said distal band and said second end of said distal band;
- a proximal band having a first end, a second end and a fastener for securing together said first end of said proximal band and said second end of said proximal band;
- a medial connector having a distal end and a proximal end, said distal end of said medial connector being connected to said distal band and said proximal end of said medial connector being connected to said proximal band;
- a lateral connector having a distal end and a proximal end, said distal end of said lateral connector being connected to said distal band and said proximal end of said lateral connector being connected to said proximal band;
- said distal band, said proximal band, said medial connector and said lateral connector together defining a central opening sized to receive the patella of a patient;
- a hinge mechanism comprising a distal segment, a proximal segment and a pivot for pivotally connecting said distal segment and said proximal segment, said distal segment of said hinge mechanism being connected to said distal band and said proximal segment of said hinge mechanism being connected to said proximal band;
- a first cable guide mounted to the posterior portion of said pivot;
- a second cable guide mounted to said proximal segment of said hinge mechanism;
- a third cable guide secured to said lateral connector;
- a cable having a first end and a second end;
- said first end of said cable being mounted to said distal segment of said hinge mechanism, said second end of said cable being mounted to at least one of said distal band and said lateral connector, and said cable being routed proximally along said distal segment of said hinge mechanism, through said first cable guide, proximally along said proximal segment of said hinge mechanism, through said second cable guide, laterally along said proximal band, distally along said lateral connector and through said third cable guide;
- wherein, when said anatomical brace is mounted to the knee of a patient so that said distal band is secured to the calf of the patient, said proximal band is secured to the thigh of the patient and the patella of the patient is received in said central opening of said brace body, and when the knee thereafter moves to full extension, said cable is tensioned, whereby to apply a proximal/medial force to the patella of the patient, and when the knee thereafter moves to full flexion, said cable is relaxed, so that the proximal/medial force is released.
- In another preferred form of the invention, there is provided a method for dynamically stabilizing the patella during knee articulation so as to address patella tracking error, said method comprising:
- providing an anatomical brace comprising:
-
- a brace body comprising:
- a distal band having a first end, a second end and a fastener for securing together said first end of said distal band and said second end of said distal band;
- a proximal band having a first end, a second end and a fastener for securing together said first end of said proximal band and said second end of said proximal band;
- a medial connector having a distal end and a proximal end, said distal end of said medial connector being connected to said distal band and said proximal end of said medial connector being connected to said proximal band;
- a lateral connector having a distal end and a proximal end, said distal end of said lateral connector being connected to said distal band and said proximal end of said lateral connector being connected to said proximal band;
- said distal band, said proximal band, said medial connector and said lateral connector together defining a central opening sized to receive the patella of a patient;
- a hinge mechanism comprising a distal segment, a proximal segment and a pivot for pivotally connecting said distal segment and said proximal segment, said distal segment of said hinge mechanism being connected to said distal band and said proximal segment of said hinge mechanism being connected to said proximal band;
- a first cable guide mounted to the posterior portion of said pivot;
- a second cable guide mounted to said proximal segment of said hinge mechanism;
- a third cable guide secured to said lateral connector;
- a cable having a first end and a second end;
- said first end of said cable being mounted to said distal segment of said hinge mechanism, said second end of said cable being mounted to at least one of said distal band and said lateral connector, and said cable being routed proximally along said distal segment of said hinge mechanism, through said first cable guide, proximally along said proximal segment of said hinge mechanism, through said second cable guide, laterally along said proximal band, distally along said lateral connector and through said third cable guide; and
- mounting said anatomical brace to the knee of a patient so that said distal band is secured to the calf of the patient, said proximal band is secured to the thigh of the patient and the patella of the patient is received in said central opening of said brace body;
- such that when the knee thereafter moves to full extension, said cable is tensioned, whereby to apply a proximal/medial force to the patella of the patient, and when the knee thereafter moves to full flexion, said cable is relaxed, so that the proximal/medial force is released.
- a brace body comprising:
- These and other objects and features of the present invention will be more fully disclosed or rendered obvious by the following detailed description of the preferred embodiments of the invention, which is to be considered together with the accompanying drawings wherein like numbers refer to like parts, and further wherein:
-
FIG. 1 is a schematic view showing the novel anatomical brace of the present invention from the medial side, with the knee in full flexion; -
FIG. 2 is a schematic view showing the novel anatomical brace of the present invention from the anterior side, with the knee in full flexion; -
FIG. 3 is a schematic view showing the novel anatomical brace of the present invention from the lateral side, with the knee in full flexion; -
FIG. 4 is a schematic view showing the novel anatomical brace of the present invention from the medial side, with the knee in full extension; -
FIG. 5 is a schematic view showing the novel anatomical brace of the present invention from the anterior side, with the knee in full extension; -
FIG. 6 is a schematic view showing the novel anatomical brace of the present invention from the lateral side, with the knee in full extension; -
FIG. 7 is a schematic view showing the front (anterior) side of the novel anatomical brace of the present invention, with the anatomical brace laid out flat on a surface; -
FIG. 8 is a schematic view showing the rear (posterior) side of the novel anatomical brace of the present invention, with the anatomical brace laid out flat on a surface; -
FIGS. 9-12 are schematic views showing operation of the novel anatomical brace as the knee moves from flexion to extension; -
FIGS. 13 and 14 are schematic views showing operation of the novel anatomical brace as the knee moves from extension to flexion; -
FIG. 15 is a schematic view showing another form of the novel anatomical brace of the present invention; -
FIG. 16 is a schematic view showing still another form of the novel anatomical brace of the present invention; and -
FIG. 17 is a schematic view showing one form of a cover which may be positioned over the novel anatomical brace during use. - The present invention comprises the provision and use of a novel anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.
- Among other things, the novel anatomical brace is configured to apply distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension.
- And the novel anatomical brace is configured to be relatively lightweight and non-intrusive, by eliminating the so-called “double hinge construction”, and by avoiding the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace).
- And the novel anatomical brace is configured to be more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient.
- And the novel anatomical brace is configured to relax the forces applied to the patella during knee flexion so that the novel anatomical brace is not “too tight” around the kneecap during knee flexion.
- Construction of the Novel Anatomical Brace
- Looking first at
FIGS. 1-8 , in one preferred form of the invention there is provided a novelanatomical brace 5 for dynamically stabilizing the patella during knee articulation so as to address patella tracking errors.Anatomical brace 5 generally comprises abrace body 10 comprising adistal band 15 having afirst end 20 and asecond end 25, aproximal band 30 having afirst end 35 and asecond end 40, amedial connector 45 having adistal end 50 and aproximal end 55, and alateral connector 60 having adistal end 65 and aproximal end 70.Distal band 15,proximal band 30,medial connector 45 andlateral connector 60 together define acentral opening 72 withinbrace body 10.Brace body 10 is flexible, and is preferably formed out of a flexible sheet material such as a woven fabric, a synthetic rubber, etc. In one preferred form of the invention, bracebody 10 is formed out of neoprene or a neoprene blend. - One
half 75 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the front (anterior) side offirst end 20 ofdistal band 15 and the other half 80 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the rear (posterior) side ofsecond end 25 ofdistal band 15, such thatdistal band 15 can be wrapped about the calf of a patient and secured in place. Onehalf 85 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the front (anterior) side offirst end 35 ofproximal band 30 and the other half 90 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the rear (posterior) side ofsecond end 40 ofproximal band 30, such thatproximal band 30 can be wrapped about the thigh of a patient and secured in place. - A pair of
distal straps 95, each having afirst end 100 and asecond end 105, are secured todistal band 15 at their first ends 100. Onehalf 110 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the front (anterior) side of each of first ends 100 ofdistal straps 95 and theother half 115 of a hook-and-mesh (e.g, Velcro®) fastener is fixed to the rear (posterior) side of each of second ends 105 ofdistal straps 95, such thatdistal straps 95 can be wrapped overdistal band 15 and secured in place afterdistal band 15 has been secured to the calf of a patient. - A
proximal strap 120, having afirst end 125 and asecond end 130, is secured toproximal band 30 at itsfirst end 125. Onehalf 135 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the front (anterior) side offirst end 125 ofproximal strap 120 and theother half 140 of a hook-and-mesh (e.g., Velcro®) fastener is fixed to the rear (posterior) side ofsecond end 130 ofproximal strap 120, such thatproximal strap 120 can be wrapped overproximal band 30 and secured in place afterproximal band 30 has been secured to the thigh of a patient. - Central opening 72 of
brace body 10 is sized to receive the patella of a patient, as will hereinafter be discussed. - A
hinge mechanism 145 is mounted overmedial connector 45 and secured todistal band 15 andproximal band 30. More particularly,hinge mechanism 145 comprises adistal segment 150 and aproximal segment 155, withdistal segment 150 being connected toproximal segment 155 at apivot 160.Distal segment 150 ofhinge mechanism 145 is secured todistal band 15 andproximal segment 155 ofhinge mechanism 145 is secured toproximal band 30.Distal segment 150 ofhinge mechanism 145, andproximal segment 155 ofhinge mechanism 145, are each relatively stiff, and are preferably formed out of a lightweight metal, or a plastic, or a carbon fiber, etc. Pivot 160 ofhinge mechanism 145 is relatively frictionless (i.e., it is easily articulated) and is preferably formed as an assembly comprising a central disc-shaped body to which bothdistal segment 150 andproximal segment 155 are pivotally attached. Alternatively, pivot 160 can comprise a simple “rivet pivot” or “screw pivot” of the sort well known in the art. - A first cable guide (e.g., a pivot guide) 162 is mounted to the portion of
pivot 160 which faces posteriorly whenanatomical brace 5 is secured to the knee of a patient (for purposes of the present disclosure,first cable guide 162 is sometimes hereinafter referred to as being mounted to “the posterior portion ofpivot 160”, and/or to “the posterior side ofpivot 160”, etc.). - A second cable guide (e.g., a guide pulley) 165 is adjustably mounted to
proximal segment 155 ofhinge mechanism 145. More particularly, second cable guide (e.g., guide pulley) 165 is mounted toproximal segment 155 ofhinge mechanism 145 so that the distance between second cable guide (e.g., guide pulley) 165 and pivot 160 may be adjusted by the user. In one preferred form of the invention, second cable guide (e.g., guide pulley) 165 is adjustably mounted toproximal segment 155 ofhinge mechanism 145, e.g., using a screw and a plurality of holes. - A third cable guide (e.g., a brace tunnel) 167 is formed on
lateral connector 60. Wherethird cable guide 167 comprises a brace tunnel, the brace tunnel may be formed out of the same material asbrace body 10, or the brace tunnel may be formed out of a different material thanbrace body 10. - A
cable 170 extends betweendistal segment 150 ofhinge mechanism 145 and a distal lateral portion ofbrace body 10 ofanatomical brace 5. More particularly,cable 170 comprises afirst end 182 which is adjustably secured todistal segment 150 ofhinge 145, and asecond end 183 which is adjustably secured to a lateral portion ofdistal band 15, with the intermediate portion ofcable 170 extending proximally alongdistal segment 150 ofhinge mechanism 150, through first cable guide (e.g., pivot guide) 162, proximally alongproximal segment 155 ofhinge mechanism 150, through second cable guide (e.g., guide pulley) 165, laterally alongproximal band 30, distally alonglateral connector 60, and then through third cable guide (e.g., brace tunnel) 167. - Note that with this cable pathway,
first end 182 ofcable 170 passes through first cable guide (e.g., pivot guide) 162, which is positioned on the posterior side ofpivot 160 so as to keepfirst end 182 ofcable 170 toward the posterior side ofpivot 160. By virtue of this construction, and as will hereinafter be discussed in further detail,cable 170 is able to release tension when the knee flexes and increase tension when the knee extends. This is a significant improvement in the art. Thus it will be seen that the present invention provides a hinged knee brace (i.e., a patellofemoral knee brace) with a cable system where the cable passes along the length of the hinge and posteriorly to the hinge pivot. This unique design allows for tightening of the cable (therefore resulting in the application of pressure to the kneecap) during knee extension and loosening of the cable (therefore resulting in releasing pressure from the kneecap) during flexion. - And note that with this cable pathway,
second end 183 ofcable 170 passes through third cable guide (e.g., brace tunnel) 167 positioned onlateral connector 60 so as to stabilizesecond end 183 ofcable 170 laterally of the patella, andsecond end 183 ofcable 170 is secured to a lateral portion ofdistal band 15. By virtue of this construction,cable 170 is able to apply lateral-to-medial, and distal-to-proximal, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) to the patella as the knee moves from flexion to extension. - It should be appreciated that
first end 182 ofcable 170 is adjustably mounted todistal segment 150 ofhinge mechanism 145 such that the position offirst end 182 ofcable 170 can be adjusted relative todistal segment 150 ofhinge mechanism 145, whereby to change the angle, direction and/or tension ofcable 170, in order to accommodate the patient's anatomy. In one preferred form of the invention,first end 182 ofcable 170 is adjustably mounted todistal segment 150 ofhinge mechanism 145 using a screw and a plurality of holes. - It should also be appreciated that
second end 183 ofcable 170 is adjustably mounted todistal band 15 ofbrace body 10 such that the position ofsecond end 183 ofcable 170 can be adjusted relative todistal band 15 ofbrace body 10, whereby to change the angle, direction and/or tension ofcable 170, in order to accommodate the patient's anatomy. In one preferred form of the invention,second end 183 ofcable 170 is adjustably mounted todistal band 15 using a hook-and-mesh (e.g., Velcro®) fastener. By way of example but not limitation, onehalf 184 of a hook-and-mesh (e.g., Velcro®) fastener is fixed tosecond end 183 ofcable 170 and the other half of a hook-and-mesh (e.g., Velcro®) fastener is provided by theelement 75 previously described. - And it should be appreciated that second cable guide (e.g., guide pulley) 165 is adjustably mounted to
proximal segment 155 ofhinge mechanism 145 such that the position of second cable guide (e.g., guide pulley) 165 onproximal segment 155 ofhinge mechanism 145 can be adjusted, whereby to change the angle, direction and/or tension ofcable 170, in order to accommodate the patient's anatomy. - In one preferred form of the invention,
first end 182 ofcable 170 is formed out of a relatively inelastic material such as stainless steel andsecond end 183 ofcable 170 is formed out of an elastomeric material (e.g., rubber, a rubber substitute, an elastic weave, etc.). As a result of this construction, whencable 170 is tensioned,first end 182 ofcable 170 is substantially unstretchable while second end 175 ofcable 170 can elongate to some (i.e., a limited) extent. - Note that forming
second end 183 ofcable 170 out of an elastomeric material has several significant advantages. First, it is convenient for the healthcare professional during fitting ofanatomical brace 5, since it minimizes the need for cable sizing and eliminates concerns about excessive or inadequate cable lengths. Second, it eliminates concerns about cable bunching when the knee is in flexion (i.e., when the knee is bent), since the elastomeric nature of the cable takes up excess cable length when tension on the cable is relaxed. Third, the elastomeric nature of the cable is able to accommodate the patient's anatomy during extension (i.e., knee straightening), and eliminates the concern that the limit of the cable will be reached before the leg is in full extension. Of course, it will also be appreciated that whilesecond end 183 ofcable 170 is preferably elastic to some (i.e., a limited) extent, it is not so elastic as to preventcable 170 and bracebody 10 from applying forces to the patella during flexion of the knee. And fourth, during knee extension, the elastomeric nature ofsecond end 183 of the tensionedcable 170 pulls the tibia towards the femur, whereby to provide (through the patella tendon) distal-to-proximal forces on the patella (which reduces the load on the patella tendon, thereby makinganatomical brace 5 useful for patients with patella tendonitis). - In use, and still looking now at
FIGS. 1-8 ,anatomical brace 5 is first secured to the patient by positioningbrace body 10 over the knee so thatcentral opening 72 ofbrace body 10 receives the patella of the patient and makes a relatively close fit about the distal and lateral portions of the patella, placingmedial connector 45 over the medial portion of the knee, and placinglateral connector 60 over the lateral portion of the knee; and by fittingdistal band 15 about the calf of the patient and making it fast with hook-and-mesh (e.g, Velcro®)fastener 75, 80, and fittingproximal band 30 about the thigh of the patient and making it fast with hook-and-mesh (e.g., Velcro®)fastener 85, 90. Thendistal straps 95 are tightened aboutdistal band 15 using hook-and-mesh (e.g., Velcro®)fasteners proximal strap 120 is tightened aboutproximal band 30 using hook-and-mesh (e.g, Velcro®)fastener - Note that by positioning
brace body 10 so thatcentral opening 72 ofbrace body 10 receives the patella of the patient,brace body 10 andcable 170 ofanatomical brace 5 will surround the patella of the patient. - Note also that by securing
distal straps 95 overdistal band 15, a more secure yet comfortable attachment can be made to the calf of the patient, and by securingproximal strap 120 overproximal band 30, a more secure yet comfortable attachment can be made to the thigh of the patient. - Note further that when
anatomical brace 5 is positioned in this manner about the knee of the patient,hinge mechanism 145 will extend along the medial portion of the knee, and the rear of the knee is left substantially uncovered byanatomical brace 5. - And note also that no hinge mechanism is disposed along the lateral portion of the knee.
- Next,
cable 170 has itsfirst end 182 adjustably secured todistal segment 150 ofhinge mechanism 145. Then, with the knee close to (but not at) full extension (i.e., with the knee nearly straightened),cable 170 is routed proximally alongdistal segment 150 of hinge mechanism, through first cable guide (e.g., pivot guide) 162, proximally alongproximal segment 155 ofhinge mechanism 150, through second cable guide (e.g., guide pulley) 165, laterally alongproximal band 30, distally alonglateral connector 60, through third cable guide (e.g., brace tunnel) 167 and then down to a distal lateral portion ofbrace body 10 of anatomical brace 5 (e.g. to hook-and-fastener element 75), wheresecond end 183 ofcable 170 is adjustably secured in place. - Note that when
cable 170 is routed in this manner, the cable passes posterior to pivot 160 and alongside, and substantially engages, the lateral portions of the patella, and terminates distal to the patella. - As a result, when the knee thereafter moves to full extension,
cable 170 is tensioned, whereby to apply a distal-to-proximal, as well as lateral-to-medial, force (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) on the patella; and when the knee thereafter moves to flexion,cable 170 is relaxed, so that the forces applied to the patella by the cable are also relaxed. - More particularly, when the knee moves to full extension,
cable 170 is tensioned, whereby to pullbrace body 10 ofanatomical brace 5 proximally and medially (i.e., in a proximal/medial diagonal direction). This proximal/medial force is applied to (i) the patella of the patient via brace body 10 (inasmuch ascentral opening 72 ofbrace body 10 receives the patella of the patient and makes a relatively close fit about the distal and lateral portions of the patella), and (ii) the tibia of the patient (inasmuch asdistal band 15 or bracebody 10 is secured to the upper calf of the patient, and hence the tibia of the patient, and thesecond end 183 ofcable 170 is anchored to distal band 15), which force is in turn transferred to the patella via the patella tendon. SeeFIGS. 9-12 . - Conversely, when the knee moves to full flexion,
cable 170 is relaxed, so that the proximal/medial diagonal force on brace body 10 (and hence the patella of the patient) is released. SeeFIGS. 13 and 14 . - Thus it will be seen that, on account of the foregoing construction, when the knee articulates from flexion to extension (see
FIGS. 9-12 ),anatomical brace 5 applies distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) on the patella, whereby to correct for patella tracking errors, and when the knee articulates from extension to flexion (seeFIGS. 13 and 14 ),anatomical brace 5 relaxes the forces applied to the patella. - This is a significant improvement in the art.
- Among other things, the use of a guided cable system that allows the anatomical brace to engage the patella with distal-to-proximal, as well as lateral-to-medial, forces (i.e., as distal-to-proximal/lateral-to-medial diagonal forces) during knee extension, and relax those forces during knee flexion, is a unique feature not found in the prior art and which is highly advantageous over the anatomical braces of the prior art. This is made possible by the use of the unique guided cable system of the present invention, where the cable passes along the length of the hinge mechanism and posteriorly to the hinge pivot.
- Among other things, it should also be noted that by providing
cable 170 with an elasticsecond end 183,cable 170 can stretch (to some extent) when the cable is tensioned during knee extension (i.e., during knee straightening), andcable 170 can contract (to some extent) when the cable is relaxed during knee flexion (i.e., during knee bending). - And it should be noted that, forming second end 183 of cable 170 out of an elastomeric material (i) provides increased convenience for the healthcare professional during fitting of anatomical brace 5, since it minimizes the need for cable sizing and eliminates concerns about excessive or inadequate cable lengths; (ii) eliminates concerns about cable bunching when the knee is in flexion (i.e., when the knee is bent), since the elastomeric nature of the cable takes up excess cable length when tension on the cable is relaxed; (iii) accommodates the patient's anatomy during extension (i.e., knee straightening), and eliminates the concern that the limit of the cable will be reached before the leg is in full extension; (of course, it will also be appreciated that while second end 183 of cable 170 is preferably elastic to some extent, it is not so elastic as to prevent cable 170 and brace body 10 from applying forces to the patella during flexion of the knee); and (iv) during knee extension, the elastomeric nature of second end 183 of the tensioned cable 170 pulls the tibia toward the femur, whereby to provide (through the patella tendon) distal-to-proximal forces on the patella (which reduces the load on the patella tendon, thereby making anatomical brace 5 useful for patients with patella tendonitis).
- These features are also significant improvements in the art.
- Significantly,
anatomical brace 5 is relatively lightweight and non-intrusive, since it utilizes a single-hinge construction and avoids a so-called “double hinge construction”, and avoids the use of a substantial body of fabric on the posterior side of the knee which could impede full flexion of the knee (e.g., due to bunching in the back of the brace). Thus it will be seen that the present invention provides a light weight and low profile brace that, among other things, prevents bunching in the back of the brace and tightness when the knee is bent. - And
anatomical brace 5 is more resistant to migration during use, by providing a more robust securement to the calf of the patient and by providing a more robust securement to the thigh of the patient. - And
anatomical brace 5 is configured to relax the forces applied to the patella during knee flexion so thatanatomical brace 5 is not “too tight” around the kneecap during knee flexion. - In the foregoing disclosure, it was noted that
first end 182 ofcable 170 is adjustably mounted todistal segment 150 ofhinge mechanism 145 such that the position offirst end 182 ofcable 170 can be adjusted relative todistal segment 150 ofhinge mechanism 145, whereby to change the angle, direction and/or tension ofcable 170, in order to accommodate the patient's anatomy; and it was noted that in one preferred form of the invention,first end 182 ofcable 170 is adjustably mounted todistal segment 150 ofhinge mechanism 145 using a screw and a plurality of holes. However, it will be apparent to those skilled in the art that many other mounting mechanisms may be utilized if desired. By way of example but not limitation, and looking now atFIG. 15 ,first end 182 ofcable 170 may adjustably mounted todistal segment 150 ofhinge mechanism 145 by providing arail 200 ondistal segment 150 ofhinge mechanism 145, and by mountingfirst end 182 ofcable 170 to arider 205 which is slidably mounted torail 200, with a fixation element (e.g., a set screw, not shown) being used to lockrider 205 in place at a desired position alongrail 200. - And in the foregoing disclosure, it was noted that second cable guide (e.g., guide pulley) 165 is adjustably mounted to
proximal segment 155 ofhinge mechanism 145 such that the position of second cable guide (e.g., guide pulley) 165 can be adjusted relative toproximal segment 155 ofhinge mechanism 145, whereby to change the angle, direction and/or tension ofcable 170, in order to accommodate the patient's anatomy; and it was noted that in one preferred form of the invention, second cable guide (e.g., guide pulley) 165 is adjustably mounted toproximal segment 155 ofhinge mechanism 145 using a screw and a plurality of holes. However, it will be apparent to those skilled in the art that many other mounting mechanisms may be utilized if desired. By way of example but not limitation, and looking now atFIG. 15 , second cable guide (e.g., guide pulley) 165 may adjustably mounted toproximal segment 155 ofhinge mechanism 145 by providing arail 210 onproximal segment 155 ofhinge mechanism 145, and by mounting second cable guide (e.g., guide pulley) 165 to arider 215 which is slidably mounted torail 210, with a fixation element (e.g., a set screw, not shown) being used to lockrider 215 in place at a desired position alongrail 210. -
FIG. 16 shows another form of the novel anatomical brace of the present invention. This form of the invention is generally similar to the construction shown inFIG. 15 , except that various components of the hinge mechanism are formed with a lighter weight construction. - And in the foregoing disclosure it was noted that
second end 183 ofcable 170 is adjustably mounted todistal band 15 ofbrace body 10 such that the position ofsecond end 183 ofcable 170 can be adjusted relative todistal band 15 ofbrace body 10, whereby to change the angle, direction and/or tension ofcable 170, in order to accommodate the patient's anatomy; and it was noted that in one preferred form of the invention,second end 183 ofcable 170 is adjustably mounted todistal band 15 ofbrace body 10 using a hook-and-mesh (e.g. Velcro®) fastener. However, it will be apparent to those skilled in the art that many other mounting mechanisms (e.g., snap fasteners, cable clamps, cable tie-downs, etc.) may be used to adjustably mountsecond end 183 ofcable 170 todistal band 15 ofbrace body 10. - In the foregoing disclosure, it is noted that
first cable guide 162 may be a pivot guide,second cable guide 165 may be a guide pulley, andthird cable guide 167 may be a brace tunnel; however, it should also be appreciated that other elements (e.g., rings, eyelets, tubes, etc.) may be used to formfirst cable guide 162,second cable guide 165 and/or third cable guide 167 (i.e., essentially any structure capable of guidingcable 170 in a manner consistent with the present invention). - In addition to the foregoing, it will also be appreciated that it may be desirable to provide a covering for novel
anatomical brace 5 so as to shield the operative elements of the anatomical brace from inadvertent contact during use, e.g., to shieldhinge mechanism 145,cable 170, first cable guide (e.g., guide pulley) 162, second cable guide (e.g., guide pulley) 165, third cable guide (e.g., brace tunnel) 167, etc. from inadvertent contact during use. To this end, and looking now atFIG. 17 , anelastic sleeve 220 may be provided for selectively covering novelanatomical brace 5, with theelastic sleeve 220 being pulled up over the anatomical brace during use. Alternatively, an overlying covering or panel may be permanently (or temporarily) attached to anatomical brace 5 (e.g., to portions of brace body 10), with the covering or panel able to be laid open (e.g., folded back) when it is necessary to access the operative elements of the anatomical brace (e.g., to adjust the disposition of cable 170) and the covering or panel being closable (e.g., laid back over the operative elements and secured in place) when the anatomical brace is in use. - It is to be understood that the present invention is by no means limited to the particular constructions herein disclosed and/or shown in the drawings, but also comprises any modifications or equivalents within the scope of the invention.
Claims (32)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
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US15/061,379 US11458032B2 (en) | 2014-06-28 | 2016-03-04 | Anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error |
US17/959,536 US20230108046A1 (en) | 2014-06-28 | 2022-10-04 | Anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error |
Applications Claiming Priority (4)
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US201462018575P | 2014-06-28 | 2014-06-28 | |
US201562127919P | 2015-03-04 | 2015-03-04 | |
US14/738,774 US10617550B2 (en) | 2014-06-28 | 2015-06-12 | Knee brace having a variable tensioning offset cam |
US15/061,379 US11458032B2 (en) | 2014-06-28 | 2016-03-04 | Anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error |
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US14/738,774 Continuation-In-Part US10617550B2 (en) | 2014-06-28 | 2015-06-12 | Knee brace having a variable tensioning offset cam |
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US17/959,536 Continuation US20230108046A1 (en) | 2014-06-28 | 2022-10-04 | Anatomical brace for dynamically stabilizing the patella during knee articulation so as to address patella tracking error |
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US20160256310A1 US20160256310A1 (en) | 2016-09-08 |
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2016
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US20160256310A1 (en) | 2016-09-08 |
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