WO2017072478A1 - Orthèse de genou - Google Patents

Orthèse de genou Download PDF

Info

Publication number
WO2017072478A1
WO2017072478A1 PCT/GB2016/052662 GB2016052662W WO2017072478A1 WO 2017072478 A1 WO2017072478 A1 WO 2017072478A1 GB 2016052662 W GB2016052662 W GB 2016052662W WO 2017072478 A1 WO2017072478 A1 WO 2017072478A1
Authority
WO
WIPO (PCT)
Prior art keywords
joint
sleeve
brace
strut
struts
Prior art date
Application number
PCT/GB2016/052662
Other languages
English (en)
Inventor
David FELSON
James Matthew CORDEN
Hodgin ANDREW
Carl Stone
Sam GHAZAROS
Original Assignee
Central Manchester University Hospitals Nhs Foundation Trust
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Central Manchester University Hospitals Nhs Foundation Trust filed Critical Central Manchester University Hospitals Nhs Foundation Trust
Publication of WO2017072478A1 publication Critical patent/WO2017072478A1/fr

Links

Classifications

    • 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
    • A61F5/0104—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 without articulation
    • A61F5/0106—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 without articulation for the knees
    • A61F5/0109—Sleeve-like structures
    • 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
    • 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
    • A61F2005/0137—Additional features of the articulation with two parallel pivots
    • 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
    • A61F2005/0137—Additional features of the articulation with two parallel pivots
    • A61F2005/0139—Additional features of the articulation with two parallel pivots geared
    • 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

Definitions

  • the present invention relates to a sleeve for a joint and a joint brace, suitable for use in supporting a knee joint.
  • the present invention also relates to a legging incorporating the sleeve.
  • a joint brace assembly comprising a joint brace and a sleeve or legging.
  • the knee which is one of the largest joints in the body, includes the distal femur (thigh bone), proximal tibia (shin bone) and patella (knee cap) within the joint capsule and is formed of three compartments: the patellofemoral compartment; the medial tibiofemoral compartment; and the lateral tibiofemoral compartment.
  • the fibula is also connected to the joint. Tendons connect the knee bones to the leg muscles while ligaments join these bones and contribute to stability.
  • anterior and posterior cruciate ligaments prevent the femur from sliding backward and forward on the tibia whereas medial and lateral collateral ligaments (MCL and LCL) prevent sideways movement, resulting in an even distribution of pressure medially and laterally in a healthy knee.
  • MCL and LCL medial and lateral collateral ligaments
  • Knee disorders and associated knee pain are common since the knee joint is prone to wear and tear due to its weight bearing nature, in addition to acute injury.
  • the knee is one of the most common joints to be affected by osteoarthritis (OA), a joint disease which results from the breakdown of joint cartilage and can lead to bone deformity.
  • OA osteoarthritis
  • additional risk factors include inflammatory diseases, trauma (for example a fracture or soft tissue injury such as a meniscal tear) and obesity. In particular, obesity is strongly related to the development of OA, since ground reaction forces are around 60% greater in obese people.
  • Knee OA often results in changes to the structure of the knee capsule such as loss of joint space (for example in the medial or lateral tibiofemoral compartment), the development of osteophytes and subchondral cysts, and subchondral sclerosis. These changes result in pain, swelling, stiffness and a decreased ability to move.
  • Knee braces fall into the following four general classes (as classified by The American Academy of Orthopaedic Surgeons):
  • Prophylactic Braces These braces as designed to protect the knee from damage that may occur during contact sports, for example. In particular, such braces as designed to protect the MCL from damage. In general, prophylactic braces are constructed of bars and straps.
  • Rehabilitative Braces These braces are used to allow protected motion of injured knees or knees that have been treated operatively. Such knee braces are typically used for a number of weeks immediately following injury or surgery. Rehabilitative braces usually consist of foam liners, full length rigid bars on both sides of the leg, and straps.
  • Unloader Braces These braces are used to provide pain relief in arthritic knees and function by "unloading" stress from a particular area of the joint which is affected (often the medial compartment) by re-aligning the knee joint.
  • Unloader braces are frequently used by patients with OA knees. However, such braces are prone to slipping out of place which can result in incorrect alignment of the knee joint. The use of these braces is particularly problematic when used by obese and elderly patients. This is due, in part, to the fact that the majority of knee braces currently available are focussed on rehabilitation of younger, fitter patients who are recovering from a sporting injury, for example. The increased soft tissue and poor muscle tone associated with the legs (and other joints) of obese patients often prevents the correct fitting (and hence efficacy) of braces, since the knee (or other) joint cannot be accurately located and the brace positioned accordingly.
  • braces are designed for patients without the increased soft tissue present in the obese population, the braces often slip out of place when used by obese patients.
  • Current braces are also relatively bulky and complex to secure which can be problematic for elderly and obese patients due to reduced movement and poor dexterity, for example. Such bulky braces also result in difficulty in co-ordinating appropriate clothing. The combination of these factors often results in an unwillingness to wear a brace making this effective treatment unused by most patients.
  • a sleeve for engagement with a joint brace, the joint brace comprising: a first strut and a second strut pivotable relative to the first strut, the sleeve comprising an attachment feature configured for securing the joint brace and the sleeve in a predetermined configuration relative to one another.
  • joint braces may be fitted more quickly and easily.
  • the attachment feature may be positionable to be proximate to the joint in question when the sleeve is worn by a user.
  • the attachment feature of the sleeve may be positionable proximate to the knee joint (e.g. proximate to the patella and/or proximate to the condyles forming the knee joint).
  • the attachment feature may be positionable to be proximate to the pivot point(s) of the joint brace to which the sleeve is to be attached.
  • the pivot point of the joint brace would preferably be similarly proximate to the pivot point of the joint to which it is to be attached. It will further be appreciated that in a joint brace defining two pivot points, co-location of the respective pivot points may ensure that the joint brace is able to pivot substantially co-axially with the joint to which it is to be attached.
  • the attachment feature is configured for snap fit engagement to the joint brace.
  • Other engagement configurations will be readily appreciated by the person skilled in the art (e.g. friction fit engagement, magnetic engagement, etc.).
  • the presence of an attachment feature which allows snap fit engagement allows a user to quickly fit the joint brace to the sleeve. In this way, it is possible to attach the brace to the sleeve only when required. For example, if the sleeve and joint brace were to be used with a knee joint, the sleeve could be worn at all times and the joint brace quickly attached to the sleeve when the user wishes to perform weight bearing activities.
  • the presence of a snap fit engagement mechanism may also reduce the difficulty of applying the brace, for obese or elderly patients, for example.
  • the attachment feature may be removably attachable to the sleeve. Removal of the attachment feature enables the sleeve to be washed independently of the attachment feature.
  • the attachment feature may be attached to the sleeve by way of straps or hook and loop fasteners, for example.
  • the sleeve may further comprise pockets configured to locate the struts of the joint brace parallel to the bones either side of the joint.
  • the pockets may be configured to locate the struts of the joint brace parallel to the femur and tibia.
  • the presence of pockets in which the struts of the joint brace can be placed may further contribute to the correct positioning of the joint brace in relation to the joint.
  • Such pockets, in combination with the attachment feature may also enable the joint brace to be quickly and simply positioned and attached to the sleeve. As mentioned above, this allows the joint brace to be attached to the sleeve only when required, for example during weight bearing activities (for a knee joint).
  • the sleeve may further comprise straps for securing the struts.
  • the straps may secure the struts in the pockets described above.
  • the straps may be integral to the sleeve.
  • the straps may be sewn into the material from which the sleeve is fabricated or formed integrally with the material of the sleeve. Such straps may further secure the struts to the sleeve.
  • the straps may be reinforced.
  • the straps may be fabricated from a material in which reinforcing fibres are embedded.
  • the straps may be fabricated from multiple layers of (the same or different) material to strengthen the straps.
  • the sleeve may further comprise a sleeve liner configured to retain the sleeve in position during use.
  • the sleeve liner of the invention may be configured such that once fitted, the sleeve is retained in the correct position.
  • the sleeve liner may be formed of a non-slip material such as silicone or latex, for example.
  • the sleeve liner may be silicone coated or have silicon (or other suitable non-slip material) patches on a skin-facing side of the liner to prevent movement of the sleeve relative to the leg, or other body part.
  • the sleeve liner is integral to the sleeve.
  • the sleeve liner may be sewn into the material from which a main body of the sleeve is fabricated.
  • the sleeve liner may be formed integrally with the material from which the main body of the sleeve is fabricated. Providing a sleeve liner integral to the sleeve may prevent movement of the sleeve relative to the sleeve liner, therefore reducing the change of slippage of the sleeve.
  • the sleeve liner could be separate to the main body of the sleeve. In such an embodiment, the sleeve liner could be applied to the joint first and the sleeve fitted on top of the liner. This allows the sleeve liner to be washed independently of the main sleeve body.
  • the sleeve liner may have a lattice structure which may aid retention of the sleeve in position on the joint to which it is applied, by increasing the contact surface area.
  • the lattice structure may also increase breathability of the sleeve/liner.
  • the sleeve may further comprise reinforced sections configured to alter the elasticity of the sleeve in those sections.
  • the sleeve having sections of different elasticity may allow stretching of the sleeve during movement of the joint to aid re-alignment of the joint. For instance, a section of reduced elasticity may act to pull the surrounding material inwards during stretching of the sleeve, thereby applying a degree of alignment force to the joint.
  • the reinforced sections may be positioned in the part of the sleeve which will surround the joint. Such reinforced sections may (either alternatively or in addition) act to spread the load imparted when a joint brace is attached to the sleeve.
  • Such reinforced sections may also act to redefine the area around the joint to which the sleeve is applied. This is particularly relevant in obese patients, for example.
  • the reinforced sections may also reduce movement of the excess tissue present in an obese patient. By re-defining the area surrounding the joint and preventing movement of excess tissue, the joint brace can be more accurately positioned and retained in the correct location.
  • the reinforced area may surround or partially surround the patella. This positioning of reinforced sections may further define the patella and may offer support to the joint when the joint brace is not attached to the sleeve.
  • the sleeve may further comprise a rod pocket configured to receive a stiffening rod.
  • the rod pocket may be reinforced, for example by the use of multiple layers of material from which the sleeve is fabricated.
  • the sleeve further comprises a stiffening rod received in the rod pocket.
  • the rod may be configured to engage the attachment feature.
  • the rod and attachment feature may comprise interlocking engagement features such as one or more lugs and recesses. The engagement of a stiffening rod with the attachment feature may assist in retaining the attachment feature in the correct position. This may be particularly useful if the attachment feature is removable from the sleeve.
  • the stiffening rod may be removable from the rod pocket so as to allow the sleeve to be washed independently of the stiffening rod.
  • the stiffening rod could be permanently sewn into the rod pocket.
  • the stiffening rod is preferably fabricated from a strong flexible material, such as a polymer (e.g. nylon) or composite (e.g. carbon fibre or fibreglass) for example. This flexibility allows the stiffening rod to conform to the shape of the part of the body to which the sleeve is applied.
  • a strong flexible material such as a polymer (e.g. nylon) or composite (e.g. carbon fibre or fibreglass) for example. This flexibility allows the stiffening rod to conform to the shape of the part of the body to which the sleeve is applied.
  • the sleeve of the present invention may be fabricated from any suitable material. Suitable materials for the sleeve liner have been discussed above.
  • the sleeve is formed of cotton and polyester-spandex mixes.
  • the material utilised is breathable, lightweight and/or hypoallergenic.
  • the material utilised is elasticated so as to partially redefine the legs of an obese patient, where excess soft tissue can present problems when attempting to correctly fit a joint brace.
  • a sleeve for a joint comprising an attachment feature configured for securing the joint brace of the third aspect of the invention (as discussed below) and the sleeve in a predetermined configuration.
  • the optional and/or preferred features described herein in relation to the first aspect of the invention may also be present in the sleeve configured for securing the joint brace of the third aspect of the invention.
  • a legging comprising the sleeve of the invention.
  • the legging comprises a waist band configured for positioning above the pelvic brim.
  • the waist band of the leggings extending above the pelvic brim, partial realignment effects (of the knee joint, for example) may be provided without use of the joint brace.
  • the legging may further comprise a shoulder strap and/or belt to retain the legging in position and prevent slippage of the legging once positioned by the user.
  • a joint brace for supporting a knee joint, the joint brace comprising a first strut and a second strut, each of the struts having a proximal end and a distal end, the proximal ends of the first and second struts provided adjacent one another; wherein the first strut is pivotable relative to the second strut about the proximal end of the first strut between a first configuration and a second configuration; wherein each of the first and second struts defines an axis between the distal end and the proximal end of the respective strut and wherein in the first configuration the axes defined by the first and second struts lie in a first plane; and wherein the brace further comprises first and second features that cooperate such that when the first strut pivots from
  • the strut which is urged out of the first plane may be pivoted out of the first plane, at which point the first and second struts would define a second plane which is different from the first.
  • said strut may be urged to move out of the plane by translational motion, at which point no second plane would be defined by the struts.
  • it is the action of pivoting the struts that results in the movement of one of the struts out of the first plane.
  • Such a movement allows an amount of force applied by the struts, to a joint to which the joint brace is applied, to change when the struts pivot between the first and second configurations.
  • the struts in a first configuration, may be in a generally perpendicular position with respect to one another and in this position, the struts may define a first plane which results in minimal force being applied to the joint to which the joint brace is attached.
  • the struts In a second configuration, may be in a generally parallel position with respect to one another. In this second configuration, one of the struts may move in the lateral direction, which may result in a greater force being applied to the joint. This arrangement therefore allows a greater force to be applied to a joint when the joint brace is in a particular configuration.
  • the pivotal movement of the struts relative to each other may result in a joint brace which is highly compactable, since the struts may be pivoted until they are generally aligned.
  • This capability may allow the joint brace of the invention to be conveniently stored, in a handbag for example, when the user is not wearing the joint brace.
  • the joint brace of the first aspect of the invention can, in certain embodiments, be a knee brace, in particular an "unloader" knee brace.
  • Such knee braces can be used to improve the alignment of the knee in patients with OA, for example.
  • a greater force for example an "unloading" force could be applied to the knee when in a "loading" position (i.e. a standing position) as opposed to a "resting" position (i.e. a seated position).
  • the brace further comprises a support plate assembly upon which the first and second struts are pivotally mounted.
  • the support plate assembly defines two pivot axes, the first strut pivotable around a first pivot axis and the second strut pivotable around a second pivot axis.
  • Such an arrangement may provide a two-point polycentric hinge which allows the pivotal movement of the joint brace to conform much more precisely with the natural movement of a joint to which the brace is attached, for example a knee joint.
  • the brace may be less likely to slip out of place during use, which can result in incorrect application of force to the knee and subsequent injury.
  • the pivot points would be positioned so that in use they are situated proximate to the ends of the femur and tibia that make up the knee capsule.
  • first and second struts may be pivotally mounted at a single pivot axis, in which case that axis may run through the proximal ends of the first and second struts.
  • the struts may, in certain embodiments, be coupled for corresponding rotation around their respective pivot axes by two or more meshed gears.
  • the struts may be coupled for corresponding rotation by frictional engagement.
  • each strut may be provided with a wheel, the two wheels being in frictional engagement with one other. The corresponding rotation of both struts may allow the struts to pivot substantially co-axially with the joint to which it is to be attached.
  • the first and second features of the invention may be any features whose cooperation or interaction results in one or both of the struts being urged out of the first plane.
  • the first feature comprises a ramp.
  • the first feature could be a protrusion such as a lip.
  • the second feature may be a thrust bearing, optionally a ball bearing, configured for cooperation with the first feature, for example the ramp.
  • the use of ball bearings may result in pivotal movement of the struts experiencing less frictional resistance due to interaction of the first and second features.
  • the reduced frictional resistance may result in reduced wear and therefore a longer life of the brace before repair or replacement is required.
  • the second feature could be a surface of the brace, for example a surface of one or both of the struts.
  • the first feature may be present on the support assembly.
  • the support assembly may define a ramp or multiple ramps.
  • the second feature may be present on one or both of the struts.
  • the second feature may comprise a thrust bearing on one of the struts or thrust bearings on each of the struts, the bearing(s) being positioned so as to ride over a ramp or ramps defined by the support assembly.
  • the first feature is configured to urge both struts out of the first plane when the struts pivot from the first to the second configuration.
  • the first feature may comprise two ramps positioned so as to urge the first and second struts out of the first plane on pivoting from the first configuration to the second configuration.
  • a ramp could be present on a first strut, the ramp being positioned so as to cooperate with a surface of the second strut on pivoting.
  • the configuration of the first and second features may determine the extent to which the strut(s) are urged out of the plane.
  • the first feature is a ramp
  • the 'height' of the ramp may determine the extent to which a strut is urged out of the first plane.
  • the brace may be configured to allow adjustment of the extent to which the at least one of the first and second struts moves out of the first plane.
  • the brace may comprise an adjustment mechanism which can be operated to provide that adjustment.
  • the first and second features comprise a ramp and a bearing
  • the ramp may be movable relative to the pivot axis of the strut in question, thereby adjusting the portion of the ramp which acts on the bearing during pivoting of the struts, and thus potentially changing the extent to which the strut in question is urged out of the first plane (if, for instance, the ramp increases in steepness along its length).
  • adjustment of the extent to which the at least one of the first and second struts moves out of the first plane may be performed by replacing a component of the strut.
  • the ramp may be provided as a removable 'bolt-on' component.
  • the extent to which the at least one of the first and second struts moves out of the first plane could then be adjusted by swapping the ramp of the brace for a steeper one or a shallower one.
  • a particular joint brace according to the invention may be used with a variety of patients who have different requirements in terms of the amount of force to be applied to the joint. For example, when the joint brace is a knee brace, some patients will require greater realignment of the knee than others.
  • the brace may be configured for attachment to a sleeve for the joint.
  • the brace may be configured for attachment to a sleeve according to the first aspect of the invention (discussed above) or indeed the legging according to the second aspect of the invention.
  • the support plate comprises an attachment feature for attachment of the brace to a sleeve for a joint.
  • the attachment feature may be configured for snap fit engagement with the sleeve. Other engagement configurations will be readily appreciated by the person skilled in the art (e.g. friction fit engagement, magnetic engagement, etc.).
  • the presence of an attachment feature on the brace allows quick and accurate location of the brace on the joint to which it is to be applied.
  • a sleeve according to the first aspect of the invention (or a legging according to the second aspect of the invention) is used in conjunction with the brace according to the third aspect of the invention
  • corresponding attachment features on the sleeve and brace allow the brace to be positioned correctly, with minimal effort on the part of the patient. Accordingly, the brace can be quickly attached to the joint only when required. If the joint to which the brace is applied is a knee, the user may decide to apply the brace only when performing weight bearing activities.
  • At least one of the first and second struts may further comprise a cuff configured to surround a portion of the body adjacent to the joint.
  • the cuffs may be configured to surround the thigh and/or shin/calf.
  • Such cuffs can be used to attach the struts to the joint to which the joint brace is to be applied, or to a sleeve worn over the joint, for example a sleeve according to the first aspect of the invention (or indeed a legging according to the second aspect of the invention).
  • the cuffs may be formed of a lightweight plastics material, a composite material such as carbon fibre, a metal such as aluminium or titanium, or any other suitable material.
  • the cuffs may comprise padded regions on a body-facing side of the cuff. Such padded regions may increase comfort for the user when wearing the brace.
  • the joint brace of the present invention may be formed of any suitable material.
  • the joint brace may be formed an aluminium alloy.
  • the material used for the joint brace should be strong enough to impart a realignment or unloading force on the joint to which it is applied.
  • the material should preferably be lightweight, so as not to be detrimental to the movement of the user.
  • the brace may further comprise a sleeve for a joint.
  • the sleeve for a joint is one in accordance with the first aspect of the invention, as described below.
  • the brace may further comprise a legging in accordance with the second aspect of the invention.
  • a joint brace assembly comprising the joint brace of the third aspect of the invention; and further comprising: a) the sleeve of the first aspect of the invention; or
  • a joint brace assembly comprising the sleeve of the first aspect of the invention or the legging of the second aspect of the invention; and a joint brace comprising a first strut and a second strut pivotable relative to the first strut.
  • a method of realigning a joint comprising applying the joint brace of the third aspect of the invention to a joint; and pivoting the joint such that a strut of the joint brace moves out of the first plane and imparts a force on the joint, thereby at least partially realigning the joint.
  • the method may further comprise applying a sleeve or legging according to the first or second aspects of the invention to the joint prior to the step of applying the joint brace to a joint.
  • the method may further comprise attaching the joint brace to the sleeve or legging.
  • the joint may be a knee and the method may be used for the treatment of osteoarthritis, for example.
  • Figure 1 is a perspective view of part of a legging according to an embodiment of the second aspect of the present invention.
  • Figure 2 is a perspective view of a legging according to an embodiment of the second aspect of the present invention.
  • Figure 3 shows front, side and back views of a knee brace assembly according to an embodiment of the invention comprising a joint brace according to the third aspect of the invention and a legging according to the second aspect of the present invention.
  • Figure 4 is an exploded view of a joint brace according to an embodiment of the third aspect of the present invention.
  • Figure 5 is a perspective view of a joint brace according to an embodiment of the third aspect of the present invention.
  • Figure 6 is a front view of a joint brace according to an embodiment of the third aspect of the present invention
  • Figure 7 is a schematic representation of a joint brace according to an embodiment of the third aspect of the present invention.
  • A shows a side on view of the joint brace in what would be a "resting" position (i.e. a sitting position, as shown by the schematic of the leg) when in use.
  • B shows a side on view of the joint brace in what would be a "loading" position (i.e. a standing position) when in use.
  • C is an alternative view of the joint brace of A as viewed down arrow C.
  • (D) is an alternative view of the joint brace of B as viewed down arrow D.
  • FIG 1 there is depicted a perspective view of a legging 1 according to the second aspect of the invention on a leg.
  • the legging 1 is fabricated from a cotton and polyester-spandex mix.
  • the legging 1 comprises an attachment feature 3, which in this case is a plastic disc, positioned on a lateral side of a knee joint encased by the legging 1 .
  • the attachment feature 3 can be removed from the legging 1 for washing and is attached to the legging 1 by way of straps 5.
  • the legging 1 also incorporates a reinforced sleeve or pocket 7 into which a reinforcing rod 9 is retained.
  • the reinforcing rod 9 is fabricated from a flexible material such that it conforms to the profile of the leg and is removable, for instance for washing of the legging 1 .
  • the reinforcing rod 9 engages with the lower portion of the attachment feature 3 to retain the attachment feature 3 in position.
  • the legging 1 further incorporates a reinforced ankle strap 1 1 to which a lower end of the reinforcing rod 9 is attached. The ankle strap 1 1 prevents the reinforcing rod 9 from slipping down the pocket 7 once the reinforcing rod 9 is inserted.
  • Attachment feature 3 comprises a channel 13 into which a complementary projection, (not shown) on a joint brace (not shown) can be introduced.
  • a complementary projection (not shown) on a joint brace (not shown)
  • Such connection enables the joint brace to be correctly positioned with respect to the condyles of the knee with relative ease.
  • the connection also allows a user to quickly and easily apply the joint brace to the knee when additional support and/or unloading of the knee is required, for example when walking.
  • the legging 1 has a waist band 15 which is positioned above the pelvic brim when worn by the user.
  • the legging 1 also has reinforced panels 17, 19, which in this case are positioned on the inner thigh and inner calf. These panels 17, 19 act to spread the load imparted when a joint brace 21 , for example the joint brace 77 of figure 6, is attached to the legging 1 by the cuffs 35, 37 (shown in figure 6). Similar reinforced panels 17, 19 can also be used to assist with realignment of an osteoarthritic knee without use of a joint brace 21 and/or redefine the knee joint in an obese patient with significant excess tissue.
  • the legging 1 also incorporates a support rod 23 which is positioned so as to lie on the medial side of the knee joint when in use. Such a support rod 23 provides further support to the knee joint.
  • the support rod 23 is inserted into a support rod pocket (not shown) and can be removed, for washing of the legging 1 , for example.
  • the support rod 23 may be sewn into the material of the legging 1 or permanently attached via adhesive or welding.
  • the joint brace 27 of figure 3 comprises first and second elongate struts 29, 31 pivotally mounted at a central support assembly 33.
  • An attachment feature (not shown) for attachment of the joint brace 27 to the leggings 25 is substantially centrally positioned on the support assembly 33.
  • the joint brace 27 further comprises thigh and shin/calf cuffs 35, 37 to enable the joint brace 27 to be quickly and easily attached to the leggings 25 and joint.
  • the leggings 25 of figure 3 comprise an attachment feature 39 which is, in this case, removably attached to the leggings 25 by way of straps 41 .
  • the leggings 25 also comprise reinforced sections 43, 45, 47, which when the leggings are worn alone (i.e. without the joint brace 27) may allow partial unloading of the knee joint. As mentioned above, these reinforced sections 43, 45, 47 may also act to redefine the knee joint in an obese patient with significant excess tissue.
  • the reinforced sections 43, 45, 47 may also act to spread the load imparted when joint brace 27 is attached to the legging 25 by the cuffs 35, 37.
  • the leggings 25 can be worn by the user, if desired, at all times. This may, due to the presence of the reinforced sections 43, 45, 47, allow partial unloading of the knee without the use of the joint brace 27.
  • the user can attach the joint brace 27 to the leggings 25 via the complementary attachment features (39 and not shown) and the cuffs 35, 37.
  • the presence of the complementary attachment features (39 and not shown) enables the joint brace 27 to be positioned and attached quickly and accurately when additional knee support is required, thereby ensuring that the appropriate forces are applied to the knee.
  • the joint brace 49 comprises a first elongate strut 51 and a second elongate strut 53 which can pivot with respect to each other when the joint brace 49 is assembled.
  • the two struts 51 , 53 are pivotably mounted to a support assembly 55 comprising a sleeve connection plate 57, a fixing plate 59 and a ramp plate 61 .
  • the two struts 51 , 53 pivot around respective axles supported by the fixing plate 59 and are coupled for corresponding rotation around their respective pivot axes by two meshed gears 63, 65.
  • Each strut 51 , 53 has a thrust bearing 67, in this case a ball bearing, positioned on a ramp surface-facing side 69 of the strut 51 , 53 proximate to the pivot axes (not labelled).
  • the thrust bearing 67 is positioned such that on pivoting of the respective struts 51 , 53 from a first position, in which the struts 51 , 53 are positioned generally perpendicularly with respect to each other, to a second position, in which the struts 51 , 53 are positioned generally parallel to one another, the thrust bearing 67 rides along a respective ramp of the ramp plate 61 .
  • the joint brace 49 further includes a connector 71 which in this case is positioned generally centrally on the sleeve connection plate 57 and is attached to said sleeve connection plate 57 via engagement of a protrusion 73 with a corresponding recess (not shown) on the sleeve connection plate 57.
  • a connector 71 which in this case is positioned generally centrally on the sleeve connection plate 57 and is attached to said sleeve connection plate 57 via engagement of a protrusion 73 with a corresponding recess (not shown) on the sleeve connection plate 57.
  • the thrust bearing 67 rides along the ramp plate 61 which forms part of the support assembly 55.
  • the thrust bearings 67 ride 'down' the ramp defined by the ramp plate 61 .
  • the ramp defined by the ramp plate 61 could be alternatively configured such that on pivoting of the struts 51 , 53 the thrust bearings 67 ride 'down' the ramp on movement from the first to the second position and 'up' the ramp on movement from the second to the first position.
  • the joint brace 77 of figure 6 comprises first and second elongate struts 51 , 53 pivotably mounted to a support assembly 55.
  • the joint brace 77 further comprises a thigh cuff 35 and a shin/calf cuff 37 which can be used to assist with securement of the brace 77 to the joint to which is it attached (in this case a knee).
  • the joint brace 77 could be directly attached to the joint (not shown) via the cuffs 35, 37 or could be attached to the joint via a joint sleeve, for example a joint sleeve according to the second aspect of the invention as discussed below.
  • protrusion 75 of connector 71 is engaged with a corresponding connector (not shown) on a joint sleeve (not shown), for example a joint sleeve according to the second aspect of the invention.
  • the engagement of connector 71 with a corresponding connector (not shown) on a joint sleeve (not shown) ensures that the joint brace 77 is correctly positioned with respect to the knee joint, in particular the condyles of the knee joint, to enable maximal support.
  • the struts 51 , 53 are secured to the thigh and calf/shin respectively by attachment features on the sleeve, such as elongate pockets and/or straps and, in addition, any cuffs 35, 37 present on the joint brace 77.
  • the joint brace of the present invention when used to support a knee joint, can be applied to either the lateral or medial side of the leg. In the example of figure 7, the joint brace is applied to the lateral side of the leg. As depicted in figure 7A, in the "resting" (i.e.
  • the two struts 51 , 53 are pivoted to a first configuration wherein the two struts 51 , 53 are positioned generally perpendicularly with respect to each other.
  • the angle a between the two struts is approximately 90°.
  • the thrust bearings 67 of the respective struts 51 , 53 are at or near the bottoms of their respective ramps on the ramp plate 61 .
  • the two struts 51 , 53 are generally aligned with each other, such that the angle ⁇ (see figure 7C) is, in this example, approximately 180°.
  • This angle ⁇ can be altered (prior to pivotal movement) by an angle adjustment mechanism.
  • the ⁇ angle of 180 results in minimal unloading of knee condyles.
  • the a angle increases to approximately 180° (in this example; see figure 7B) as the struts 51 , 53, which are coupled to the thigh and calf/shin pivot into a "loading" position.
  • the thrust bearings 67 ride up their respective ramps on the ramp plate 61. This urges the struts 51 , 53 out of the plane defined by the struts 51 , 53 in the "resting" position.
  • the ⁇ angle decreases to less than 180° (see figure 7D). In this case, the ⁇ angle of less than 180° results in increased unloading of the medial knee condyles when the user is in a "loading" position.
  • the ⁇ angle can be altered using an angle adjustment mechanism to alter the level of unloading imparted on movement from the resting to the loading positions. Further, if some unloading of the knee is required in the resting position this can be achieved by altering the resting ⁇ angle.
  • the joint brace can be used to unload the lateral condyles, if required. This could be achieved, for example, by attaching the joint brace to the medial side of the knee, or by changing the directionality of the ramp, such that the ⁇ angle increases on movement from the resting to the loading position.

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  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

La présente invention concerne un manchon destiné à venir en prise avec une orthèse d'articulation, l'orthèse d'articulation comprenant une première entretoise et une seconde entretoise pouvant pivoter par rapport à la première entretoise. Le manchon comprend un élément de fixation conçu pour fixer l'orthèse d'articulation et le manchon selon une configuration prédéfinie. L'invention concerne également une orthèse d'articulation permettant de soutenir l'articulation du genou. L'orthèse comprend une première entretoise et une seconde entretoise, chacune des entretoises présentant des extrémités proximale et distale, les extrémités proximales des première et seconde entretoises se présentent l'une adjacente par rapport à l'autre. La première entretoise peut pivoter par rapport à la seconde entretoise autour de l'extrémité proximale de la première entretoise entre des première et seconde configurations. Chacune des première et seconde entretoises définit un axe entre l'extrémité distale et l'extrémité proximale de l'entretoise respective. Dans la première configuration, les axes définis par les première et seconde entretoises reposent dans un premier plan. L'orthèse comprend en outre des premier et second éléments qui coopèrent de sorte que lorsque la première entretoise pivote de la première configuration vers la seconde configuration, la première entretoise et/ou la seconde entretoise est poussée hors du premier plan.
PCT/GB2016/052662 2015-10-28 2016-08-26 Orthèse de genou WO2017072478A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB1519037.4A GB201519037D0 (en) 2015-10-28 2015-10-28 Knee support brace
GB1519037.4 2015-10-28

Publications (1)

Publication Number Publication Date
WO2017072478A1 true WO2017072478A1 (fr) 2017-05-04

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GB (1) GB201519037D0 (fr)
WO (1) WO2017072478A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4697583A (en) * 1985-01-29 1987-10-06 Don Joy Orthopedic, Inc. Four-point anterior cruciate ligament brace
EP1016351A1 (fr) * 1997-04-01 2000-07-05 Wacoal Corp. Vetement de protection pour les regions des membres inferieurs
US20120220910A1 (en) * 2011-02-28 2012-08-30 Medical Specialties, Inc. Knee support device having adjustable openings at opposing ends

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4697583A (en) * 1985-01-29 1987-10-06 Don Joy Orthopedic, Inc. Four-point anterior cruciate ligament brace
EP1016351A1 (fr) * 1997-04-01 2000-07-05 Wacoal Corp. Vetement de protection pour les regions des membres inferieurs
US20120220910A1 (en) * 2011-02-28 2012-08-30 Medical Specialties, Inc. Knee support device having adjustable openings at opposing ends

Also Published As

Publication number Publication date
GB201519037D0 (en) 2015-12-09

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