WO2017147359A1

WO2017147359A1 - Knee range of motion device

Info

Publication number: WO2017147359A1
Application number: PCT/US2017/019253
Authority: WO
Inventors: Richard Stewart
Original assignee: Richard Stewart
Priority date: 2016-02-24
Filing date: 2017-02-24
Publication date: 2017-08-31
Also published as: EP3419569A1; US20170239119A1; EP3419569A4; US10420691B2

Abstract

A knee range of motion device utilizing tangential joint translation and distraction is disclosed. The device includes a carriage connected to a base, the carriage having a base attachment section; a thigh support section pivotally attached to the base attachment section; and a lower leg support section pivotally connected to the thigh support section. The device further including a carriage support extending between the thigh support section and the base, the carriage support pivotally connected to the thigh support section and adapted to slide in slots on the base; a first actuator connected to the lower leg support section to extend and retract the lower leg support section, thereby causing a foot support connected to the lower leg section to move; and a second actuator connected to the lower leg support section to raise and lower a calf support, causing an anterior and posterior tibial translation.

Description

KNEE RANGE OF MOTION DEVICE

BACKGROUND OF THE INVENTION

[000 i ] This invention relates generally to a knee rartge of motion, device, and more particularly, to a knee range of motion device utilizing tangential joint translation and distraction to help individuals regain range of motion in their knee after joint arthroplasty or arthrofihrosis.

| O02] Joint arthropiasty is a procedure used to restore the .function of: a joint. Typically, joint arthroplasty is used to relieve joint pain and disability which are caused by arthritis or a degenerative joint disease. The procedure .may include a resurfacing of the bones at the joint, a partial replacement of the joint, or even a full replacement of the joint. One of the most common joint arthroplasty procedures is performed on the knee, i.e. knee replacement surgery.

[0003] Stiffness of the knee joint following joint arthroplasty is a common problem.. People can develop scar tissue adhesions which ean limit their knee range of moiion and ultimately their functional activities. One way to reduce sti fness and combat scar tissue is to move the joint, Currently there are continuous passive motion devices, which act on a simple hinge moving the knee into flexion and extension. The knee however does not act purely as a hinge joint, but has translation along the joint surface. The knee joint can also become restricted by ligaments which may shorten, thereby necessitating joint distraction and mobilization to maintain their proper length.

[0004] Accordingly, there is a need for a continuous passive motion device configured to provide tibial translation and joint distraction.

BRIEF SUM ARY OF THE INVENTION

[0005] This need is addressed by the present invention, which provides a knee range of motion device configured to move the knee into flexion and extension as well as provide tibial translation and, joint distraction.

[0006] According to one aspect of the invention, a knee range of moiion device includes a carriage connected to a base, the carriage including a base attachment section connected to the base; a thigh support section pivotaily connected to the base attachment section and configured to support a user's upper leg; and a lower leg support section pivotaily connected to the thigh support section and configured to support a user's lower leg. The device further including a carriage support configured to support the carriage, the carriage support extending between the thigh support section and the base, the carriage support pivotaily connected to the thigh support sectiou and adapted to slide in slots on the base; a first actuator connected, to the lower leg support section to extend and retract fee lower leg support section, thereby causing a foot support connected to the lower leg section to move; and a second actuator connected to the lower leg support section to anteriorly and posteriorly glide a calf support,

10007] According to another aspect of the invention, a knee range of motion device includes a carriage connected to a base, the carriage including a base attachment section configured to attach the carriage to the base; a thigh support section pivotaily connected to the base attachment section, the thigh support section having a first and second spaced-apart thigh support members; and a lower leg support section pivotaily connected to the thigh support section, the Sower leg support section having first and second spaced-apart lower leg support members, each of the lower leg support members having an outer support, member and an inner support member, wherein the first lower kg support member is pivotaily connected to the first thigh support member and the second lower le support member is pivotaily connected to the second thigh support member. The device further including a foot support connected to the inner support member of the first and second spaced-apart lower leg support members; a carriage support configured to support the carriage, the carriage support pivotaily connected to and extending between the thigh support section and the base; first and second pneumatic cylinders, the first pneumatic cylinder being operabiy connected to the inner support member of the first lower le support member to move the inner support, member in and out of the outer support member and the second pneumatic cylinder being operabiy connected to the inne support member of the second lower leg support member to move the inner support member in and out of the outer support member, thereb moving the foot support; and a calf support extending between the first and second lower le support members and operabiy connected to third and fourth pneumatic cylinders, the third pneumatic cylinder being connected to a first end of the calf support and the fourth pneumatic cylinder being connected to a second end of the calf support such that the third and fourth pneumatic cylinders cause the calf support to move,

[0008] According to another aspect: of the invention, a method of improving joint range of motion after surgery includes the steps of providing a joint motion device; using the device to move a user's joint between a predetermined flexion position and a predetermined extension position; prior to reaching the pre-determined flexion position, using the device to move the joint to provide joint distraction and retraction; at the pre-determined flexion position, using the device to move the joint in an oscillatory manner to provide joint translation; prior to reaching the pre-determined extension position, using the device to move the joint in an oscillatory manner to provide joint translation; and at the pre-determined extension position, using the device to move the joint in an oscillatory manner to provide joint distraction and retraction.

BRIEF DESCRIPTION OF THE DRAWINGS

[0009] The invention may be best understood by reference to the following description taken in conjunction with the accompanying drawing figures, in which:

[0010] FIG. 1 is a perspective view of a user using a range of motion device;

[001 1] FIG, 2 is another perspective view of the of the range of .motion device;

[0012 j FIG. 3 is an exploded view of the range of motion device;

[0013] FIG. 4 is a side view of the range of motion device; and

[0014] FIG , 5 is. a top vie w of the range of motion device

DETAILED DESCRIPTION OF THE INVENTION

[0015] Referring to the drawings wherein identical reference numerals denote the same elements throughout the various views, FIGS. 1-5 illustrate a knee range of motion device 10 utilizing tangential joint translation to aid an individual in gaining range of motion in their knee by using the concave on convex rule and femoral roil back mechanism and distraction to prevent tightening of collateral ligaments or joint capsule. These movements further improve synovial fluid lubrication of the joi t. [00.16] The motion device 10 includes a base 12, a leg support or carriage 1 connected to the base 12, a footrest or toot support 16 connected to the carriage 14, an air compressor 18 connected to actuators such as pneumatic cylinders 20 and 22, and a slidable carriage support 24 interconnecting the carriage 14 and base 12.

[0017] The carriage 14 includes a base attachment section 30, a thigh support section 32, and a lower leg support section 34. The base attachment section 30 includes a clamp 36 adapted for sliding movement along rail 38 of die base 12 and a support member 40 extending outwardly therefrom. The clamp 36 allows a user to switch the location of the base attachment section 30 and lock it in place depending on which leg the user is treating. As shown, in FIG. 1 , if the user is treating the right leg, then the base attachment section 30 is positioned along the right side of the base 12 so that support member 40 resides along the right hip 122 of the user.

[00.18] The support member 40 is pivotaHy connected to the thigh support section 32 at pin 42. The leg being treated determines which side of the thigh support section 32 is pivotaHy connected to the support member 40. The thigh support section 32 includes first and second spaced-apart thigh support members 44 and 46 and a thigh support 48 extending therebetween. As shown, support membe 40 is pivotall attached to support .member 44. As illustrated, support member 44 is in a telescoping configuration, (two inner support members 45 and 47 to provide extension) and support member 46 is not; however, it should be appreciated that either of the support members 44 and 46 may be telescoped for pivotal connection to the support member 40. The thigh support 48 provides a hammock-type siipport that rests against the user's posterior thigh, thereby comfortably supporting the upper leg. The thigh support 48 may he made of any suitable material for providing a strong, comfortable support to the upper leg such as leather, canvas, nylon, and plastics and/or metal covered in padding.

[0019] The lower leg support section 34 includes ^'first .and second spaced-apart lower leg support member's 50 and 52 which are pivotally connected to the thigh support members 44 and 46 (support member 50 is pivotaHy connected to support -member 44 at joint 54 and support member 52 is pivotally connected to support member 46 at joint 56). Joints 54 and 56 may be of an suitable configuration to permit the thigh support section 32 and lower leg support section 34 to move smoothly relative to each other. Lower leg support member 50 includes an outer support member 60 and an inner support member 62 that, slides in and out of the outer support member 60 to allow the support member 50 to telescope. Lower leg support ^•member 52 mciudes an outer support: member 64 and an inner support .member 66 that slides in and out of the outer support member 64 to allo w the support member 52 to telescope. A calf support 6? extends between the outer support members 60 and 64 and includes a securing strap 69 to secure a user's leg thereto. As illustrated, the securing strap 69 uses Velcro to secure the user's leg; however, it should be appreciated that the securing stra 69 ma use other suitable means to secure the user's leg, such as snaps, hooks, and/or belt type holes and prong arrangement.

[0020] A U-shaped proximal calf support 68 is supported by the outer support members 60 artd 64 at a location between and below the outer support .members 60 and 64. As illustrated, the proximal calf support 68 includes a support member 70 extending between a first support ring 72 -and a second support ring 74. First support wag 72 is connected to outer support member 60 by connector 76 and second support ring 74 is connected to outer support membe 64 b connector 78.

[0021 J ^'The foot support 16 is pivotaiiy connected to the inner support members 62 and 66 by connectors 82, The foot support 1 includes a base 84, a moveable plate 86, and an ankle brace or strap 88 to strap a user's foot therein, thereby securing the foot to the foot support 16. As shown, the base 84 is pivotaily connected to the connectors 82 at opposiag ends of the base 84 and the moveable plate 86 is moveable with respect to the base 84.

[0022] The carriage support 24 extends between the thigh support section 32 and the base 12, As illustrated, the carriage support 24 is pivotaily attached to the thigh support section 32 aad slidably connected to the base 12, The carriage support: 24 includes first aad second spaced- apart carriage members 92 and 94. First carriage member 92 is pivotaily connected to thigh support member 44 at a first end 96 of the first carriage member 92, extends through first support ring 72, and is slidably connected to the base 12 at a second end 98. Second carriage ^•member 94 is pivotaiiy connected to thigh support member 46 at a first end 100, extends through second support ring 74, aad is slidably connected to fee base 12 at a second end 102. As shown, fee first and second carriage members 92 and 94 are connected to sliding mechanisms 104 that slide and/or ride in slots 1 6 aad 1 8 of the base 12. A drive mechanism 107 (such as a motor and drive screw) causes the sliding mechanisms 104 to move. Movement of the carriage support 24 causes the thigh, support section 32 and leg support section 34 to move relative to each other, for example, such movement changes an angle 0 between the thigh support section 32 and the leg support section 34,

[0023] Pneumatic cylinders 20 are supported by outer support members 60 and 64 (as shown, a single cylinder 20 is supported by outer support member 60 and a single cylinder is supported, by outer support member 64 using connector 21 , it should be appreciated that any suitable number of cylinders may be deployed). The pneumatic cylinders 20 each include an air cylinder 110 and a piston rod .112 moveable inward and outward from the cylinder 1 10, As illustrated, the piston rods 112 are connected to the inner support members 62 and 6 by connector 113 and are used to slide the inner and outer support members 62 and 66 in and out of th outer support, members 60 and 64. Pneumatic cylinders 22 are three position pneumatic cylinders which are connected to the outer support members 60 and 64 (a single cylinder 22 is secured to each outer member 60 or 64) by bracket 1.14. Opposing ends 1 16 and Ϊ I 8 of the calf support 67 and securing strap 69 are secured to respective strap brackets 7.1 which are secured to the three position pneumatic cylinders .22 to permit the cylinders 22 to move a user's leg in ^•translation, see FIG. 4.

[0024] The pneumatic cylinders 20 and 22 are connected to air compressor 18. Air compressor

18 and base 12 are operabSy connected to controller 120. As shown, the controller 120 is connected via a wired connection; however, it should be appreciated that the controller 120 ma be connected wireiessly.

[0025] In use, a. user sets up the motion device 10 for the desired leg to be moved by positioning the base attachment section 30 on the right or left side of the base 12 and uses clamp 36 to secure it. in position. The user then connects the base attachment section 30 to the thigh support section 32 (as shown in FIG. i , the base attachment section 30 is attached to thigh support member 44). The user then positions the leg in the motion device 10 by placing the base attachment section 30 along the user's hip 122, resting the user's posterior thigh on the thigh support 48, resting the user's calf on the calf support 6? and securing the leg thereto using the securing strap 69, and resting the user's foot on the foot support 16 and securing the foot thereto using the strap 88.

[0026] With the user's leg positioned and secured in the motion device 10, the user uses the controller 120 to move- the user's leg. The user ma move the leg from a ben position to an extended position (flexion and extension) and back by causing the carriage support 24 to move along the base 12 in slots 106 and 108, thereby causing the angle 0 to move between about 65 degrees and about 1 S3 degrees which corresponds to an hyper extension angle of about 3 degrees to a flexion angle of about 115 degrees, ft should be appreciated that the angle 0 and/or angle of flexion and extension may be increased, for example, the angle of flexion may he increased to about 130 degrees. A sensor 124 measures the angle of flexion and extension. As flexion increases to an adjustable end-range, the speed of flexion will slow and initiate joint distraction using cylinders 20 at a pre-determmed cycle. For example, the cycle may include distracting the joint for about 5 seconds, relaxing the joint for about 1-2 seconds, and repeating distraction and resting for 3-5 cycles which will cause both distraction and retraction of the joint. Subsequent to the cylinder 20 deactivating, cylinders 22 are activated to provide joint translation at a rate of 20 oscillations/minute for 5 oscillations. As the joint returns to end-range extension, the cylinders 22 will again provide joint translation at about 3 degrees short of end-range extension at about 20 osciHations minute. At end-range extension, the cylinders 20 again provide joint distraction for a pre-determincd amount of time (20-4 seconds, preferably 30 seconds). This cycle is then repeated. It should be appreciated that the term "end-range" refers to a limit and or stoppin point, at which the carnage support 24 stops moving along the slots 106, 108 hi a flexion direction and an extension direction. This limit corresponds to the angle of flexion and extension measured by the sensor 124, Tins end-range is adjustable by the user prior to (i.e., pre-detennraed) using the device 10.

[0027] The foregoing has described a knee range of motion device utilizing tangential joint translation and distraction. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or ail of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at l east some of such features and/or steps arc ^'mutually exclusive.

[0028] Each feature disclosed in this specification (including any accompanying claims, abstract and drawings) ma be replaced b alternative features serving the same, equivalent or similar purpose, unless expressly sta ted otherwise. Thus, unless expressly stated otherwise, each feature disclosed is one example only of a generic series of equivalent or similar features.

[0029] The invention is not restricted to the details of the foregoing embodiment^'s). The invention extends to any novel one, or any novel combination, of the featiires disclosed in this specification (including any accompanying claims, abstract aad drawings), or to any novel one, or any no vel combination, of the steps of any method or process so disclosed.

Claims

Ϊ claim;

1 , A knee range of motion device, comprising.^*

(a) a carriage connected, to a base, the carriage comprising:

(i) a base attachment -section connected to the base;

(is) a thigh support section pivotally connected to the base attachment section and configured to support a user's upper leg; and

(iii) a lower leg support section pivotally connected to the thigh support section and configured to support a user's lower leg;

(b) a carriage support configured to support die carriage, the carriage support extending between the thigh support section and the base, the carriage support pivotally connected to the thigh support section and adapted to slide in slots on the base;

(c) a first actuator connected to the lower le support section to distract and retract the lower le support section, thereb causing a foot support connected to the lower leg section to move; and

(d) a second actuator connected to the lower leg support section to anteriorly and posteriorly glide a calf support.

2, The device according to claim 1 , wherein the lower leg support section includes first and second spaced-apart lower leg support members, each of the lower leg support members having an outer support member and an inner support member configured to slide in and out of the outer support member.

3, The device according to claim. 2_t wherein the foot support is connected to the inner support member.

4. Tlie device according to claim 2, wherein the calf support extends between the first and second lower leg support members and is connected to the second actuator.

5. The devic according to claim , wherein the second actiiator is connected to the tower leg support section at a location where the calf support is connected to the first and second lower leg support members,

6. The device according to claim 1 , further including a controller to control movement of the device, the controller providing commands to cause;

(a) the carriage support to slide along the slots of the base, thereby causing an angle between the thigh support section and lower leg section to increase or decrease;

(b) the first actuator to distract or retract the lower leg support section; and

(c) the second actuator to anteriorly and posteriorly glide the calf support device in an oscillatory manner.

?. A knee range of motion device, comprising:

(a) a carriage connected to a base, the carriage including:

(i) a base attachment sectio configured to attach the carriage ¾ the base;

(ii) a thigh support section pivotal!y connected to the base attachment section, the thigh support section having a first and second spaeed-apart thigh support members; and

(hi) a lower leg support section pivoialiy connected to the thigh support section, the lower leg support section having first and second spaeed-apart lower leg support members, each of the lower leg support members having an outer support member and an inner support member, wherein the first lower leg support member is pivoialiy connected to the first thigh support member and the second !ower leg support member is pivotally connected to the second thigh support member;

(b) a foot support connected to the inner support member of the first and second spaccd-apart lower leg support members;

(c) a carriage support, configured to support the carriage, the carriage support pivotally connected to and extending betwee the thigh support section and the base;

(d) first and second pneumatic cylinders, the first pneumatic cylinder being operably connected to the inner support member of the first lower leg support member to move the inner support membe in. and out of the outer support member and the second pneumatic cylinder being operably connected to the inner support member of the second lower leg support member to move the inner support member in and out of the outer support member, thereby moving the foot support; and

(e) a calf support extending between the first and second lower leg support members and operably connected to third and fourth pneumatic cylinders, the third pneumatic cylinder being connected to a first end of the calf support and the foitrth pneumatic cylinder being connected to a second end of the calf support such that the thi rd and fourth pneumatic cylinders caitse the calf support to move.

8. The device according to claim 7, wherein the first and second pneumatic cylmders cause the foot support to move, thereby pulling and pushing a user's foot secured in the foot support to cause knee joint distraction.

9. The device according to claim 7, wherein the carriage support moves along slots in the base to cause the carriage to move from an extended position where a user's leg secured in the carriage is extended, to a retracted position where the user's leg is bent to cause knee joint flexion and extension.

- 1 Ϊ -

10. ^'The device according to claim 7, wherein the third and fourt pneumatic cylinders cause the calf support to move anteriorly and posteriorly in an oscillatory mariner, thereby causing knee join t translation.

1 i , A method of using the de vice of claim 7 to improve a knee joint's range of motion, comprising;

(a) moving the carriage support along slots in the base to move a user's leg between a predetermined, flexion -position and a predetermined extension position;

(b) a or prior to reachin the predetermined flexion position, using the first and second pneumatic cylinders to move the foot support in as oscillatory maimer to provide joint distraction and retraction;

(e) at the predeteraiined flexio position, using the third and fourth pneumatic cylinders to move the calf support in an oscillatory manner io provide joint translation;

(d) at o prior to reachin the predetermine extension position, using the third and fourth pneumatic cylinders to move the ealf suppoit in an oscillatory manner to provide joint translation; and

(e) at the predetermined extension position, using tire first and second pneumatic cylinders to move the foot support in an oscillatory manner to provide joint distraction and retraction.

12, A method of improving joint range of motion, comprising the steps of:

(a) providing a joint motion device;

(b) using the device to move a user's joint between a pre-determined flexion position and a predetermined extensio position;

(c) at or prior to reaching the pre-determined flexion position, using the device to move the joint to provide joint distraction and retraction; (c) at the pi s-determioed flexion position, using the device to move the joint in an oscillatory manner to provide joint translation;

(d) at or prior to leaching the pre-deteraiined extension position, using the device to move the joint in an oscillatory manner to pro vide joint translation; and

(e) at the pre-determined extension position, using the device to move the joint in an oscillatory manner to provide joint distraction and retraction,

13. Hie method according to claim ί 2, wherein the device includes a carriage connected to a base, the carriage configured to support a user's leg and includes a thigh support section and a lower leg support section.

14. The ^"method according to claim 13, wherein a foot support is connected to the lower ieg support section.

15. The method according to claim .14, wherein an actuator is operably connected to the foot support and causes the foot support to move in a oscillatory manner to provide distraction and retraction of the joint.

16. The method according to claim 13, wherein the device further includes a carriage support, the earriage support having a first end pivotaily connected to the thigh support and a second end slidaMy connected to a slot in the base.

17. The method according to claim .56, wherein movemen of the carriage support along the slot in the base causes the earriage to move between the flexion and extension positions, thereby providing joint flexion and extension.

18. The method according to claim 13, wherein a calf support is connected to the lower leg support section.

19. The method according to -claim 18, wherein an actuator is connected to the calf support to cause the calf support to move in an oscillatory manner to provide joint translation.