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WO2012041309A2 - Orthèse pour articulation corporelle - Google Patents

Orthèse pour articulation corporelle Download PDF

Info

Publication number
WO2012041309A2
WO2012041309A2 PCT/DE2011/075187 DE2011075187W WO2012041309A2 WO 2012041309 A2 WO2012041309 A2 WO 2012041309A2 DE 2011075187 W DE2011075187 W DE 2011075187W WO 2012041309 A2 WO2012041309 A2 WO 2012041309A2
Authority
WO
WIPO (PCT)
Prior art keywords
orthosis
axis
joint
segment
compensation
Prior art date
Application number
PCT/DE2011/075187
Other languages
German (de)
English (en)
Other versions
WO2012041309A3 (fr
Inventor
David Hochmann
Lucas Thieme
Original Assignee
Technische Universität Berlin
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 Technische Universität Berlin filed Critical Technische Universität Berlin
Publication of WO2012041309A2 publication Critical patent/WO2012041309A2/fr
Publication of WO2012041309A3 publication Critical patent/WO2012041309A3/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. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as 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. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the knees
    • A61F5/0125—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the knees the device articulating around a single pivot-point
    • 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. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as 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

Definitions

  • the invention relates to an orthosis for a body joint, in particular a knee brace. Background of the invention
  • Orthoses are functional, body-encircling or body-based aids that can be used for different orthopedic purposes, such as stabilizing, immobilizing, mobilizing, relieving, correcting, retracting, fixing or redressing, and replace or improve unusual body functions. Since the orthoses are fastened on the one hand to the displaceable and compressible soft-tissue jacket and, on the other hand, are arranged parallel to the human joints whose motion they can not perfectly reproduce, a relative movement arises between the body segment and the orthosis, which is referred to as migration. This is particularly relevant in joints with highly complex physiological kinematics and large ranges of motion, such as the knee joint.
  • each orthoses are known in which the joint between a first joint part and a second joint part by one or more arcuate guide slots in the first joint part and by a or a plurality of engaging in the guide slots guide pin is formed on the other hinge part.
  • the present invention is based on the object to provide an orthosis for a body joint, which is adapted to the joint kinematics improved.
  • the present invention should on Because of the axis incongruity, damaging constraining forces can be minimized or completely avoided.
  • the invention encompasses the idea of an orthosis for a body joint, in particular knee orthosis, with the following features:
  • a first orthotic segment which with a first body part receiving and a first
  • a fastening device is configured, which is configured to attach the first orthosis segment to a body part on a first body joint side,
  • a second orthotic segment which is formed with a second body part receptacle and a second fastening device that is configured to fix the second orthotic segment to a body part on a second body joint side
  • a joint device which is associated with the body joint and via which the first and second orthotic segments are articulated
  • a compensating mechanism which forms a relative movement resulting from an axis incongruity between a body joint axis of the body joint and a joint axis of the joint device, at least partially releasing.
  • the compensation mechanism By means of the compensation mechanism, it is possible to compensate for the axis incongruity between the body joint axis of the body joint and the joint axis of the joint device during flexion and extension of the body joint, so that in comparison with the prior art on the orthosis due to the axis incongruence occurring constraining forces partially or completely are avoided.
  • the compensation mechanism allows a compensating movement in the orthosis itself, which affects their stability properties as little as possible. For example, in the knee, the increasing incongruity between the articulation device and knee kinematics, which increases with increasing flexion, is avoided, which otherwise leads to an increase in the forces exerted on the soft tissue. It is avoided that the forced forces greater than the conditional by several factors such as belt tension, soft tissue condition or the like adhesive force of the orthosis.
  • the movement release means made possible with the aid of the compensation or compensation mechanism preferably comprises a relative movement changing the distance between the first and / or the second orthosis segment on the one hand and the joint axis on the other hand.
  • the change in distance is in this case based on a connection axis between the hinge axis and associated orthosis segment.
  • the fastening device on the first and / or the second orthotic segment is formed, for example, with so-called orthotic straps with which the orthosis is fastened to the body parts adjacent to the body joint after the orthosis has been attached to the body of the user.
  • a preferred embodiment of the invention provides that the compensation mechanism is formed to be coupled to the first and / or the second orthotic segment. In this way, different embodiments are made possible, in which the compensation of the axis incongruity takes place either on the first orthotic segment, on the second orthotic segment or on both orthotic segments.
  • a compensating movement can thus also include relative part movements on the first and on the second orthotic segment.
  • the compensation of the relative movement preferably takes place by means of the orthotic segment on the thigh, which for this purpose is displaceable relative to the joint axis of the joint device.
  • the upper arm segment is preferably used for this purpose.
  • the compensating or compensating and distance-changing relative movement takes place on the orthosis between orthosis parts above a point of the weight of the orthosis receiving point, which is the attachment of the orthosis on the lower leg regularly in the leg orthosis, for example.
  • the compensation mechanism is formed with at least one linear guide, in which a compensating movement takes place along a linear path of movement.
  • Linear guide means a linear trajectory.
  • the compensation mechanism may comprise a plurality of partial linear guides which may be formed on the first and / or on the second orthotic segment. It may be provided that a plurality of partial linear guides are arranged on one of the orthosis segments around the associated body part, for example in front, behind and / or laterally. In one embodiment, partial linear guides may be formed in pairs opposite one another.
  • a development may provide that in two or more linear guides, the rectilinear trajectories form an angle with each other. In the case of more than two part linear guides, the included angles may differ or be the same. If rectilinear trajectories of two partial linear guides enclose an angle, then these are just not formed in parallel.
  • An advantageous embodiment of the invention provides that in the at least one linear guide, a linear guide direction is adjustable.
  • the adjustability of the linear guide direction relates, for example, to the adjustability of an angle of the linear movement path relative to a normal axis of the associated orthosis segment.
  • a further development of the invention that has a cylinder-piston rod arrangement. It can also be provided several cylinder piston rod arrangements.
  • the at least one linear guide has a groove or gap guide.
  • a plurality of linear guides may be provided with groove or gap guide.
  • use can Nutriche or plastic sliding bushes, for example made of Teflon.
  • rails with associated rolling elements or ball circulation units can be used. A combination of several of these elements may be provided.
  • a development of the invention can provide that the compensation mechanism is formed with at least one non-linear guide, in which a compensating movement takes place along a non-linear trajectory.
  • the movement to compensate for the axis inconsistency in this embodiment comprises a movement along a non-linear path, that is usually a curved path of movement.
  • a plurality of partial non-linear guides may be formed, which are associated with the first and / or the second orthosis segment.
  • the compensation mechanism is configured to lock a compensation of the axis incongruity between the body joint axis of the body joint and the joint axis of the joint device in a use state and to release it in another usage state, which is different from the usage state.
  • Conditions of use of the orthosis can be distinguished on the basis of one or more parameters, including, for example, the angle of flexion or a mechanical force introduced on the articulation device for the actuation thereof.
  • the motion to compensate for the axis mismatch is enabled or disabled. In this case, it can be provided that a more extensive compensation movement is blocked if a threshold value has been reached for one or more parameters. Alternatively or additionally, it can be provided that a compensation movement is released when a corresponding threshold value has been reached for one or more parameters.
  • the blocking of the compensatory movement can be done by means of damping, braking and / or blocking.
  • the compensation mechanism is configured to block the compensation of the axis incongruity for a use state in which a flexion angle is less than 20 °, preferably less than 30 ° and more preferably less than 40 °
  • damping elements are provided, which provide an opposing force acting against the compensating movement hinge angle dependent.
  • damping and / or blocking of the compensating movement can take place as a function of the angle of flexion.
  • the compensation mechanism is configured to block the compensation of the axis incongruity for a use state in which a mechanical orthosis load threshold value or a mechanical orthosis loading area are not given.
  • an advantageous embodiment of the invention provides that the compensation mechanism is configured to block the compensation of the axis incongruity for a use state in which a speed threshold or a speed range for a joint movement is not given.
  • the compensating movement is disabled or released when a speed threshold is reached upon actuation of the articulating device due to body flexion or extension.
  • the relative movement between the orthosis parts taking place for compensation is controlled and controlled.
  • Various sensor elements may be provided to detect information indicative of activities of the wearer of the orthosis, for example the phase of a gait cycle or the loading of the orthosis.
  • acceleration sensors, pressure sensors, sensors for measuring an angle and / or strain sensors can be used as sensors.
  • the detected sensor signals are forwarded to a control device, which evaluates the signals obtained.
  • the compensatory movement is then influenced, for example by means of blocking, releasing, braking and / or damping.
  • the controller actuators for example, damping or brake actuators.
  • hydraulic cylinders can be used. A fluid flowing into or out of these cylinders may be controlled by means of an adjustable throttle. Influencing the throttle allows an influence on the compensation movement.
  • a development of the invention provides that the compensation mechanism is formed with a sensor and control device. Description of preferred embodiments of the invention
  • FIG. 1 is a schematic representation of a knee orthosis according to the prior art
  • Fig. 2 is a schematic representation of an orthosis, in which a compensation mechanism is formed with a linear guide with a cylinder-piston rod assembly
  • Fig. 3 is a schematic representation of an orthosis, in a compensation mechanism is formed with a groove or gap guide
  • FIG. 4 shows a schematic illustration of an orthosis in which a compensation mechanism with a plurality of linear guides is formed, which enclose an angle with one another;
  • FIG. 5 is a schematic illustration of an orthosis in which a compensation mechanism with a plurality of partial linear guides is formed on an orthotic segment;
  • FIG. 6 is a schematic representation of an orthosis in which a compensation mechanism is formed with a linear guide
  • Fig. 7 is a schematic representation of an orthosis, in which a compensation mechanism is formed with a non-linear guide, and
  • Fig. 8 is a schematic representation of an orthosis, in which a compensation mechanism is formed with a sensor and control device.
  • Fig. 1 shows a schematic representation of a knee orthosis according to the prior art.
  • the knee orthosis comprises an upper and a lower orthotic segment 1, 2 which couple with the aid of a respective joint splint 2, 3 to a joint device 4.
  • the upper and the lower orthotic segments 1, 2 are each designed for receiving body parts of a body joint, namely an upper leg and a lower leg.
  • fastening straps 5, 6 are provided for attachment to the body parts.
  • FIGS. 2 to 8 show a schematic representation of an orthosis with an upper and a lower orthotic segment 20, 21, on each of which fastening devices 22, 23 are formed, preferably in the form of so-called orthosis straps.
  • the upper and the lower orthosis segments 20, 21 are each configured in the illustrated exemplary embodiment to accommodate an upper leg and a lower leg 24, 25. The attachment to the upper and lower legs 24, 25 takes place with the aid of the fastening device 22, 23.
  • a compensation mechanism is formed with a linear guide 28, which comprises a cylinder-piston rod assembly 29 in the illustrated embodiment.
  • a linear guide 28 which comprises a cylinder-piston rod assembly 29 in the illustrated embodiment.
  • FIG. 4 shows a schematic representation of an orthosis with a plurality of partial linear guides 40, 41, which enclose an angle with respect to the respectively assigned rectilinear trajectories, ie do not run parallel.
  • Fig. 5 shows a schematic representation of an orthosis, in which a compensation mechanism is formed with a very simple linear guide 60, in which a pin 61 is arranged in a linear guide 62.
  • Fig. 7 shows a schematic representation of an orthosis, in which a compensation mechanism with a non-linear guide 70 is formed, which has two Operalichtlmear Adjusten 71, 72 each with a curved trajectory.
  • Fig. 8 shows a schematic representation of an orthosis in which a balancing mechanism is formed with a sensor and control device 80 which couples to two cylinder piston rod assemblies 81, 82 to detect usage parameters for the orthosis and, in dependence thereon, the cylinders Control piston rod assemblies 81, 82 for compensating movement to compensate for axis mismatch. This is done, for example, by adjusting associated hydraulic cylinders with respect to the fluid flowing in or out of them by means of the sensor and control device 80.
  • the invention has been described above with reference to various embodiments with reference to a knee orthosis , However, the embodiments of the orthosis are similarly useful for orthoses for other body joints, such as an elbow orthosis.
  • the features of the invention disclosed in the above description, the claims and the drawings may be of importance both individually and in any combination for the realization of the invention in its various embodiments.

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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)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une orthèse pour une articulation corporelle, notamment une orthèse du genou, comprenant un premier segment d'orthèse (20), qui est formé d'un premier logement de partie corporelle et d'un premier dispositif de fixation (22) conçu pour fixer le premier segment d'orthèse (20) à une partie corporelle sur une première face de l'articulation corporelle, un deuxième segment d'orthèse (21), qui est formé d'un deuxième logement de partie corporelle et d'un deuxième dispositif de fixation (23) conçu pour fixer le deuxième segment d'orthèse (20) à une partie corporelle sur une deuxième face de l'articulation corporelle, un dispositif d'articulation (26), qui est associé à l'articulation corporelle et par l'intermédiaire duquel le premier et le deuxième segment d'orthèse (20,21) sont reliés de manière articulée, et un mécanisme de compensation qui est formé pour au moins partiellement libérer un mouvement relatif se développant sur la base d'une incongruence axiale entre un axe de l'articulation corporelle et un axe d'articulation du dispositif d'articulation (29).
PCT/DE2011/075187 2010-08-04 2011-08-04 Orthèse pour articulation corporelle WO2012041309A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE201010036832 DE102010036832A1 (de) 2010-08-04 2010-08-04 Orthese für ein Körpergelenk
DE102010036832.6 2010-08-04

Publications (2)

Publication Number Publication Date
WO2012041309A2 true WO2012041309A2 (fr) 2012-04-05
WO2012041309A3 WO2012041309A3 (fr) 2012-07-26

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PCT/DE2011/075187 WO2012041309A2 (fr) 2010-08-04 2011-08-04 Orthèse pour articulation corporelle

Country Status (2)

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DE (1) DE102010036832A1 (fr)
WO (1) WO2012041309A2 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109328047A (zh) * 2016-06-27 2019-02-12 戴维·里德·罗宾森 下肢隔离腿部支架

Citations (9)

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Publication number Priority date Publication date Assignee Title
DE3825813A1 (de) 1988-07-29 1990-02-01 S & G Orthopaedietechnik Gmbh Fuehrungsschiene fuer eine kniegelenk-orthese
DE29705405U1 (de) 1997-03-25 1997-05-28 Gorisch, Wolfram, Dr., 81929 München Kniegelenk-Orthese
US5741221A (en) 1994-10-07 1998-04-21 Wetz; Hans Henning Knee-joint orthesis having different medical and lateral hinge mechanisms
WO2005032437A1 (fr) 2003-10-07 2005-04-14 Asociación Instituto De Biomecánica De Valencia Articulation orthetique pour le genou
DE102004046743A1 (de) 2004-09-27 2006-04-06 Gerhard Lambert Knieorthese
EP1647246A1 (fr) 2004-07-28 2006-04-19 Thierry Marc Orthese dynamique polycentrique de l'articulation du genou
DE202006005095U1 (de) 2006-03-28 2006-06-01 Aequos Endoprothetik Gmbh Exoprothese oder Orthese zur Stabilisierung des menschlichen Kniegelenkes
DE60122483T2 (de) 2000-04-07 2007-03-29 Mayo Foundation For Medical Education And Research, Rochester Elektromechanische gelenkkontrollvorrichtung mit schlingfederkupplung
DE102006015921A1 (de) 2006-04-05 2007-10-18 Michael Ottleben Knieorthese

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US5018514A (en) * 1987-06-11 1991-05-28 Brace Technologies, Inc. Knee brace
US20030109817A1 (en) * 2001-12-11 2003-06-12 Shimon Berl Supplementary knee support brace
US7507215B2 (en) * 2005-07-08 2009-03-24 Jri Development Group, Llc Orthotic brace
DE102008027639A1 (de) * 2008-06-06 2009-12-24 Fior & Gentz Gmbh Orthesengelenk zum Unterstützen eines anatomischen Kniegelenks

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Publication number Priority date Publication date Assignee Title
DE3825813A1 (de) 1988-07-29 1990-02-01 S & G Orthopaedietechnik Gmbh Fuehrungsschiene fuer eine kniegelenk-orthese
US5741221A (en) 1994-10-07 1998-04-21 Wetz; Hans Henning Knee-joint orthesis having different medical and lateral hinge mechanisms
DE29705405U1 (de) 1997-03-25 1997-05-28 Gorisch, Wolfram, Dr., 81929 München Kniegelenk-Orthese
DE60122483T2 (de) 2000-04-07 2007-03-29 Mayo Foundation For Medical Education And Research, Rochester Elektromechanische gelenkkontrollvorrichtung mit schlingfederkupplung
WO2005032437A1 (fr) 2003-10-07 2005-04-14 Asociación Instituto De Biomecánica De Valencia Articulation orthetique pour le genou
EP1647246A1 (fr) 2004-07-28 2006-04-19 Thierry Marc Orthese dynamique polycentrique de l'articulation du genou
DE102004046743A1 (de) 2004-09-27 2006-04-06 Gerhard Lambert Knieorthese
DE202006005095U1 (de) 2006-03-28 2006-06-01 Aequos Endoprothetik Gmbh Exoprothese oder Orthese zur Stabilisierung des menschlichen Kniegelenkes
DE102006015921A1 (de) 2006-04-05 2007-10-18 Michael Ottleben Knieorthese

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BERSCHIN: "Anspruch und Wirklichkeit in der orthetischen Kniestabilisierung", ORTHOPÄDIE-TECHNIK, vol. 12, no. 04, pages 976 - 980
BEYNNON ET AL.: "The effect of functional knee-braces on strain on the anterior cruciate ligament in vivo", J BONE JOINT SURG AM., vol. 74, 1992, pages 1298 - 1312, XP000322579
GRIFFKA: "Systematik der Kniegelenkorthetik", ORTHOPÄDIE-TECHNIK, May 1995 (1995-05-01), pages 389 - 397
HIEMSTRA ET AL.: "Knee Immobilization for Pain Control After a Hamstring Tendon Anterior Cruciate Ligament, Reconstruction: A Randomized Clinical Trial", AM. J SPORTS MED., vol. 37, 18 September 2008 (2008-09-18), pages 56
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109328047A (zh) * 2016-06-27 2019-02-12 戴维·里德·罗宾森 下肢隔离腿部支架

Also Published As

Publication number Publication date
WO2012041309A3 (fr) 2012-07-26
DE102010036832A1 (de) 2012-02-09

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