U.S. patent number 3,779,654 [Application Number 05/169,735] was granted by the patent office on 1973-12-18 for artificial joint.
Invention is credited to Robert V. Horne.
United States Patent |
3,779,654 |
Horne |
December 18, 1973 |
ARTIFICIAL JOINT
Abstract
An artificial joint for simulating motion of a natural slide and
hinge joint of the body, such as those at the knee, elbow or ankle.
The disclosed joint comprises rigid overlapping plates connected by
a pivot and slide arrangement. First and second pivot bearing
elements engage first and second arcuate bearing surfaces on the
respective plates to interconnect the plates for controlled sliding
and pivoting action relative to one another. One bearing surface
has a configuration approximating the convex extremity of one
member in the simulated joint. The remaining bearing surface
controls the spacing of the two pivot axes to introduce proper
forward or rearward displacement thereof in simulating joint
movement. The joint may be utilized as a lateral brace for a
natural joint, or may be utilized as a lateral brace for a natural
joint, or may be modified to serve as an articulating joint in an
artificial limb.
Inventors: |
Horne; Robert V. (Walla Walla,
WA) |
Family
ID: |
22616966 |
Appl.
No.: |
05/169,735 |
Filed: |
August 6, 1971 |
Current U.S.
Class: |
403/62; 602/16;
623/47; 623/39; 623/59 |
Current CPC
Class: |
A61F
5/0123 (20130101); A61F 2/6607 (20130101); A61F
2/646 (20130101); A61F 2/582 (20130101); A61F
2220/0025 (20130101); A61F 2002/30523 (20130101); A61B
2017/567 (20130101); F16C 2316/10 (20130101); Y10T
403/32081 (20150115); A61F 2005/0165 (20130101); A61F
2005/0139 (20130101) |
Current International
Class: |
A61F
2/60 (20060101); A61F 2/50 (20060101); A61F
2/66 (20060101); A61F 2/58 (20060101); A61F
2/64 (20060101); A61F 5/01 (20060101); A61F
2/00 (20060101); F16c 011/00 (); A61f 001/04 ();
A61f 005/00 () |
Field of
Search: |
;128/8R,8C,8E,8F,8H
;3/2,22-30,33-35,12.2,12.3 ;287/100,101,92 ;46/161,173 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
855,611 |
|
Nov 1952 |
|
DT |
|
826,333 |
|
Dec 1951 |
|
DT |
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Claims
Having thus described my invention, I claim:
1. An artificial joint for use in braces, artificial limbs and the
like, for simulating the functions of the articulating members in a
natural slide and hinge joint of the body, such as the knee, elbow,
or ankle, comprising:
first and second joint elements having overlapping end portions and
being movable with respect to one another to one side of a position
wherein the joint elements are in longitudinal alignment;
first arcuate bearing surface means formed across the end portion
of said first joint element within the zone of overlap of said
joint elements, said first arcuate bearing surface means including
a curved edge surface substantially corresponding in curvature to a
lateral projection of the curvature of the convex extremity of one
member in the natural body joint being simulated;
second arcuate bearing surface means formed across the end portion
of said second joint element within the zone of overlap of said
joint elements, said second arcuate bearing surface means including
a curved edge surface having a radius of curvature differing from
that of the curved edge surface of said first arcuate bearing
surface means;
first pivot and bearing means mounted to said second joint element
about a first axis, said first pivot and bearing means being
engageable with the curved edge surface of said first arcuate
bearing surface means;
second pivot and bearing means mounted to said first joint element
about a second axis spaced from said first axis, said second pivot
and bearing means being engageable with the curved edge surface of
said second arcuate bearing surface means;
the centers of curvature of the curved edge surfaces of said first
and second bearing surface means being respectively offset from
said first and second axes;
first and second stop surfaces formed respectively on said first
and second joint elements and located respectively at corresponding
ends of said curved edge surfaces of said first and second arcuate
surface bearing means in the path of movement of said first and
second pivot and bearing means for engagement therewith when the
first and second joint elements are longitudinally aligned, said
curved edge surfaces extending to one side of a line through said
first and second axes when said first and second pivot and bearing
means are in engagement with said first and second stop
surfaces;
said curved edges through the first and second axes converging
toward one another as they extend to said one side of said line
when the first and second joint elements are in longitudinal
alignment, whereby the spacing between said first and second axes
is varied in response to movement of said first and second pivot
and bearing means along the curved edge surfaces during relative
motion between said first and second joint elements.
2. A joint as set out in claim 1 wherein each of said first and
second bearing surface means comprises a groove having equally
spaced curved convex and concave edge surfaces facing inwardly
toward one another and engageable by said first and second pivot
and bearing means respectively;
said first and second stop surfaces comprising end surfaces
extending between the convex and concave surfaces of the grooves to
define the limits of travel of said first and second pivot and
bearing means along said grooves.
3. A joint as set out in claim 2 wherein said joint elements are in
the form of sheets or plates of structural material having planar
outer surfaces;
said grooves being formed through said sheets or plates;
said pivot and bearing means each having radially enlarged heads at
their outer ends bearing against the planar outer surfaces of said
joint elements and maintaining them in adjacent, overlapping,
parallel positions along their zone of overlap.
4. An artificial joint structure for simulating the motion of the
articulating members in a natural slide and hinge joint of the
body, such as the knee, elbow or ankle, comprising:
a pair of rigid plates adapted to be secured to the articulating
members of the joint for movement therewith to one side from a
position of longitudinal alignment of the members, the plates each
having an end portion arranged in overlapping relation to one
another;
pivot and slide means interconnecting the end portions of said pair
of rigid plates, comprising:
a first pivot unit mounted to the end portion of one plate about a
first axis perpendicular thereto;
a first groove across the end portion of the remaining plate
defining opposed convex and concave edges engaged by said first
pivot unit and approximating in curvature a lateral projection of
the curvature of the convex extremity of the articulating members
of the natural joint being simulated;
a second pivot unit mounted to the end portion of the remaining
plate about a second axis perpendicular thereto and spaced from
said first axis;
a second groove across the end portion of said one plate defining
opposed convex and concave edges engaged by said second pivot unit,
the curvature of the second groove differing from that of said
groove;
the centers of curvature of said first and second grooves being
respectively offset from said second and first axes;
said first and second grooves terminating at corresponding ends
thereof along first and second stop surfaces between their convex
and concave edges in the paths of movement of said first and second
pivot units for engagement therewith when the plates are at said
position of longitudinal alignment of the joint members, said
grooves extending to one side of a line through the first and
second axes when the first and second pivot units are in engagement
with said first and second stop surfaces;
said grooves converging toward one another as they extend to said
one side of said line through said first and second axes when the
plates are at said position of longitudinal alignment of the joint
members, whereby the spacing between the first and second axes is
varied in response to movement of said pivot units along the
grooves during relative motion between the plates.
Description
BACKGROUND OF THE INVENTION
The present disclosure relates to an artificial joint designed to
closely simulate and approximate the movement of a natural slide
and hinge joint in the human body. It has specific application to
support or replacement of the joint found at the knee, elbow and
ankle. It may be used as a lateral protective device alongside a
normal, healthy joint. It might also be designed as a
load-supportive and motion-controlling brace for a damaged,
weakened or diseased joint. Furthermore, it can be designed to
serve as an effective joint in an articulated artificial limb.
The design of joints, in both artificial limbs and braces, has
developed through the years as those designing such joints have
attempted to approximate the complex natural movement which will be
discussed in greater detail below. The earliest joints, which are
still used in many applications today, involve simple single pivots
with controlling stops to limit angular movement. Early examples of
such joints, illustrated in artificial legs, are shown in U.S. Pat.
Nos. 26,753 and 41,282. A supportive leg brace including such a
pivot is illustrated in U.S. Pat. No. 2,558,986.
Several recent patents have been directed toward the provision of
lateral support or bracing alongside the knee so as to protect the
knee area from injury due to lateral forces. These have been
proposed primarily as protection for the legs of persons playing
football. Examples are shown in U.S. Pat. No. 2,959,168, which
utilizes a single fixed pivot and U.S. Pat. No. 3,350,719, which
uses a double pivot, each pivot connection being centered about a
single axis. Two very recent U.S. Pats., No. 3,575,166 and No.
3,581,741 disclose knee braces of the lateral type which purport to
simulate the rocking-hinge joint motion and sliding motion of a
knee by a pivot that includes a pivot shaft within an enlarged
opening so as to leave the pivot shaft free to move radially within
the confines of the opening.
It is well-recognized that no single fixed pivot can approximate
natural hinge joint movement. The use of a brace containing a fixed
pivot connection alongside a healthy knee soon becomes
uncomfortable because the action of the fixed pivot causes the
joint members in the body to rub and bind in an unnatural manner.
The use of a loosely-mounted pivot, while it might afford
additional freedom for joint movement, necessarily fails to assure
proper longitudinal load support at the artificial joint or
adequate control of movement so as to serve as an effective
supportive brace. Dual pivots, whether simple bearings or geared,
do not assure both the proper longitudinal load support and freedom
of movement, as well as control of the relative motion between the
joint members.
One further joint for approximating a natural joint movement is
French Pat. No. 1,162,322, granted to Deprez. It discloses two
roller bearings mounted in a special groove, both bearings being on
a single artificial joint member. While the pivot connections are
fixed in their spacing relative to one another, they can travel
through an irregular arc to provide a sliding-type pivot in an
artificial limb. The close simulation of natural joint movement in
a healthy joint, which is required in a lateral brace, would be
most difficult to achieve with this type joint, which would require
custom design of the arcuate path to fit each particular natural
joint.
In general, no prior joint has successfully simulated the complex
sliding-pivot movement of the natural joint in the human body.
While certain types of joints, such as geared joints using dual
pivots, have found acceptance in the support of diseased limbs, and
while other approximate joints serve to varying degrees to simulate
joint movement in artificial limbs, the available joints have not
succeeded in providing both free joint movement and longitudinal
load-bearing capability so as to have acceptance as a supportive
device for healthy limbs for athletic purposes and other
applications where lateral protective systems alongside a limb
joint might avoid injury or reduce fatigue. The present joint was
developed specifically to fill this gap and solve this real need
for a practical artificial joint that can be used alongside a
natural joint without creating undesirable binding or uncontrolled
motion and having the capability of withstanding the longitudinal
forces that might be applied to the natural joint.
SUMMARY OF THE INVENTION
The present invention comprises a pivoted joint structure that
might be incorporated in a lateral brace or in an artificial limb.
It simulates the motion of the articulated members in a hinge joint
of the body. It essentially comprises a pair of rigid plates having
end portions transversely arranged in overlapping relation. The
plates are interconnected by first and second pivots or bearings,
one being mounted to each plate. Each pivot or bearing engages an
arcuate bearing surface on the plate opposite to the one on which
it is located. One of these bearing surfaces approximates the
arcuate configuration of the convex extremity of one member in the
simulated joint. The other bearing surface is formed about a center
adjacent the axis of the pivot or bearing that engages the first
bearing surface and faces in a direction opposite to the first
bearing surface. Its arcuate curvature controls the relative
displacement between the two pivots or bearings. The bearing
surfaces includes stops that are positioned in the path of the two
pivots or bearings to limit relative movement between the
interconnected plates between positions that simulate extension and
flexion of the simulated joint.
It is a first object of this invention to provide a mechanical
joint structure that simulates the movement of the articulated
member in a slide and hinge joint of the body and which has full
longitudinal load-supporting capability in all angular
positions.
Another object of this invention is to provide such a pivoted joint
structure that can be utilized adjacent a normal healthy slide and
hinge joint without binding or discomfort to the user, affording
full freedom of limb use and lateral protective support to the
natural joint.
Another object of this invention is to provide such a joint
structure that can be used in supportive bracess or in the joints
incorporated within or alongside artificial limbs.
These and further objects will be evident from the following
disclosure, taken along with the accompanying drawings, which
illustrate the preferred embodiments of the joint and show the
manner by which the joint elements are related to the natural bone
structures of the body. Modifications can obviously be made in the
structural features of the joint as necessary to accommodate it to
a particular application, and such changes are not excluded from
the content of this disclosure.
DESCRIPTION OF THE DRAWINGS
FIG. 1 is a side view of a knee brace incorporating the present
joint;
FIG. 2 is a side view of an artificial limb incorporating the
present joint at both the knee and ankle;
FIG. 3 is a schematic side view of a typical joint structure
according to this disclosure;
FIG. 4 is a side view of the joint, showing the relationship of the
joint to a natural knee;
FIG. 5 is a view similar to FIG. 4 showing partial bending of the
joint and knee structure;
FIG. 6 is an exploded perspective view of the basic joint structure
shown in FIGS. 3-5;
FIG. 7 is an enlarged side view of a joint similar to that shown in
FIG. 4 but illustrating the use of gears as the pivoted bearing
members;
FIG. 8 is a rear elevation view from the left in FIG. 4 showing a
single lap connection between the joint members;
FIG. 9 is a rear elevation view showing a double lap joint
configuration;
FIG. 10 is a side view of a second embodiment of the joint and its
relation to the bones of the ankle; and
FIG. 11 is a side view of another embodiment of the joint and its
relation to the bones at the elbow.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The drawings illustrate several variations representative of
practical applications of the joint disclosed herein. FIG. 1 and
FIGS. 3 through 6 show the basic joint structure as it would be
incorporated in a lateral brace designed for use alongside the knee
of a wearer. FIG. 2 shows application of the joint structure to the
knee and ankle joints of an artificial limb. FIG. 10 schematically
illustrates application of the joint structure to an ankle brace.
FIG. 11 similarly illustrates schematically application of the
joint to an elbow brace.
The present joint is designed to simulate the natural movement of
articulated body joints of the human body which are freely movable
combination and sliding and hinge joints of the diarthroses type.
The action in such a combination sliding and hinge joint is limited
to movement in one plane, either forward or backward. The hinge
joints with which this disclosure is concerned are specifically the
knee, ankle, and elbow. Such diarthrodial joints have a rather
elaborate structure and complex motion pattern.
The two or more bones of these joints are united by fibrous tissue
and the opposed ends of the bone are covered by a layer of
cartilage, called articular cartilage. The joint is reinforced and
strengthened by ligaments. Specific details of each joint are
described below.
Movement at combination sliding and hinge joints of the body is
limited to flexion and extension. Flexion is the bending of the
joint to decrease the angle between the parts. Extension is the
straightening or stretching out of the joint, increasing the angle
between the parts. It is the reverse of flexion. When such joints
are bent, reference is made to movement about a transverse axis at
the joint, this axis being taken as an imaginary line about which
movement occurs. Since the articular surfaces are not regular, as
they would be in a mechanical ball and socket, or in hinge or pivot
joints of uniform radius, there is no single center of movement.
The "axis" at such joints shifts its position slightly during
movement of the joint. Flexion and extension take place about this
moving transverse axis. It is essentially perpendicular to the
longitudinal axes along the bones of the member, these two
longitudinal axes of the joined bone structures being essentially
aligned when the joined members are extended.
The present joint structure, which is best seen in FIG. 3,
essentially comprises a pair of rigid plates 10, 11 which are
transversely arranged in an overlapping relation. Plates 10 and 11
have substantially parallel side surfaces slidably engaging one
another for lateral strength in a direction perpendicular to such
surfaces. The outer end of upper plate 10 locates a first pivot or
bearing unit 12. As shown in FIG. 6, the upper pivot or bearing 12
might be a simple bolt and nut assembly 13, 14 having enlarged
heads at its outer ends and rotatably journaling an intermediate
collar 15.
The outer cylindrical surface of collar 15 is movably engaged
within a curved upper slide groove 17 formed through plate 11. The
curved surfaces of groove 17 are designated by the numerals 16 and
18.
Plates 10 and 11 are also pivotally joined by a second lower pivot
or bearing unit 20 which is located on plate 11. It is shown in
FIG. 6 as comprising a bolt and nut assembly 21, 22 along with an
encircling collar 23. The periphery of collar 23 rides within an
arcuate lower slide groove 24. Groove 24 includes an arcuate
surface 25 that is facing in a direction opposed to surface 18, and
a similarly arched surface 26 that faces oppositely to surface
16.
As can be seen in FIG. 4, the curvature of surfaces 25, 26 along
groove 24 substantially correspond to the curvature of the convex
end of one of the members in the natural bone joint which is
simulated by the connection between plates 10 and 11. The curvature
of surfaces 16, 18 in groove 17 varies from the curvature of
surfaces 25, 26. In the illustrated example, the radius of groove
17 is less than the radius of groove 24. Referring to FIG. 3, the
center of curvature for groove 17 is indicated at 27 and the center
of curvature for groove 24 is indicated at 28. It can be seen that
the centers 27, 28 are adjacent the respective axes of pivots 20
and 12, but are not necessarily coincidental. The exact choice of
location of the various pivot points, axes and each groove radius
is determined by analysis of the size and bone structure
configuration in the joint that is being simulated.
If the grooves 17 and 24 were both respectively centered at the
axes of pivots 20 and 12, the plates 10 and 11 would pivot about a
single fixed axis located centrally along a line connecting their
respective axes. The joint would then function as a single pivot
joint and would fail to simulate the complex articulating motion of
the natural body joint.
I have found that by varying the respective radius of the grooves
17 and 24 with respect to one another and by properly offsetting
the centers of grooves 17, 24 from the axes of pivots 20 and 12,
that I can impart, under normal loading conditions, a varying
sliding and pivoting motion to the plates 10 and 11 which quite
accurately simulates normal joint movement. The resultant momentary
pivotal axis between plates 10 and 11 will vary in location in the
same manner as does the natural transverse axis of rotation in the
hinge joint of the body.
Reference shall now be made to FIGS. 4 and 5, which relate the
above joint structure to the anatomy of the knee. The bone
structure at the knee is well known and described in detail in
various anatomy texts. FIGS. 4 and 5 merely illustrate the general
outline of the principal members with which this device is
concerned. They are shown in a single plane that would be
essentially vertical and taken through the longitudinal center of a
knee joint. The drawings illustrate the lower or distal end of the
thigh bone or femur 30. The distal end of the femur 30 presents a
generally convex surface, indicated at 31, which extends over the
outer ends of the condyles. The medial bone of the leg is the tibia
32, which has a flattened, slightly concave proximal end shown at
33. The space between the areas indicated by surfaces 31 and 33 is
filled by tissue and cartilage.
In the design of the present joint, shown in FIGS. 4 and 5 as being
superimposed on the basic bone structure, the curvature of the
lower slide groove 24 closely approximates the curvature of the
convex end surface 31 at the end of member 30. When located on a
natural limb, the groove 24 is preferably positioned just slightly
inward along member 30 from the natural occuring location of
surface 31. The upper slide groove 17 is also located so as to
overlie the member 30. The radius of each groove 17, 24 is
preferably selected so as to maintain the width of plates 10 and 11
within the normal width of the natural joint members and eliminate
any necessity of the artificial joint protruding beyond these
natural members.
As can be seen in FIG. 5, during flexion of the artificial joint,
or bending of plates 10 and 11 relative to one another, the pivots
12 and 20 move along the lengths of the respective slide grooves 17
and 24. This movement of pivots 12 and 20 occurs simultaneously as
each plate 10 and 11 is guided by the bearing surfaces contacted by
the two pivots. When the joint is under compression loading, the
pivot 12 will bear against surface 16 and pivot 20 will bear
against surface 26. If the joint is in tension, pivot 12 will bear
against surface 18 and pivot 20 will bear against surface 25.
The movement of pivot unit 12 within slide groove 17 causes the
lower end of plate 10 to follow the natural movement of the lower
end of the femur 30. As pivot unit 12 moves along the length of
groove 17, the compressive loading forces exerted on plates 10 and
11 tend to maintain pivot units 12 and 20 at a minimum separation
from one another, limited by the curvature of the respective
grooves 17 and 24. Thus, the plate 10 will slide forwardly relative
to plate 11 while pivoting about the axis at pivot unit 12.
The slide grooves 17 and 24 further serve to define the extent of
bending movement permitted between plates 10 and 11. They include
end stop surfaces 35 and 36 which are abutted by pivots 12 and 20
respectively when the plates 10 and 11 are extended (FIG. 4). In
this condition, pivots 12 and 20 will be substantially aligned
along the longitudinal axis of the simulated joint. Slide grooves
17 and 24 also include opposite end stops 37 and 38, which are
engaged by pivots 12 and 20 respectively when plates 10 and 11 are
fully flexed to the normal limits of the simulated joints. Thus,
plates 10 and 11 provide positive loading support to prevent
unnatural bending of the joint in question.
One important feature of this joint is its ability to operate under
normal load conditions. Under any load, whether in compression or
tension, the joint is under complete control of the wearer, since
the forces directed by the weight of the person upon the pivots and
the bearing surfaces permit only one relative angular location of
plates 10 and 11 with respect to one another at any given moment,
this being the usual articulated position of the natural joint that
is simulated.
FIGS. 1 and 2 illustrate practical applications of the present
joint. FIG. 1 shows the joint incorporated in a brace designed to
be worn alongside the knee for vertical and lateral protective
support. The previously described plates 10 and 11 are formed
integrally as upwardly and downwardly extended supports 40, 41,
which respectively encircle a portion of the thigh and calf of the
user's leg 39. The supports 40, 41 are securely held in place by
encircling straps 42, 43, which are adjustably locked by any
suitable means. One preferable manner of locking straps 42, 43 is
by use of "Velcro" type fastening material. Common buckles, laces
and other fastening devices may be substituted as needed. The
supports 40, 41, as well as the areas about the joint structure
itself, may be suitably molded and padded so as to be worn in
comfort directly adjacent the leg 39.
The brace illustrated generally in FIG. 1 is applicable to use in
orthopedic or in surgical brace situations, as well as providing
protective knee supports for sports and athletic use, especially in
relation to football, basketball and rodeo. Clinical indications
that would specify use of such a knee brace are a painful knee
joint due to chronic osteoarthritis, chronic synovitis, trauma,
surgical operations to correct internal damage or rupture of the
quadriceps tendon or any of the tendons giving strength to the leg
in medial-lateral and anterior-posterior stability.
A brace such as shown in FIG. 1 can assist in alleviating the
condition of the user in the above situations. First, when worn by
a healthy person with normal knee joints, it can assist in
preventing the problem. It is particularly useful in providing
transverse reinforcement to the body joint. Second, during
rehabilitation or healing periods, the brace can assist in
strengthening the knee by holding it in correct medial-lateral
alignment during flexion or extension of the knee. Because the
brace assists in taking some of the normal longitudinal loading of
the leg, it reduces friction at the weight-bearing areas of the
femur and tibia. This is particularly helpful in the case of an
arthritic joint or in situations where the natural padding between
these bones has either been removed or has deteriorated. The limits
to angular movement provided by the end stop surfaces 35, 36 assist
in the orthodic management of genu recurvatum, which is commonly
termed "back knee."
The brace incorporating this joint was designed not only for the
function of assisting the knee in comfort, but also as an
economical alternative to available braces to aid in reducing the
cost of expensive custom-made braces presently used to assist in
correcting the above clinical situations. The joint structure can
be manufactured from suitable sheet material or molded in the form
of plates to provide load support equal to that now provided by
complicated braces made of heavy steel and using both medial and
lateral uprights. A single joint on the outside of the limb as
shown in FIG. 1 can effectively replace the extensive and
complicated brace structures as are in use today. This type of
brace should be able to be manufactured in large quantities, sized
over several ranges and marketed at a moderate price. It is
extremely adaptable and can probably be self-fitted by individuals
needing such an appliance for preventive purposes.
The joint structure might be constructed of metals, such as
aluminum, stainless steel, orthopedic steel, or various plastics
and resins. If a soft-surfaced material or plastic is used in the
construction of the joint, reinforced pivots and bearing surfaces
should be provided to prevent excess wear during use. In more
deluxe permanent braces or artificial limbs, ball bearings, can be
utilized for the bearing or pivot units. The brace may be secured
to the limb by leather lacers, elastic supports, lacings, straps
and other alternative fastenings. The joint should be padded to
make use of the facility of locating the joint structure directly
adjacent to the limb. Such close use does not result in abrasion,
because the joint perfectly matches the moving functions of the
knee.
FIG. 2 illustrates the joint as it might be used in connection with
an artificial limb or prosthesis. The particular artificial limb
structure is shown as designed for an above-the-knee amputation.
The present joint, consisting of the previously described plates
10, 11 is provided at the outer sides of the limb members 45, 46
which form the artificial knee. When used in such an application,
the previously-described pivots or bearing units should be geared
for positive movement. This arrangement is generally illustrated in
FIG. 7, where gears 47, 48 engage matching geared tracks 50, 51 in
grooves 52, 53. Grooves 52, 53 correspond to the
previously-described grooves 17, 24, respectively. Gears 47 and 48
may be operatively connected by a gear train, drive belt, operating
cylinders or motors (not shown) in the manner commonly used to
impart movement in the joints of artificial limbs.
To further analyze the somewhat complex action of the present
joint, the simulated body joint motion is substantially keyed to
the curved lower slide groove 24, which simulates the bearing
surface at the top of the tibia in its relation to the rolling
motion of the lower surface at the distal end of the femur. The
lower pivot and bearing unit 20 not only acts as a bearing
structure engaged within the lower slide groove 24, but laterally
holds the upper and lower plates 10, 11 to one another. The
enlarged surfaces of bolts 13, 21 maintain the desired transverse
relationship between the parallel structures of plates 10 and 11.
The unit 20 supports the weight transmitted from plate 10 by
rolling or sliding along the lower slide groove 24. It simulates
the bearing surface of the femur as it relates to the proximal end
of the tibia.
In a simulated knee joint, the upper pivot or bearing unit 12 is
located approximately 1 inch above the unit 20. Unit 12 also acts
as a weight bearing member for the plates 10 and 11, but its main
function is to serve as a roller guide bearing that moves along the
graduated surface across groove 17. Its movement forces the outer
end of plate 10 to move rearwardly and the plate 11 to move
forwardly relative to one another when the joint is in flexion and
to move oppositely when it is in extension. This is accomplished by
varying the distance between the two pivot and bearing units 12,
20, whereby achieving a guided sliding action to control the joint
in the same manner as provided in the natural knee joint. Without
the control afforded by the two pivot and bearing units, the lower
plate 11 would shift uncontrollably along the path of groove 24 and
would fail to provide vertical load support capability.
The end stop surfaces 35, 36 prevent plates 10 and 11 from moving
too far relative to one another in extension. The positive contact
of these stop surfaces by pivot and bearing units 12, 20 gives
double strength to the joint structure when in a completely
extended condition (FIG. 4). The locations of units 12, 20 when in
full extension is substantially along the aligned longitudinal axes
of plates 10, 11.
The mechanical structure of the joint can be varied depending on
the material used in its construction and the nature of the load
applied to it. Two exemplary configurations are shown in FIGS. 8
and 9. In FIG. 8 which corresponds to FIGS. 4, 5 and 6, the plates
10 and 11 are directly adjacent to one another in a single lap
joint, being held laterally by the enlarged heads of bolts 13, 21
and nuts 14, 22. FIG. 9 illustrates a modification using a box or
clevis joint in a double lap configuration. Upper plate 10 is
divided into two sections which fit over the lower plate 11. This
would provide a more stable transverse structure, but increases the
effective width of the apparatus.
FIG. 11 shows the present joint applied to an arm brace or
prosthesis. The joint structure is shown superimposed over the
outline of the basic bone structure at the elbow. The arm joint at
the elbow is very similar to that described above with respect to
the knee. It is not a fixed pivot joint, but again is best
described as a slide and hinge joint. The distal end of the arm
bone (humerus) 54 has two articulating surfaces which are indicated
by the convex outline at 55. One of these surfaces articulates with
the head of the radius 56, and the other with the proximal end of
the ulna 57. The ulna 57 and radius 56 slide up over the convex
configuration of the humerus, giving the elbow the same action in
flexion or extension as the knee. As can be seen in FIG. 8, the
joint structure consisting of plates 10 and 11 is essentially
identical to the plates 10 and 11 described with respect to the
knee. The lower slide groove 24 is located outwardly adjacent to
the lower end surface 55 of the humerus 54. The upper slide groove
17 is positioned alongside humerus 54 and inward of the groove
24.
When used as an arm joint to simulate action of the elbow, the
present joint simulates the natural motion of the arm when it is
flexing or extending. It does not bind the arm into the end of the
bone socket, nor will it pull an amputated arm from a supporting
socket at the elbow. Also, the limits to sliding movement due to
the arcuate length of each groove 17, 24 prevents unnatural flexion
of the arm when it is bent.
FIG. 10 shows application of the joint to the ankle structure. The
ankle joint is extremely complex and definitely not a fixed pivot
joint. It is a slide and hinge joint involving considerable
compression ability. The tibia and fibula, shown generally at 32,
rest on the talus, indicated at 58. The upwardly facing top surface
of the talus has a generally convex configuration and the lower or
distal end of the tibia and fibula are slightly concave. The convex
surface of the talus is generally indicated at 60. As a person
bears weight on a leg and moves over the foot, the foot is brought
into dorsal flexion. A fixed pivot, if utilized in an ankle brace,
has a tendency not to follow the joint and causes the brace to
raise and lower. The center of the ankle joint itself shifts
anteriorally and posteriorally.
As shown in FIG. 10, the relative location of the plates 10 and 11
is reversed in applying the present joint to the ankle structure.
Again, the groove 17 is shaped to conform to the general outline of
the bone structure at 60, which is convex, and the controlling
groove 24 is located inwardly of that simulating bone surface
provided by groove 17. The joint otherwise is identical to that
previously described and its functional operating relationship is
believed to be evident from the earlier discussion. The joint
provides the ankle with much more freedom of motion than a single
pivot and eliminates the movement of a brace up and down relative
to the ankle structure. The joint will remain in a more central
position relative to the fibula as the foot is flexing and
extending. As the two pivot bearing units 12, 20 come to full
extension and engage the ends of grooves 17, 24, the brace prevents
the foot from going into planter flexion if the person has a drop
foot. The limits of pivotal movement can be modified and set at
different degrees of planter flexion. Another advantage of the
joint is that it so closely simulates the movement of the natural
body joint that it can be padded and worn directly against the
body.
FIG. 2 further illustrates use of the inverted joint as an
artificial joint in an artificial ankle structure, connecting the
lower end of an artificial calf 46 to a foot 61. Again, the joint
can be provided at both sides of the artificial limb structure and
can be powered or drivingly connected to produce the required
artificial movement in such a limb, according to known
practices.
It is to be understood that the joint structure can be modified to
incorporate gears, rollers, springs, pulleys, belts, and rubber
bands to drivingly interconnect the pivot and bearing units and
surfaces of the slide grooves above. When geared, the positive
engagement of the gears provides more graduated control of joint
movement and strength to the resulting action. A geared joint can
be powered or have a belt, roller, or spring control. The purpose
of a belt would be to slow down the movement of the joint. Rubber
bands connecting the geared rollers so that they would roll in
opposite directions and work against each other would assist the
patient in extending the leg when the brace is used on a leg or
limb that needs help in extension. This also can be utilized in
artificial limb joints to assist in the extension of the lower or
outer part of the limb. Springs may be used in place of such rubber
bands. Springs connected to the gears would be wound as the gears
turned in one direction, tightening the spring, and then as the
load is removed, the brace would automatically extend itself. The
use of such driving connections is believed to be well within the
skill of one trained in the art of designing limbs and braces of
this general type.
Other modifications might be made with respect to this structure,
both as to designs of the joint elements and choice of materials.
These structural design changes are intended to be within the scope
of this disclosure, which is defined only in the following
claims.
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