U.S. patent number RE37,297 [Application Number 09/339,646] was granted by the patent office on 2001-07-24 for dynamic orthopedic knee brace assembly.
Invention is credited to Kirby Smith, III.
United States Patent |
RE37,297 |
Smith, III |
July 24, 2001 |
Dynamic orthopedic knee brace assembly
Abstract
A knee brace assembly for various uses, e.g., restricting
anterior tibial movement. The knee brace assembly includes a
proximal cuff for engaging the wearer's leg above the knee and a
distal cuff for engaging the wearer's leg below the knee. The
proximal and distal cuffs are linked together by a hinge that
permits pivotal movement of the proximal cuff relative to the
distal cuff. The proximal cuff has lateral and medial portions each
having a slot extending there along. A strap guiding assembly is
slidably mounted within each of the slots. Each strap guiding
assembly is arranged to slide between a proximal extreme when the
wearer's leg is in flexion and a distal extreme as the wearer
extends his or her leg. A biasing device biases each strap guiding
assembly towards its proximal extreme. A cross-strap, having free
ends and a length, is provided for engagement with the wearer's
leg. The cross-strap attaches to the wearer's leg below the knee
and wraps behind the knee in crisscross fashion. The free ends of
the strap attach to the strap guiding assembly. The cross-strap is
operative in response to extension of the wearer's leg to pull the
strap guiding assembly from the proximal extreme towards the distal
extreme thus creating a force counteractive to abnormal anterior
movement of the tibia.
Inventors: |
Smith, III; Kirby (Marietta,
GA) |
Family
ID: |
25524814 |
Appl.
No.: |
09/339,646 |
Filed: |
June 24, 1999 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
Reissue of: |
977094 |
Nov 24, 1997 |
05857989 |
Jan 12, 1999 |
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Current U.S.
Class: |
602/26;
602/16 |
Current CPC
Class: |
A61F
5/0123 (20130101) |
Current International
Class: |
A61F
5/01 (20060101); A61F 005/00 () |
Field of
Search: |
;128/DIG.15,882,887,881
;602/26,24,16,20 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Advertisement for the Innovation C.Ti Brace.* .
Advertisement for the Innovation C.Ti. 2 Brace.* .
Advertisement for the Innovation C.Ti.2 Lite, Edge, Edge Lite,
Sentry C180 and MVP Braces.* .
Advertisement for the Innovation Sentry Brace.* .
Advertisement for the Innovation MVP Brace.* .
Advertisement for the Brace Technologies Cincinnati ACL Brace.*
.
Advertisement for the Omni Scientific OS-5 TM Brace.* .
Advertisement for the 3M Health Care Lennox Hill TM Brace.* .
Advertisement for the Orthotic Consultants SKO TM Brace.* .
Advertisement for the Orthotic Consultants TKO TM Brace.* .
Advertisement for the Townsend Design ACL Brace.* .
Advertisement for the Smith & Nephew Donjoy DONJOY 4-Point TM
Brace.* .
Advertisement for the Smith & Nephew Donjoy GOLD-POINT TM
Brace.* .
Advertisement for the Smith & Nephew Donjoy PLAY-MAKER TM
Brace.* .
Advertisement for the Smith & Nephew Donjoy DEFIANCE TM Brace.*
.
Advertisement for the Generation Orthotics Poli-Axial
Osteoarthritis Brace.* .
Advertisement for the Orthomedics ECKO TM II Brace..
|
Primary Examiner: Yu; Justine R.
Attorney, Agent or Firm: Caesar, Rivise, Bernstein, Cohen
& Pokotilow, Ltd.
Claims
I claim:
1. A knee brace assembly for restricting anterior translation of a
wearer's tibia, the wearer also having a leg including a thigh, a
knee and a leg portion below the knee, said knee brace assembly
comprising:
a. first means for engaging the wearer's thigh, said first means
comprising a lateral portion positioned over the lateral side of
the wearer's thigh and a medial portion positioned over the medial
side of the wearer's thigh, said lateral and medial portions each
having a slot extending there along;
b. second means for engaging the wearer's leg portion below the
knee;
c. hinging means linked to said first and second means to permit
pivotal movement of said first means relative to said second
means;
d. strap guiding means slidably mounted within each of said slots,
said strap guiding means being arranged to slide between a proximal
extreme when the wearer's leg is in flexion towards a distal
extreme as the wearer extends his or her leg;
e. biasing means resiliently biasing said movable strap guides
towards said proximal extreme; and,
f. a cross-strap provided for engagement with the wearer's leg,
said cross-strap comprising free ends and a length therebetween, a
portion of said length comprising tibial pressure application
means, said cross-strap being attachable over the wearer's leg with
said tibial pressure application means located over the wearer's
tibia, said cross-strap wrapping behind the wearer's knee in a
crisscross manner, the free ends of said cross-strap being
attachable to said strap guiding means and in response to extension
of the wearer's leg said cross-strap tightening geometrically
around the wearer's knee and pulling said strap guiding means from
said proximal extreme towards said distal extreme thus enabling
said tibial pressure application means to provide resistance to the
anterior movement of the tibia.
2. The knee brace assembly of claim 1 wherein said first means
comprises a proximal cuff engageable with the wearer's thigh and
wherein said second means comprises a distal cuff engageable with
the wearer's leg portion below the knee.
3. The knee brace assembly of claim 2 wherein said proximal cuff
additionally comprises an arcuate portion for engagement with the
anterior portion of the wearer's thigh and said distal cuff
additionally comprises an arcuate portion for engagement with the
anterior portion of the wearer's leg below the knee.
4. The knee brace assembly of claim 2 wherein said medial and
lateral portions of said proximal cuff and said medial and lateral
portions of said distal cuff are pivotally connected to said
hinging means.
5. The knee brace assembly of claim 2 wherein said biasing means
comprises an elastic band anchored at one end to said proximal
cuff, said elastic band being connected at its opposite end to said
strap guiding means.
6. The knee brace assembly of claim 2 wherein said biasing means
comprises a spring anchored at one end to said proximal cuff, said
spring being connected at its opposite end to said strap guiding
means.
7. The knee brace assembly of claim 6 wherein said spring is a leaf
spring.
8. The knee brace assembly of claim 2 wherein said proximal cuff
additionally comprises a longitudinal axis, said slots extending
parallel to said longitudinal axis.
9. The knee brace assembly of claim 2 wherein said proximal and
distal cuffs are formed of lightweight, high-impact thermoplastic
material.
10. The knee brace assembly of claim 2 wherein said proximal and
distal cuffs are formed of a carbon fiber filament material.
11. The knee brace assembly of claim 2 additionally comprising a
sleeve encircling the wearer's leg below the knee, said cross-strap
being releasably attachable over said sleeve.
12. The knee brace assembly of claim 11 wherein said distal cuff is
engageable with the wearer's leg over said suspension sleeve.
13. The knee brace assembly of claim 2 additionally comprising
adjustably tightenable first strap means for engaging said proximal
cuff to the wearer's thigh and adjustably tightenable second strap
means for engaging said distal cuff to the wearer's leg portion
below the knee.
14. The knee brace assembly of claim 13 wherein each of said first
and second strap means includes an elastic segment.
15. The knee brace assembly of claim 1 wherein each of said medial
and lateral portions comprises a rigid thigh support member
engageable with the wearer's thigh and wherein said second means
comprises a pair of rigid calf support members engageable with the
wearer's leg portion below the knee.
16. The knee brace assembly of claim 1 wherein said cross-strap is
non-elastic and adjustably tightenable to selectively vary the
magnitude of said force counteractive to abnormal anterior movement
of the tibia.
17. The knee brace assembly of claim 1 wherein said hinging means
comprises a pair of hinges positioned over the medial and lateral
sides of the wearer's knee.
18. The knee brace assembly of claim 17 wherein said proximal and
distal cuffs and said hinges are lined with non-allergenic foam
padding for direct engagement with the wearer's skin.
19. The knee brace assembly of claim 17 wherein said hinges are
polycentric hinges.
20. The knee brace assembly of claim 1 wherein said strap guide
means are pivotable.
21. The knee brace assembly of claim 1 wherein said cross-strap is
adjustable..Iadd.
22. A knee brace assembly for restricting anterior translation of a
wearer's tibia, said knee brace assembly comprising:
a. a rigid, inelastic upper cuff adapted to be secured to the
thigh;
b. a rigid, inelastic lower cuff adapted to be secured to the leg
below the knee;
c. a hinge connecting said upper and lower cuffs to permit
rotational movement of said upper cuff relative to said lower
cuff;
d. a strap comprising a pair of free ends and an intermediate
section therebetween, said intermediate section of said strap being
attachable over the wearer's tibia at a location below said hinge
and interior of the lower cuff, said strap crossing upon itself,
said free ends of said strap attaching to said upper cuff, said
strap being arranged to tighten geometrically around the wearer's
knee in response to extension of the wearer's leg to apply a force
thereto, said force providing resistance to the anterior movement
of the tibia..Iaddend..Iadd.
23. The knee brace assembly of claim 22 wherein said strap is
formed of a non-elastic flexible web and is adjustably tightenable
to selectively vary the magnitude of said force counteractive to
abnormal anterior movement of the tibia..Iaddend..Iadd.
24. The knee brace assembly of claim 22 additionally comprising a
sleeve adapted to encircle the wearer's leg below the knee, said
strap being releasably securable over said
sleeve..Iaddend..Iadd.
25. The knee brace assembly of claim 22 wherein said cuff
additionally comprises a plurality of rings attached thereto, said
strap being securable to said cuff by slipping said free ends
thereof through said rings and looping said free ends
therearound..Iaddend..Iadd.
26. The knee brace assembly of claim 24 wherein said sleeve
comprises a plush exterior surface and wherein said strap includes
a hook patch disposed on the length thereof, said hook patch being
releasably securable to the plush exterior surface of said sleeve
at a position that lies over the wearer's tibia just below the
wearer's knee..Iaddend..Iadd.
27. The knee brace assembly of claim 22 additionally comprising a
plurality of straps for securing said cuff to said
thigh..Iaddend..Iadd.
28. A knee brace assembly for restricting anterior translation of a
wearer's tibia, said knee brace assembly comprising:
a. a pair of supports, one of said pair adapted to be secured to
the medial side of the leg, the other of said pair adapted to be
secured to the lateral side of the leg, each of said pair of
supports comprising a rigid, inelastic upper portion adapted to be
secured to the thigh and a rigid, inelastic lower portion adapted
to be secured to the leg below the knee, each of said pair of
supports additionally comprising a hinge connecting said upper and
lower portions to permit rotational movement of said upper portion
relative to said lower portion;
b. a strap comprising a pair of free ends and an intermediate
section therebetween, said intermediate section of said strap being
attachable over the wearer's tibia at a location below said hinge
and interior of the lower portion of said supports, said strap
crossing upon itself, said free ends of said strap attaching to
said upper portion, said strap being arranged to tighten
geometrically around the wearer's knee in response to extension of
the wearer's leg to apply a force thereto, said force providing
resistance to the anterior movement of the
tibia..Iaddend..Iadd.
29. The knee brace assembly of claim 28 additionally comprising a
plurality of straps for securing said pair of supports to the
wearer's thigh..Iaddend.
Description
This invention relates generally to orthopedic knee braces, and
more particularly to knee braces for use by persons having anterior
cruciate ligament laxity or insufficiency to protect them from
injury due to abnormal anterior tibial movement.
BACKGROUND OF THE INVENTION
Various types of knee braces are shown in the patent literature and
are commercially available. The following constitute examples of
prior art braces that deal with restricting anterior movement of
the tibia: U.S. Pat. Nos. 4,9055,369 (Bledsoe et al.); 5,433,699
(Smith, III); 4,751,920 (Mauldin et al.) and 4,781,180 (Solomonow).
The apparatus shown by Mauldin is a knee brace that has a first
attachment portion to attach the brace to the wearer's thigh and a
second attachment portion to attach the brace to the wearer's tibia
and a hinge connected to the medial side of the first and second
attachment portions by way of a thigh bar and tibia bar,
respectively. An adjustable gearing mechanism located at the hinge
permits the wearer to limit the amount of rotation of the tibia bar
with respect to the thigh bar. However, this brace suffers from
failing to be able to prevent anterior translation of the tibia by
the application of posterior pressure directed at the tibia
tubercle location. Instead, like its predecessors, the Mauldin
apparatus attempts to limit tibial rotation by limiting medial
hinge motion.
The apparatus shown by Solomonow is a knee brace having an upper
framework attached to the thigh and a lower framework attached to
the lower leg just below the knee. These two frameworks are hinged
on the medial and lateral sides of the leg (bilateral hinge). A
bell crank is pivotally connected to the lower framework. An
adjustable screw coupled to one side of the bell crank engages an
offset portion of the upper framework whenever the leg is extended.
The other side of the bell crank is coupled to a tibial restraining
strap. As the leg is extended, the lower framework and bell crank
are rotated counterclockwise until the offset of the upper
framework contacts the screw, rotating the bell crank in a
clockwise direction and thereby tightening the tibial restraining
strap against anterior movement of the tibia.
The apparatus as shown by Bledsoe et al. is a knee brace which also
utilizes bilateral hinges to connect the thigh support and calf
support sections. The bilateral hinges basically comprise
adjustable drive plates that alternate the pivoting point of the
thigh support and calf support throughout leg flexion and
extension. By varying the pivot point at different points
throughout leg extension, a counter shearing force is generated to
reduce the shearing force created by the quadriceps muscle which
cause the undesirable anterior shift of the tibia of the leg.
Other prior art knee braces are disclosed in U.S. Pat. Nos.
3,581,741 (Rosman); 5,277,698 (Taylor); 5,512,039 (White);
3,387,305 (Shafer); 4,240,414 (Theisler); 4,805,606 (McDavid, III);
4,961,416 (Moore et al.); and U.S. Pat. No. 4,854,308
(Drillio).
Examples of prior art knee braces which are commercially available
are: Innovative Sports C.Ti., C.Ti..sup.2, C.Ti..sup.2 Lite, Edge,
Edge Lite, Sentry, C180 and MVP all of which are sold by Innovation
Sports, Inc. Of Irvine, Calif.; Cincinnati ACL which is sold by
Brace Technologies, Inc. Of Cincinnati, Ohio, the OS-5 (TM)
non-custom functional knee support which is sold by Omni
Scientific, Inc. Of Martinez, Calif.; the Lennox Hill (TM) OTS
Brace and Spectralite Brace which are sold by 3M Health Care of
Long Island City, N.Y.; the SKO (TM) and TKO (TM) knee orthoses
which are manufactured by Orthotic Consultants of Southern
California; the ACL model knee brace which is sold by Townsend
Design of Bakersfield, Calif.; the DONJOY 4-Point (TM), Gold-Point
(TM), Playmaker (TM), and Defiance (TM) all of which are sold by
Smith & Nephew Donjoy, Inc. of Carlsbad, Calif.; the Poli-Axial
Osteoarthritis Brace which is sold by Generation Orthotics, Inc.;
and, the ECKO (TM) II Extension Control Knee Orthosis which is sold
by Orthomedics of Brea, Calif.
While the aforementioned patents seem suitable for their intended
purposes, it would be a significant advance in the art to provide a
knee brace assembly that applies posterior pressure on the wearer's
tibia in response to extension of the wearer's leg through the use
of a cross-strap that is positioned over the wearer's tibia,
wrapped in crisscross manner behind the wearer's knee and attached
to biased strap guides slidably mounted to the brace assembly.
OBJECTS OF THE INVENTION
Accordingly, it is a general object of this invention to provide a
knee brace assembly which overcomes the disadvantages of the prior
art.
It is a further object of this invention to provide a knee brace
assembly for restricting anterior movement of the wearer's
tibia.
It is a further object of this invention to provide a knee brace
assembly for restricting abnormal anterior tibial movement without
preventing the wearer from being able to fully extend his/her
leg.
It is a further object of this invention to provide a knee brace
assembly that is inexpensive to manufacture.
It is a further object of this invention to provide a knee brace
assembly that is reliable in operation.
It is a further object of this invention to provide a knee brace
assembly that is simple in construction.
It is a further object of this invention to provide a knee brace
assembly that is lightweight.
It is a further object of this invention to provide a knee brace
assembly that is comfortable when worn.
SUMMARY OF THE INVENTION
These and other objects of this invention are achieved by providing
a knee brace assembly for restricting anterior tibial movement. The
knee brace assembly includes a proximal cuff for engaging the
wearer's leg above the knee and a distal cuff for engaging the
wearer's leg below the knee. The proximal and distal cuffs are
linked together by a hinge means that permits pivotal rotation of
the proximal cuff relative to the distal cuff. The proximal cuff
has lateral and medial portions each having a slot extending there
along. A strap guiding means is slidably mounted within each of the
slots. Each strap guiding means is arranged to slide between a
proximal extreme when the wearer's leg is in flexion and a distal
extreme as the wearer extends his or her leg. A biasing means
biases each strap guiding means towards its proximal extreme. A
cross-strap, having free ends and a length, is provided for
engagement with the wearer's leg. The cross-strap attaches to the
wearer's leg below the knee and wraps behind the knee in crisscross
fashion. The free ends of the strap attach to the strap guiding
means. The cross-strap is operative in response to extension of the
wearer's leg to pull the strap guiding means from the proximal
extreme towards the distal extreme thus creating a force
counteractive to abnormal anterior movement of the tibia.
DESCRIPTION OF THE DRAWINGS
Other objects and many attendant features of this invention will
become readily appreciated as the same becomes better understood by
reference to the following detailed description when considered in
connection with the accompanying drawings wherein:
FIG. 1 is an isometric view of a first embodiment of the present
invention;
FIG. 2 is an enlarged sectional view taken along line 2--2 of FIG.
1;
FIG. 3 is an enlarged sectional view taken along line 3--3 of FIG.
1;
FIG. 4 is an enlarged sectional view taken along line 4--4 of FIG.
3;
FIG. 5 is a sectional view taken along line 5--5 of FIG. 1;
FIG. 6 is a sectional view taken along line 6--6 of FIG. 1;
FIG. 7 is an exploded isometric view of a first embodiment of the
present invention;
FIG. 8 is an isometric view of a second embodiment of the present
invention;
FIG. 9 is an enlarged sectional view taken along line 9--9 of FIG.
8;
FIG. 10 is an enlarged sectional view taken along line 10--10 of
FIG. 8;
FIG. 11 is an enlarged view of an area shown in FIG. 10 encircled
by a line labeled FIG. 11;
FIG. 12 is an enlarged sectional view taken along line 12--12 of
FIG. 10;
FIG. 13 is a sectional view taken along line 13--13 of FIG. 8; and,
FIG. 14 is an exploded isometric view of a second embodiment of the
present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now in greater detail to the various figures of the
drawings wherein like reference numerals refer to like parts there
is shown at 20 in FIGS. 1, 5 and 7 a first embodiment of the
dynamic orthopedic knee brace assembly of the present invention. As
shown in FIGS. 1 and 5, the knee brace assembly 20 is shown
attached to a human left leg 25 (shown in phantom) having a thigh
portion 30, a knee 35 and leg portion below the knee 40. The left
leg 25 is chosen for convenience only and the brace assembly 20 can
be affixed to either the right or left leg. Generally speaking, the
knee brace assembly 20 functions to counteract anterior shifting of
the tibia when the anterior cruciate ligament in the illustrated
leg is missing or damaged. Such anterior shifting of the tibia
occurs for a variety of reasons and often occurs when a person is
engaging in physical activities that involve sudden turning to the
right or to the left, sudden stopping, jumping, running backwards
or other types of movement. Where the anterior cruciate ligament is
missing or damaged, such anterior shifting of the tibia can also
occur when a person simply extends his or her leg from a flexed
position towards its fully straightened position (FIGS. 1 and 3).
Referring now to FIG. 7, the knee brace assembly 20 of the present
invention comprises three basic parts: a bracing component 45, a
cross-strap 50 and a sleeve 55. The bracing component 45 comprises
an upper or proximal cuff 60, which is engageable with a wearer's
thigh, a distal cuff 65, which is engageable with the wearer's leg
portion below the knee 40, and a pair of polycentric hinges 70
which pivotally join the cuffs 60 and 65 together. Straps, used for
securing the cuffs to the wearer's leg, are shown generally at 75
and 80.
Referring now to FIGS. 1 and 7, the bracing component 45 is
constructed to fit a wearer's leg as will become apparent
hereinafter. The upper or proximal cuff 60, is formed to fit the
anterior portion of the wearer's leg above the knee, and is
essentially curvilinear in configuration and shaped to fit over the
wearer's thigh 30. The proximal cuff 60 has medial and lateral
depending portions 90 and 95, respectively, and a front arcuate
portion 85 (FIG. 1). The proximal cuff 60 is open at the posterior
portion so that it may be placed over the thigh 30 from the
anterior or front. The distal cuff 65 is similar in construction to
the proximal cuff in that it is curvilinearly shaped and formed to
fit the anterior portion of the wearer's leg portion below the knee
40. It also includes a front arcuate portion 100, a medial
depending portion 110 and a lateral depending portion 105.
The proximal and distal cuffs 60 and 65 and the polycentric hinges
70 are made of lightweight, high impact thermoplastic material
which can be formed to fit the contours of the individual wearer's
leg. The cuffs 60 and 65 may be fabricated from any suitable
material, e.g., carbon fiber filament, carbon fiber filament and
polymer composite, carbon/titanium composite, woven carbon fiber
infused with acrylic resin. Preferably, the cuffs 60 and 65 are
fabricated from a material that is water resistant and
non-corrosive to enable the wearer to use the knee brace assembly
in a full range of activities including working, walking, running,
vigorous athletics and high-impact sports including freshwater and
salt water sports.
Referring now to FIGS. 6 and 7, the proximal cuff 60 is padded on
the inside surface by a durable non-allergenic foam pad 115. In
FIG. 6, a top view of the knee brace assembly 20 is shown wherein
the inside surface of the proximal cuff is provided with a
VELCRO.RTM. hook patch 135 secured, e.g., glued, thereon that is
arranged to be brought into engagement the plush exterior surface
of the foam pad 115.
As shown in FIG. 7, the polycentric hinges 70 are also padded on
the inside surface by a durable non-allergenic foam pad 120. The
padded cuff and hinges are positioned to absorb anterior or frontal
impacts, as well as lateral impacts to the outside of the leg and
medial impacts to the inside of the leg.
Referring now to FIGS. 1, 6 and 7, the cuff strap 75 provides
releasable securement of the proximal cuff 60 to the wearer's thigh
30. The cuff strap 75 may be formed of any suitable flexible
material, e.g., nylon, and includes an elastic segment 77,
VELCRO.RTM. loop segments 76 secured to the inner and outer
surfaces thereof by any suitable means, e.g., sewing. The cuff
strap 75 also includes VELCRO.RTM. hook segment 125 disposed at the
free ends thereof. The free ends of the cuff strap 75 are slipped
through and looped around elongated slots 130 located on opposite
sides of the proximal cuff 60. Each free end of the cuff strap 75
is then folded back onto itself so that the hook segment 125
releasably engages the loop segment 76 thereby permitting the strap
75 to be tightened or loosened for comfort. The cuff strap 80
provides releasable securement of the distal cuff 65 to the
wearer's leg below the knee 40 in a similar manner.
Referring now to FIGS. 1, 5 and 7, the medial and lateral depending
portions 90 and 95 of the proximal cuff 60 each include a
vertically oriented elongated slot 140. As best shown in FIG. 7, a
strap guide assembly 145a is slidably mounted within the elongated
slot 140 located on the lateral depending portion 95. Likewise, as
best shown in FIG. 5, a strap guide assembly 145b is slidably
mounted within the elongated slot 140 located on the medial
depending portion 90 of the proximal cuff 60.
Referring now to FIGS. 3 and 4, the strap guide assembly 145a shown
therein includes a ring portion 146 trapped within a bracket
portion 148. The bracket portion 148 is disposed over the outside
surface of the lateral depending portion 95 of the proximal cuff
60. The strap guide assembly 145a also includes a flange portion
149 disposed on the inside surface of the lateral depending portion
95 of the cuff. The bracket 148 and flange 149 portions of the
strap guide assembly 145a are held together and slidably mounted to
the slot 140 by means of a rivet assembly 147 that enables the
strap guide assembly 145a to slidably move within the slot 140
between two extremes: a distal extreme, as shown in FIG. 1 and a
proximal extreme, as shown in FIG. 7.
Referring again to FIG. 3, an elastic band 160, e.g., a rubber
band, is anchored at one of its ends to the flange 149 by any
suitable means, e.g., tying. At its opposite end, the elastic band
160 is anchored to the inside surface of the lateral depending
portion 95 of the proximal cuff 60 by any suitable means, e.g.,
rivet 166. In this manner, the elastic band 160 serves as a means
for normally biasing the strap guide assembly 145a to the proximal
extreme within the vertically oriented slot 140 as shown in FIG.
7.
As best shown in FIG. 5, the strap guide assembly 145b is slidably
mounted within the elongated slot 140 located on the medial
depending portion 90 of the proximal cuff 60. The strap guide
assembly 145b is similar in construction to the strap guide
assembly 145a and includes a ring portion 165 trapped within a
bracket portion 170 disposed over the outside surface of the medial
depending portion 90 of the proximal cuff 60. The strap guide
assembly 145b also includes a flange portion 175, the bracket and
flange portions, 170 and 175, respectively, being held together and
slidably mounted to the slot 140 by means of a rivet assembly 180
to enable the strap guide assembly 145b to slidably move between
distal and proximal extremes. An elastic band 185, e.g., a rubber
band, is anchored at one of its ends to the flange 175 by any
suitable means, e.g., tying. At its opposite end, the elastic band
185 is anchored to the inside surface of the medial depending
portion 90 of the proximal cuff 60 by any suitable means, e.g.,
rivet 190. In this manner, the elastic band 185 serves as a means
to normally bias the strap guide assembly 145b to the proximal
extreme within the vertically oriented slot 140 as shown in FIG.
5.
Referring now to FIGS. 1, 5 and 7, the prosthetic sleeve 55 is
provided to assist in the attachment of the cross strap 50 and may
be constructed of any suitable material, e.g., one-eighth inch
thick neoprene having a brushed nylon outer surface and a smooth
neoprene inner surface. The sleeve 55 is shown as being arranged to
be wrapped around and secure to the wearer's leg portion just below
the knee 40. An alternative sleeve, such as a full patella support
sleeve which wraps around and secures to the wearer's thigh and
calf, both above and below the wearer's knee could be utilized in
substitution for the sleeve 55 in accordance with this invention.
As best shown in FIG. 7, the sleeve 55 is provided with a laterally
extending attachment strap 191 on which a VELCRO.RTM. hook segment
is disposed. As best shown in FIG. 5, once the sleeve 55 is wrapped
around the wearer's calf just below the knee 35, the hook segment
on the attachment strap 191 releasably engages the plush outer
surface of the sleeve 55 thereby permitting the sleeve 55 to be
tightened or loosened for comfort.
Referring now to FIG. 7, the cross-strap 50 is formed of a
non-elastic flexible web using any suitable material, e.g., nylon,
and comprises an interior surface (best shown in FIGS. 2 and 7), an
exterior surface (best shown in FIG. 2) and free ends to which
VELCRO.RTM. hook patches 200 and 205 are secured. As best shown in
FIGS. 2 and 7, VELCRO.RTM. loop segments 206 are secured to both
the interior and exterior surfaces of the cross-strap 50 by any
suitable means, e.g., sewing. Positioned on the interior surface of
the cross-strap 50 approximately midway along the length thereof is
a VELCRO.RTM. hook patch 195 arranged for releasable securement
with the plush exterior surface of the sleeve 55 at a position on
the sleeve 55 that lies over the wearer's tibia just below the
wearer's knee 35. The positioning of the hook patch 195 on the
outer surface of the sleeve 55 is best illustrated in FIG. 1 and by
the dotted line 199 in FIG. 7. The cross-strap 50 is also provided
with a pad 59 slidably mounted thereon to be positioned behind the
wearer's knee when the cross-strap is secured to the wearer's leg
in the manner described below.
Referring now to FIGS. 1 and 5, once the hook patch 195 cross strap
50 is releasably secured to the sleeve 55 in the manner described
above, the proximal and distal cuffs 60 and 65 of the bracing
component 45 are releasably secured to the wearer's thigh 30 and
leg portion below the knee 40 by attachment with straps 75 and 80.
As best shown in FIG. 2, a VELCRO.RTM. hook patch 209 is secured,
e.g., glued, to the inside surface of the distal cuff 65 and is
provided to engage with the plush exterior surface of the sleeve 55
thus providing an added means for securing the distal cuff 65 to
the wearer's leg portion below the knee 40.
Thereafter, the free ends of the cross-strap 50 are crossed behind
the wearer's knee 35 and slipped through and looped around the ring
portions 146 and 165 of the pivotally mounted strap guide
assemblies 145a and 145b. Each free end of the cross-strap 50 is
then folded back onto itself so that the hook patches 200 and 205
releasably engage the loop segments 206 of the cross-strap 50
thereby permitting the cross-strap 50 to be tightened or loosened
for comfort. The slidable pad 59 may be positioned behind the
wearer's knee to suit the user's comfort. In accordance with this
invention, when releasably securing the free ends of the
cross-strap to the strap guide assemblies 145a and 145b, the wearer
must maintain his or her knee in approximately thirty degrees of
flexion. Moreover, the cross-strap must be applied to fit snugly
around the wearer's knee but not so tightly as to be
uncomfortable.
During use of the knee brace assembly 20, when the wearer's leg is
fully flexed, the quadriceps muscle exerts only a relatively slight
anterior displacement force on the tibia. This displacement force
increases significantly as the wearer extends his or her leg closer
and closer toward the fully extended position. It can be readily
seen that when wearing the brace 20, as the wearer begins to extend
his or her leg 25 towards full extension, the cross-strap 50
tightens geometrically around the wearer's knee 35 above and below
the joint line and also applies posteriorly directed pressure to
the anterior portion of the wearer's tibia just below the knee. The
posteriorly directed pressure exerted against the tibia by the
cross-strap 50 restrains anterior translation of the tibia.
At this juncture, it is important to point out that anterior tibial
translation can result from a number of causes other than
displacement forces created by the quadriceps muscle. For example,
anterior tibial translation can result from force exerted against
the tibia when the wearer is engaged in physical activity that
involves sudden turning to the left or right, sudden stopping,
jumping and running backwards. The posteriorly directed pressure
exerted against the tibia by the cross-strap 50 will restrain
anterior translation of the tibia during such physical
activity.
At the same time, the cross-strap 50 applies a tensile force upon
the strap guide assemblies 145a and 145b urging them to move from
their normally biased proximal extreme to their distal extreme. As
the strap guide assemblies move towards the distal extreme, the
elastic bands 160, 185 will stretch and exert a counteractive
tensile force upon the strap guide assemblies resistive to their
distal movement. The movement of the strap guide assemblies enables
the wearer to straighten his or her leg into full extension while
applying increasing amounts of pressure to the wearer's tibia just
below the knee.
Referring now to FIGS. 8 and 14, there is shown at 300 a second
embodiment of the dynamic orthopedic knee brace assembly of the
present invention. As best shown in FIG. 14, the knee brace
assembly 300 shown therein comprises three basic parts: a bracing
component 305, a cross-strap 310 and a sleeve 315. The knee brace
assembly 300 functions to counteract anterior shifting of the tibia
that can occur during physical activities that involve sudden
turning to the right or left, sudden stopping, jumping or running
backwards when the anterior cruciate ligament in the illustrated
leg is missing or damaged.
As best shown in FIGS. 8 and 14, the bracing component 305
comprises a pair of elongated rigid thigh support members 320 and
325 extending along medial and lateral sides of the thigh,
respectively, and a pair of elongated rigid lower leg support
members 330 and 335 extending along the medial and lateral sides of
the wearer's leg portion below the knee, respectively. The inner
ends of the thigh and lower leg support pairs are pivotally
interconnected by means of a pair of polycentric hinges 340. The
thigh support members 320, 325, lower leg support members 330, 335
and polycentric hinges 340 are made of any suitable lightweight
material, e.g., carbon fiber filament, thermosensitive carbon
composite materials. Preferably, these components are fabricated
from a material that is water resistant and non-corrosive to enable
the wearer to use the knee brace assembly in a full range of
activities including working, walking, and vigorous athletics. The
polycentric hinges 340 are padded on the inside surface by a
durable non-allergenic foam pad 345.
As best shown in FIGS. 8 and 14, the support members are releasably
secured to the wearer's leg (not shown) above and below the knee by
means of straps shown generally at 350, 352, 355, 360, 362, 365 and
367. Referring now to FIG. 9, a top view of the knee brace assembly
300 is shown therein illustrating the manner in which the straps
350 and 352 releasably secure the rigid thigh support members 320
and 325 to the wearer's thigh. The straps 350 and 352, shown
therein, each include a VELCRO.RTM. hook segment 351 disposed at
each end thereof. One end of the strap 350 is slipped through and
looped around an elongated slot 375 located in the thigh support
member 320 while the other end of the strap 350 is slipped through
and looped around an elongated slot 380 located in the thigh
support member 325. One end of the strap 352 is slipped through and
looped around an elongated slot 385 located in the lateral thigh
support member 320 while the other end of the strap 352 is slipped
through and looped around an elongated slot 390 located in the
medial thigh support member 325. Each end of the straps 350 and 352
is then folded back onto itself so that the hook segments 351
releasably engage VELCRO.RTM. loop segments secured, e.g., sewn, to
the outer surface of the straps 350 and 352 thereby permitting the
straps 350 and 352 to be tightened or loosened for comfort.
Referring now to FIGS. 8 and 14, the strap 355 slips through and
loops around elongated slots 381 and 386 and releasably engages to
itself in the manner in which strap 350 and 352 releasably
engage.
Referring now to FIG. 8, straps 355, 360, 362, 365 and 367
releasably secure the rigid lower leg support members 330 and 335
to the wearer's leg portion below the knee in a manner similar to
that described above in connection with releasable attachment of
the rigid thigh support members to the wearer's thigh using straps
350, 352 and 355.
Referring now to FIGS. 8 and 14, the rigid thigh support member 320
includes a vertically oriented elongated slot 395 in which a strap
guide assembly 400 is slidably mounted. Similarly, the rigid thigh
support member 325 includes a vertically oriented elongated slot
396 in which a strap guide assembly 405 is slidably mounted. The
strap guide assemblies 400 and 405 each include a ring portion 410
trapped within a bracket portion 415. As best shown in FIGS. 10 and
11, the bracket portion 415 of each strap guide assembly 400 and
405 is disposed over the outside surface of the thigh support
members 320 and 325. As best shown in FIGS. 8 and 13, each strap
guide assembly 400 and 405 also includes a leaf spring 420 disposed
on the inside surface of the thigh support members 320 and 325. As
best shown in FIGS. 11 and 14, the bracket portion 415 and one end
of the leaf spring portion 420 of the strap guide assemblies 400
and 405 are secured together and mounted on opposite sides of the
elongated slots 395 and 396 by means of a rivet assembly 425 that
enables the strap guide assemblies 400 and 405 to slidably move
within the slots 395 and 396 between two extremes: a distal
extreme, as shown in FIGS. 8 and 13, and a proximal extreme (not
shown).
Referring now to FIGS. 13 and 14, as previously mentioned, one end
of the leaf spring 420 is secured to the strap guide assemblies 400
and 405 by means of a rivet 425. At its other end, the leaf springs
420 is anchored to the inside surface of the rigid thigh support
members 320 and 325 by means of a rivet assembly 430. In this
manner, the leaf spring 420 serves as a means for normally biasing
the strap guide assemblies 400 and 405 to the proximal extreme
within the vertically oriented slots 395 and 396, respectively. At
this juncture it is important to point out that rather than a leaf
spring, alternative means could be employed for biasing the strap
guide assemblies towards the proximal extreme, e.g., a coiled
spring, an elastic band, a rubber band, etc.
Referring now to FIGS. 8 and 14, the prosthetic sleeve 315 is
provided to assist in the attachment of the cross-strap 310 and may
be constructed of any suitable material, e.g., one-eighth inch
thick neoprene having a plush outer surface and a smooth neoprene
inner surface. The sleeve 315 shown is a full patella support
sleeve which wraps around and secures to the wearer's thigh and
calf above and below the wearer's knee. As best shown in FIG. 14,
the sleeve 315 is provided with a laterally extending attachment
strap 316 on which a VELCRO.RTM. hook segment is disposed. The
sleeve 315 also provides a patella opening 317 through which the
knee can protrude when the sleeve 315 is worn. Once the sleeve 315
is wrapped around the wearer's leg, the attachment strap 316
releasably engages the plush outer surface of the sleeve 315 to be
tightened or loosened for comfort.
The cross-strap 310 is formed of a non-elastic flexible web using
any suitable material, e.g., nylon, and comprises free ends, an
interior surface, shown in FIG. 14 and an exterior surface, hidden
from view in FIG. 14. The interior surface comprises VELCRO.RTM.
loop segments 440 secured thereto by any suitable means, e.g.,
sewing, and a centrally located VELCRO.RTM. hook patch 435 also
secured thereto by any suitable means, e.g., sewing. The hook patch
435 is arranged for releasable securement with the plush exterior
surface of the sleeve 315 just below the patella opening 317 of the
sleeve 315. This position, as best illustrated by the dotted line
399 in FIG. 14, corresponds with the wearer's tibia. The exterior
surface of the cross-strap 310 comprises VELCRO.RTM. hook patches
445 at the free ends thereof and a VELCRO.RTM. loop segment (not
shown) extending therebetween. The cross-strap 310 is also provided
with a pad 359 slidably mounted thereon to be positioned behind the
wearer's knee when the cross-strap 310 is releasably secured to the
wearer's leg.
Once the cross-strap 310 is releasably secured to the sleeve 315 at
the location described above and illustrated in FIG. 14, i.e., just
below the patella opening 317, the bracing component 305 is
releasably secured to the wearer's thigh and leg portion below the
knee using straps 350, 352, 355, 360, 362, 365 and 367. Thereafter,
the free ends of the cross-strap 310 are crossed behind the
wearer's knee and slipped through and looped around the ring
portions 410 of the pivotally mounted strap guide assemblies 400
and 405. Each free end of the cross-strap 310 is then folded back
onto itself so that the hook patches 445 releasably engage the loop
segment secured thereby permitting the cross-strap 310 to be
tightened or loosened for comfort.
During use of the knee brace assembly 300, when the wearer's leg is
fully flexed, the quadriceps muscle exerts only a relatively slight
anterior displacement force on the tibia. This displacement force
increases significantly as the wearer extends his or her leg closer
an closer toward the fully extended position. It can be readily
seen that when wearing the brace 300, as the wearer begins to
extend his or her leg towards full extension, the cross-strap 310
tightens geometrically around the wearer's knee above and below the
joint line and also applies posteriorly directed pressure to the
anterior portion of the wearer's tibia just below the knee. This
posteriorly directed pressure exerted against the tibia by the
cross-strap 310 restrains anterior translation of the tibia.
At this juncture, it is important to point out that anterior tibial
translation can result from a number of causes other than
displacement forces created by the quadriceps muscle. For example,
anterior tibial translation can result from force exerted against
the tibia when the wearer is engaged in physical activity that
involves sudden turning to the left or right, sudden stopping,
jumping and running backwards. The posteriorly directed pressure
exerted against the tibia by the cross-strap 310 will restrain
anterior translation of the tibia during such physical
activity.
At the same time, the cross-strap 310 applies a tensile force upon
the strap guide assemblies 400 and 405 urging them to move from
their normally biased proximal extreme to their distal extreme. As
best shown in FIG. 13, as the strap guide assemblies move towards
the distal extreme, the leaf springs 420 will compress and exert a
counteractive tensile force upon the strap guide assemblies
resistive to their distal movement. The movement of the strap guide
assemblies enables the wearer to straighten his or her leg into
full extension while exerting additional counteractive force to
prevent anterior translation of the tibia.
* * * * *