|Publication number||USRE37209 E1|
|Application number||US 08/406,772|
|Publication date||Jun 5, 2001|
|Filing date||Mar 16, 1995|
|Priority date||Oct 21, 1988|
|Publication number||08406772, 406772, US RE37209 E1, US RE37209E1, US-E1-RE37209, USRE37209 E1, USRE37209E1|
|Inventors||David Ellis Hensley, Bradley Russell Kielman|
|Original Assignee||David Ellis Hensley, Bradley Russell Kielman|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (20), Referenced by (47), Classifications (4), Legal Events (3)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application is a continuation of U.S. Ser. No. 08/243,554 filed May 16, 1994 (now abandoned), which is a reissue of U.S. Ser. No. 08/099,249 filed Jul. 29, 1993 (now abandoned), which is a continuation of U.S. Ser. No. 07/959,452 filed Oct. 8, 1992 (now abandoned), which is a continuation of U.S. Ser. No. 07/444,782 filed Dec. 1, 1989 (now abandoned), which is a reissue of U.S. Ser. No. 07/260,943 filed Oct. 21, 1988 and issued as U.S. Pat. No. 4,865,024.
This invention relates to orthosis orthoses for the prevention or rehabilitation of joint injuries. It relates to an orthotic fulcrum, and for point design particularly to decelerate in one direction eliminating instability and motion problems with respect to joint extension, hyperextension, or flexion.
Just as there are many indications for orthotic management of knee and elbow joints so are there many varieties of braces for the leg and arm. Joint extension in physically active individuals, such as athletes, or in people having joint injuries, can introduce instability and the risk of injury or further injury due to the increased angular limb velocities associated with their activities or relative to their disability. Joint flexion in these people can also place severe energy and fatigue costs on their quadriceps or triceps muscles. While prior art braces include desirable features for providing extension stability, for limiting hyperextension and for providing flexion mobility, they have the kinds of problems described below.
Means for limiting hyperextension, such as pins abuting edges, co-engaging recesses and shoulders, and stops near the fulcrum to limit angular motion, themselves provide the fulcrum about which accelerating and extending limbs can rotate into injurious hyperextension. In other words, the braces themselves can do harm. Free motion braces have similar problems. Friction control arrangements, while slowing limb extension, have the disadvantage of requiring force to overcome the designed-in friction forces when the limb is flexed, a disadvantage to athletes needing quick reaction and to patients needing to conserve energy stores and avoid undue fatigue. Also, stops, pins, edges, shoulders and like tend to add undesirable weight to a brace, increasing fatigue, slowing motion, and adding discomfort. Finally, the kinds of features described in the prior art for extension/flexion stability/mobility generally are uniquely built into the knee or elbow brace design and are thus neither economically adaptable to a wide variety of other braces nor easily adjustable to wearer, medical or athletic needs.
The foregoing problems suggest the following minimal design criteria for an orthotic device providing extension stability, limiting hyperextension, and providing flexion mobility:
1. Should automatically decelerate the angular velocity of the limb during the last fifteen to twenty degrees of design motion prior to contact with any stop, pin, shoulder or similar stopping means.
2. Should not slow the speed of ranging of the joint other than as specified in 1 above.
3. Should be lightweight.
4. Should be economically adaptable to a wide range of braces.
5. Should be economical of manufacture and assembly.
6. Should be adjustable with respect to the range of motion within which it operates.
7. Should be adjustable with respect to the forces expected to be encountered by the limb, as conditioned by the user's activity level, state of health, weight, and usage environment, e.g., playing surface as in the case of athletics.
It is the object of this invention to meet the foregoing design requirements with features which solve the problems heretofore described, which also renders it a vast improvement on it's its original merits over the prior art.
An orthotic device with a particularly designed fulcrum point which limits hyperextension, provides extension stability, and facilitates flexion mobility is provided. The device includes adjustable and adaptable spring rods attached near brace fulcrum points(s) with a novel post and pivot arrangement, as depicted in the drawings. As the hinge is rotated toward the fully extended position, i.e., so that the arms form an angle of 180 degrees with each other, twin posts engage the spring rods to cause deceleration of the angular motion.
One embodiment includes conventional upper and lower rigid elongated arms with geared ends and integral stop stops for limiting rotation beyond 180 degrees, together with means for linking the arms adjacently and for rotating the arms in the same plane about a pivot or pivot points. An assembly of plates, spacers, bushings and screws is provided to secure the arms and to insure they rotate in the same plane. The assembly is designed both to permit the arms to be locked in any position during manufacture, while fitting the orthotic fulcrum assembly to an orthosis, and also to permit free motion of the arms during usage so that the speed of motion of the ranging of the joint is not reduced or impaired. In one embodiment a lightweight spring rod is serpentinely assembled to the orthotic fulcrum's outer connecting plate by means of friction reduction roller posts and central pivot screw. Placement of the roller posts controls the point during limb extension when the spring rod is activated, with roller post positioning being determined during manufacture by the needs of the user with respect to limitation of the range of motion, the point at which deceleration of limb angular motion is required and the like. Since the spring rod mechanically dampens the rate of angular motion of the hinge, adjustment of the rate of deceleration is controlled by adjusting the material or cross-sectional area of the spring rod to change the force required. Adjustment of the point at which deceleration starts is controlled by the variable placement of the roller posts so as to engage the spring rod sooner or later during the extension process. As shown in the drawings, the spring assembly can be easily adapted to a variety of different hinges and braces.
These and other features and benefits of this invention will be obvious from the drawings and disclosure which follow.
FIG. 1 is a perspective view of an extension deceleration orthotic hinge according to the principles of this invention: ;
FIG. 2 is a front elevation view taken on line 2—2 of FIG. 1:;
FIG. 3 is a side elevation view taken on line 3—3 of FIG. 2:;
FIG. 4 is a fragmentary perspective view showing how the spring rod, roller posts, and pivot screw assembly is are adapted to a centric, single axis hinge: ; and
FIG. 5 is a complete overview of the Extension Deceleration Orthosis labeling extension deceleration orthosis showing individual components of the orthosis.
An orthotic fulcrum 10 according to principles of this orthosis invention includes an elongated, rigid, thin, flat lower bar 11 and an elongated, rigid, thin, flat upper bar 12. The bars are also called arms in the art. These arms, which should be of equal thickness, lie in the same plane and engage each other adjacently by means of gear teeth on each of their ends at 12a ( see FIG. 3 ) in the polycentric orthotic fulcrum design. The polycentric orthotic fulcrum is known in the art. The arms are connected by rigid, inner plate 13 on the inside of the orthotic fulcrum and rigid, outer plate 14 on the outside of the orthotic fulcrum point so as to overlap the arms arms' engaged gear teeth. The arms and plates are fastened together by screws 15 and 16. These screws pass thru fulcrm point bushings 17 and 18 and fit into threaded holes in inner plate 13.
The orthotic fulcrum bushings 17 and 18 serve as pivot points for the orthotic fulcrum assembly. The length of hinge bushings 17 and 18 should be slightly shorter than the combined thickness of either arm plus the outer plate 14, since such design permits locking of the orthotic fulcrum in any position to facilitate manufacture, assembly and fitting into a large assembly, such as, an orthosis. When assembled for use the screws 15 and 16 are adjusted so as to permit the fulcrum point 10 to move freely over its range of motion, and then lock screw 19, which is positioned to simultaneously clamp a shoulder on each of screws 15 and 16, is tightened into a threaded hole in outer plate 14 so as to prevent screws 15 and 16 from turning.
Stops are provided on the geared ends of arms 11 and 12 so as to limit their range of motion. In order to prevent hyperextension of the limb, which can be caused when the angularly moving arms strike the stops, a deceleration means is provided, which is the principle principal improvement in the art, as described below.
Post 20 passes through friction reduction roller 21 and into a variabley variably placed threaded hole in the upper arm 12, to which it is tightened and adjusted so as to allow the roller 21 to turn freely. Post 22 passes through friction reduction roller 23 and into a variably placed hole in lower arm 11, to which it is tightened and adjusted so as to allow the roller 23 to turn freely. Pivot screw 24 passes through friction reduction roller 25 and is tightened into a threaded hole in outer plate 14, which hole is centered between assembled screws 15 and 16 on a line tangential to the adjacent pitch diameters of the gears on the ends of the assembled arms 11 and 12. A spring steel wire is formed serpentinely to make spring rod 26, which is assembled to fit around pivot screw 24 and roller 25. A shoulder on pivot screw 24 acts as a retainer to hold spring rod 26 against outer plate 14 and against the edges of screws 15 and 16. Spring rod 26 is curved to fit around screws 15 and 16 and is curved conversely to fit around friction reduction roller posts 20 and 22. The ends of spring rod 26 contact rollers 21 and 23 during extension of the orthotic fulcrum, resulting in deceleration of the angular velocity of the orthotic fulcrum and parts. The material and cross-sectional area of spring rod 26 can be varied to suit differences in the user's activity level and state of health and to suit required rates of deceleration of the angular motion of the hinge. The angle of curvature of spring rod 26 can be varied to adjust the point when deceleration occurs, which is a function of when rollers 21 and 23 first contact spring rod 26during orthotic extension.
Upright arms 12 are attached to each other by means of a thin metal band 27, varying in thickness, width and length, each determined by requirements of individual appendage size, usually one-half the circumference of the appendage at the same length proximal to the fulcrum point. The means of fastening is rivets 40 drilled and pinned through both arm 12 and band 27. Band 28 is fastened to medial and laterial lower arms 11 in the same method as band 27is fastened to the upper arms 12. Together with the arms 11 and 12, bands 27 and 28 make up the skeletal structure of the orthosis. Proximal circumference strap 29 encapsulates the appendage to the orthosis along with the distal circumference strap 30. These straps are compressive and hold the appendage firmly inside the orthosis. This is achieved by fastening strap 29 to a band 27 at one end by permanent fixation to interface or pad 39 and removable fastener 31 to fixed fastener 32 at the other end for circumferential wrap. The same is true for the attachment of strap 30 to band 28.
Two more prehension straps are used to encapsulate the appendage and they are the patella straps 33 and 36. Strap 33 is attached to pad 39 and arm 12 by nylon thread on one end and 34to truss clip 34on the other. Truss clip 34 is attached to member 35 with nylon thread in a reinforce stitch pattern completing the encapsulation of the knee, and also providing suspension. Member 35 is a pelite thermo pad that acts as an attachment point for patella strap 33 and strap 36. Strap 36 attaches to pad 38 in the same way patella strap 33 attaches to pad 39. 37 strap Strap 37is an anti-rotation strap and runs up through the orthosis and around the medial or lateral or both sides of the knee in a spiraling wrap attaching to the 27 band 27with the origin of the 28 band , this28. This resists rotary forces at the fulcrum point of the orthosis when applied to a flexing and extending appendage.
Although this invention has been described in the context of an orthotic device, it should be understood that is it also has application to any orthotic fulcrum contrivance, such as an orthotic power assisted arm, where it is desirable to decelerate the angular momentum of the orthotics fulcrum motion before a stop is contacted or before any restraining devices are excessively stretched.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US817785||Feb 23, 1906||Apr 17, 1906||Charles E Kritsch||Joint for artificial limbs.|
|US1072369||Apr 26, 1913||Sep 2, 1913||Knee and ankle brace.|
|US4320747||Oct 6, 1980||Mar 23, 1982||Daniell Jr Roy B||Slidably-coupled joint|
|US4337764||Mar 2, 1981||Jul 6, 1982||United States Manufacturing Company||Adjustable motion brace|
|US4361142||Aug 20, 1981||Nov 30, 1982||Northwestern University||Knee orthosis and joint construction therefor|
|US4370977||May 4, 1981||Feb 1, 1983||Kenneth D. Driver||Knee and elbow brace|
|US4372298||Jul 20, 1981||Feb 8, 1983||U.S. Manufacturing Co.||Knee brace|
|US4428369||Jul 20, 1981||Jan 31, 1984||Arthur C. Peckham||Corrective and protective knee brace|
|US4433679||Sep 29, 1982||Feb 28, 1984||Mauldin Donald M||Knee and elbow brace|
|US4487200||Apr 25, 1983||Dec 11, 1984||Medical Designs, Inc.||Brace for knee|
|US4489718||Mar 8, 1983||Dec 25, 1984||Medical Designs, Inc.||Knee brace hinge|
|US4503846||Jul 6, 1983||Mar 12, 1985||Medical Designs, Inc.||Derotation leg brace|
|US4506661||Apr 21, 1983||Mar 26, 1985||Foster Dean J||Balanced suspension knee brace|
|US4524764||Sep 6, 1983||Jun 25, 1985||Miller Harold E||Knee brace|
|US4751920||Jan 20, 1987||Jun 21, 1988||3D Orthopedic, Inc.||Pivoting knee brace with rotating and translating tibia collar|
|US4803975||Mar 31, 1987||Feb 14, 1989||Meyers Andrew H||Orthotic device for controlling knee instabilities|
|DE304059C||Title not available|
|GB2098490A||Title not available|
|PL37574A||Title not available|
|WO1984000264A1||Jun 29, 1983||Jan 19, 1984||Alex Ivachev||A subscriber video-tv system|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US7192407||Jan 30, 2003||Mar 20, 2007||Djo, Llc||Motion controlling hinge for orthopedic brace|
|US7235058 *||Sep 11, 2002||Jun 26, 2007||Djo, Llc||Lockable hinge|
|US7367958||Apr 19, 2007||May 6, 2008||Massachusetts Institute Of Technology||Method of using powered orthotic device|
|US7396337||Nov 21, 2003||Jul 8, 2008||Massachusetts Institute Of Technology||Powered orthotic device|
|US7534217||Feb 14, 2007||May 19, 2009||Djo, Llc||Motion controlling hinge for orthopedic brace|
|US7544174||Sep 29, 2006||Jun 9, 2009||Djo, Llc||Quiet flexion/extension stop for orthopedic brace and orthopedic brace incorporating a quiet flexion/extension stop|
|US7553289||Feb 20, 2007||Jun 30, 2009||Gregory Cadichon||Method, apparatus, and system for bracing a knee|
|US7597022 *||May 9, 2006||Oct 6, 2009||Dura Global Technologies, Inc.||Easy release mechanism at park position for automatic transmission shifter|
|US7722555 *||Jun 26, 2007||May 25, 2010||Djo, Llc||Lockable hinge|
|US7811242||Jun 20, 2005||Oct 12, 2010||Djo, Llc||Motion controlling hinge for orthopedic brace|
|US7846115||Apr 10, 2009||Dec 7, 2010||Djo, Llc||Motion controlling hinge for orthopedic brace|
|US7967765||Nov 10, 2004||Jun 28, 2011||Djo, Llc||Orthopedic brace suspension system|
|US8308669 *||May 20, 2009||Nov 13, 2012||Nace Richard A||Knee orthosis with hinged shin and thigh cuff|
|US8308671||Aug 28, 2008||Nov 13, 2012||Nace Richard A||Knee orthosis|
|US8585620||Mar 18, 2009||Nov 19, 2013||Myomo, Inc.||Powered orthotic device and method of using same|
|US8926534||Sep 19, 2007||Jan 6, 2015||Myomo, Inc.||Powered orthotic device and method of using same|
|US8945035||Oct 10, 2012||Feb 3, 2015||Richard A. Nace||Knee brace with improved gait swing assist|
|US9089403 *||Oct 10, 2012||Jul 28, 2015||Medical Alliance Sa||Knee orthosis with hinged shin and thigh cuffs|
|US9125730||Oct 31, 2012||Sep 8, 2015||Ossur Hf||Orthopedic device for dynamically treating the knee|
|US9186270||Apr 19, 2012||Nov 17, 2015||The United States Of America As Represented By The Secretary Of The Army||Dynamic exoskeletal orthosis|
|US9220624||Sep 14, 2011||Dec 29, 2015||Ossur Hf||Posterior cruciate ligament support brace|
|US9254216||Jul 24, 2012||Feb 9, 2016||Farhad M. Limonadi||Method and apparatus for limiting range of motion of the body of the user|
|US9289640 *||Dec 3, 2013||Mar 22, 2016||Steven M. Cersonsky||Resistance brace|
|US9351864||Jan 27, 2014||May 31, 2016||Ossur Hf||Orthopedic device having a dynamic control system|
|US9398994||Nov 15, 2013||Jul 26, 2016||Myomo, Inc.||Powered orthotic device and method of using same|
|US9539135||Jul 17, 2014||Jan 10, 2017||Ossur Hf||Orthopedic device having a dynamic control system and method for using the same|
|US9597786||Aug 20, 2014||Mar 21, 2017||Ossur Hf||Torque limiting tool and method for using the same|
|US20030051470 *||Sep 13, 2002||Mar 20, 2003||David Maddock||Control system for hydraulic equipment attachments|
|US20040049140 *||Sep 11, 2002||Mar 11, 2004||Doty Alexis E.||Lockable Hinge|
|US20040153015 *||Jan 30, 2003||Aug 5, 2004||Scott Seligman||Motion controlling hinge for orthopedic brace|
|US20050148918 *||Nov 10, 2004||Jul 7, 2005||Nathanson Jeremy J.||Orthopedic brace suspension system|
|US20060009722 *||Jun 20, 2005||Jan 12, 2006||Scott Seligman||Motion controlling hinge for orthopedic brace|
|US20070135745 *||Feb 14, 2007||Jun 14, 2007||Scott Seligman||Motion controlling hinge for orthopedic brace|
|US20070191743 *||Apr 19, 2007||Aug 16, 2007||Massachusetts Institute Of Technology||Method of Using Powered Orthotic Device|
|US20070261510 *||May 9, 2006||Nov 15, 2007||Wang Yong Q||Easy Release Mechanism at Park Position for Automatic Transmission Shifter|
|US20080071386 *||Sep 19, 2007||Mar 20, 2008||Myomo, Inc.||Powered Orthotic Device and Method of Using Same|
|US20080077065 *||Jun 26, 2007||Mar 27, 2008||Djo, Llc||Lockable hinge|
|US20090227925 *||Mar 18, 2009||Sep 10, 2009||Mcbean John M||Powered Orthotic Device and Method of Using Same|
|US20090292229 *||May 20, 2009||Nov 26, 2009||Nace Richard A||Knee orthosis with hinged shin and thigh cuff|
|US20100056970 *||Aug 28, 2008||Mar 4, 2010||Nace Richard A||Knee orthosis|
|US20110065553 *||Mar 23, 2009||Mar 17, 2011||Cersonsky Steven M||Body Mounted Muscular Brace|
|US20130041300 *||Oct 10, 2012||Feb 14, 2013||Richard A. Nace||Knee Orthosis with Hinged Shin and Thigh Cuffs|
|US20130165833 *||Feb 22, 2013||Jun 27, 2013||The Government Of The United States As Represented By The Secretary Of The Army||Dynamic Exoskeletal Orthosis|
|US20140094351 *||Dec 3, 2013||Apr 3, 2014||Steven M. Cersonsky||Resistance Brace|
|US20150290010 *||Jun 24, 2015||Oct 15, 2015||Medical Alliance, S.A.||Knee Orthosis for Treatment of PCL Injury|
|EP2345393A1||Jun 21, 2005||Jul 20, 2011||Djo, Llc||Motion controlling hinge for orthopaedic brace|
|WO2016210121A1 *||Jun 23, 2016||Dec 29, 2016||The Regents Of The University Of California||Passive power-conservative artificial knee|
|Sep 15, 2003||FPAY||Fee payment|
Year of fee payment: 12
|Sep 15, 2003||SULP||Surcharge for late payment|
|Sep 29, 2003||PRDP||Patent reinstated due to the acceptance of a late maintenance fee|
Effective date: 20010605