Abstract:
A double upright knee brace for treating knee flexion contracture includes upper and lower sections, each section having a pair of leg members and an anteriorly disposed integral thigh and shin cuff. A pair of hinges is intermediately positioned to the upper and lower sections. Notches formed in the upper and lower sections provide a catch for a pair of elastic bands, one each deployed on opposed sides of the knee brace, which provide a gait swing assist mechanism for the brace. A multitude of adjustable straps are deployed on both the anterior and posterior sides of the brace. A pair of air bladders, one deployed posteriorly below the knee and one deployed anteriorly above the knee, provide posterior-anterior mobilization when a patient wears the brace, stands up and ambulates. A pair of inner air bladders mounted on inner surfaces of the hinges stabilizes the knee joint.

Description:
FIELD OF THE INVENTION 
     This invention relates to orthotic devices in the treatment of joint flexion contractures. In particular, it relates to a knee brace for the treatment of knee joint flexion contracture wherein the knee brace employs air bladders employed at specific locations such that the knee brace can be used while the patient is standing upright and ambulating to provide posterior-anterior mobilization. 
     BACKGROUND OF THE INVENTION 
     Orthotic devices and appliances are well known in the prior art for treating a multitude of inflictions in the joints of human patients. The typical joints treated are the wrists, elbows, shoulders, hips, ankles and knees. All types of inflictions can be treated with various known orthotic devices in all of these critical joints. The inflictions include traumatic injury by blunt force, arthritis, abnormal contracture due to stroke, infections in the bones and surrounding tissue, deterioration through old age, excessive use and a myriad of other known medical conditions. All of these inflictions have things in common. They all result in moderate to severe pain in the stricken joint and the inability for the joint to flex and extend without proper treatment and medical intervention. And even in the case of treatment, of which is currently used in the prior art, it still does not return the patient to anywhere near a normal life. Further, the lack of proper flexion and extension inevitably leads to a bevy of secondary problems, such as loss of muscle strength surrounding the stricken joint and lack of use of the stricken joint. In the case of the hips, ankles and knees, many times the patient cannot walk. Or, if the ability to walk still exists, it is done with an improper gait, many times with the use of walker and usually with excruciating pain, which is then typically treated with strong and addictive pain medication therapy. 
     Nowhere are these problems more prevalent than with the knee joint, and in particular the inability for the leg with the inflicted knee joint to properly extend after it has contracted (“a flexion deformity”) due to whatever infliction has been experienced by the patient. This is known has “knee flexion contracture” or the inability for the patient to fully straighten or extend the knee. Normal active range of motion of the knee for a healthy person is 0° extension and 140° flexion. Patients having a flexion deformity, either one or both of them (extension and flexion) are reduced, sometimes severally. Normally, this occurs as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the inflicted knee joint. 
     Prior art devices and methods of treatment (i.e., physical therapy), best used in tandem, do exist to treat knee flexion contracture, but such devices and methods are typically used while the patient lies on bed or sits in a chair. The devices typically employ casting of the knee to employ a custom made brace to affect stretching of the knee flexors. Pressure is applied, just as is done in physical therapy (“PT”) when the brace is not employed, by utilizing strapping to affect posterior-anterior mobilization. Or in other words, pressure is applied on top of the thigh (anterior) downward and upon the back of the calf (posterior) upward with strapping while attempting to flex the knee and straighten the leg. These same exercises can be done when not employing the brace by the hands of a physical therapist. However, as stated above, both the known knee braces and the PT are done while the patient lies in bed or sits in a chair. Nowhere in the prior art does a knee brace or other orthotic device exist, which permits the patient to apply posterior-anterior mobilization while the patient stands up, let along while he ambulates. 
     Accordingly, an improved knee brace is clearly needed to affect posterior-anterior mobilization, which does not regulate the patient to a bed or chair during treatment. Such improved knee brace could be used with continued PT, but would not necessarily be required since the improved knee brace would imitate the PT while the patient ambulates. 
     Such an improved knee brace would have increased benefits since if the patient is ambulating, then he is also strengthening his muscles above, around and below the knee joint, something that is thought impossible to achieve while employing known flexion contracture knee braces in conjunction with physical therapy. 
     SUMMARY OF THE INVENTION 
     We have invented an improved knee brace for treating knee flexion contractures, which overcomes all of the deficiencies seen in the prior art. Our improved knee brace not only stabilizes an inflicted knee joint, which can not fully extend, but it also provides for posterior-anterior mobilization and permits the patient to wear the brace while he ambulates, thereby permitting him to strengthen his muscles above, around and below the knee joint all the while treating his flexion contracture. And the use of such improved knee brace increases the recovering time of persons inflicted with knee flexion contracture over those devices and methods of treatment known in the prior art. 
     Our knee brace employs a double upright design wherein distinct upper and lower sections are separately attached by a pair of polycentric hinges at lower and upper ends, respectively, of the upper and lower sections. The upper and lower sections each have an integrally formed anteriorly disposed thigh and shin cuff portion, respectively. A multitude of anteriorly and posteriorly disposed adjustable and quick release strapping is employed along the upper and lower sections. A pair of adjustable air bladders is releasably attached along inner surfaces of the hinges. At least one elastic band, on each side of the knee brace, is attached at opposed ends to the lower and upper ends of the upper and lower sections and is align within a groove formed in outer side edges of the hinges for providing a gait swing assist mechanism. The hinges have a multitude of holes formed therein for providing varying degrees and/or ranges of flexion and extension by the use of adjustable stop members. 
     An anteriorly disposed elongated adjustable air bladder is positioned along inner surfaces of upper section anterior strapping and a posteriorly disposed elongated adjustable air bladder is positioned along inner surfaces of lower section posterior strapping for providing posterior-anterior mobilization when a patient employs the knee brace, stands up and ambulates. 
     Based upon the unique design of the knee brace briefly summarized directly above, our knee brace allows the patient to wear it as he ambulates and adjust the amount of pressure of each air bladder according to need. He can therefore treat knee flexion contracture as he simultaneously strengthens his surrounding muscles and all the while ambulating and correcting his gait with a goal of achieving proper heel to toe placement during ambulation. 
     It is therefore a first aspect of the present to provide an orthotic device for treating joint flexion contracture. 
     It is a second aspect of the present invention to provide a knee brace for treating knee flexion contracture. 
     It is third aspect of the present invention to provide a double upright knee brace having upper and lower sections separately attached by a pair of hinges. 
     It is a fourth aspect of the present invention to provide a gait swing assist mechanism attached along the hinges of the knee brace to assist in ambulation and the extension of the leg and knee joint after flexion. 
     It is a fifth aspect of the present invention to provide for posterior-anterior mobilization while the patient ambulates through the use of air bladders positioned upon the thigh above the knee and behind the calf below the knee. 
     Many more advantages over the prior art will be evident after considering the Brief Description of the Drawings and the Detailed Description of the Preferred Embodiment set forth herein directly below. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The detailed description of the invention, contained herein below, may be better understood when accompanied by a brief description of the drawings, wherein: 
         FIG. 1  is a front perspective view of the orthotic device of the present invention in a non-flexed (relaxed) position; 
         FIG. 2  is a rear perspective view of the orthotic device of the present invention in a non-flexed (relaxed) position; 
         FIG. 3  is a front perspective view of the orthotic device of the present invention in a flexed (tensioned) position; 
         FIG. 4  is a rear perspective view of the orthotic device of the present invention in a flexed (tensioned) position; and 
         FIG. 5  is a close-up view of the lower section illustrating a quick release mechanism employed on the of multitude of straps of the orthotic device of the present invention when it is in an open or “unsnapped” position and also illustrating how the upper and lower air bladders are attached to the inner surfaces of the upper and lower bladder plates, respectively. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Throughout the following detailed description, the same reference numerals refer to the same elements in all figures. 
     Referring to  FIGS. 1 and 2 , an orthotic device for treating knee flexion contractures (also known as a “knee brace”)  10  is shown. Knee brace  10  has upper and lower double upright sections,  12  and  14 , respectively. Separating upper and lower sections  12  and  14  are a pair of hinges  16 . Although unicentric hinges  16  can be employed with knee brace  10  of the present invention, in the preferred embodiment, polycentric hinges are used as shown in  FIGS. 1 and 2 . 
     With continuing reference to  FIGS. 1 and 2 , each hinge  16  has a series of holes  22  formed there through which are used to control, set and/or limit a range of motion of a patient&#39;s knee when knee brace  10  is employed on a patient. To set the range of motion, upper and lower adjustable stop members,  18  and  20  respectively, are used in the series of holes  22 . 
     With reference now to just  FIG. 1 , knee brace upper section  12  has an anterior thigh cuff  24  intermediately positioned the double uprights of upper section  12 . Anterior thigh cuff  24  can be attached to the upper section  12  double uprights by any known attachment mechanism. However, in the preferred embodiment, thigh cuff  24  is integrally formed with upper section  12  such that upper section  12  and thigh cuff  24  are one continuous piece of dynamically conformable plastic. Likewise, knee brace lower section  14  has an anterior shin cuff  26  intermediately positioned the double uprights of lower section  12 . Anterior shin thigh cuff  26  can also be attached to the lower section  12  double uprights by any known attachment mechanism. However again, in the preferred embodiment, shin cuff  26  is integrally formed with lower section  14  such that lower section  12  and shin cuff  26  are one continuous piece of dynamically conformable plastic. 
     With reference to both  FIGS. 1 and 2 , upper section  12  has a pair of upwardly extending notches  28  formed in a lower end  32  of each double upright of upper section  12  on opposed sides of knee brace  10 . Likewise, lower section  14  has a pair of downwardly extending notches  30  formed in an upper end  34  of each double upright of lower section on opposed sides of knee brace  10 . One or more elastic bands  36  are attached to upwardly extending notches  28  and downwardly extending notches  30  in upper and lower sections,  12  and  14  respectively, at opposed ends of elastic band or bands  36 . As shown  FIGS. 1 and 2 , only one elastic band  36  is employed. However, more than one, preferably two elastic bands  36 , can be deployed to provide more resistance and gait swing assist to knee brace  10  when a patient using knee brace  10  flex his or her knee and/or ambulates. Elastic band or bands  36  lay within grooves  37  formed along an outer circumferential edge of each hinge  16 . 
     Still referring to both  FIGS. 1 and 2 , an inner pad  38  is removeably attached to an inner surface  39  of upper section  12 . Likewise, an inner pad  40  is removeably attached to an inner surface  41  of lower section  14 . Both inner pads  38  and  40  are used to provide a more comfortable fit to the patient and also work to prevent brace migration when the patient using knee brace  10  ambulates. In a preferred embodiment, hook and loop material is employed. However, other known materials and/or devices can be employed to make inner pads  38  and  40  removeably attachable. 
     With reference to  FIG. 2 , a posteriorly positioned upper thigh strap  42  attaches at opposed ends to back edges of upper section  12  where the double uprights meet the rear of the thigh cuff  24 . Posteriorly positioned upper thigh strap  42  in conjunction with anteriorly positioned thigh cuff  24 , provide a complete circular attachment around the entire circumference of a patient&#39;s thigh when knee brace  10  is employed on the leg of the patient. Still further, a pair of posteriorly positioned middle thigh straps  44 , positioned below posteriorly positioned upper thigh strap  42 , attach at opposed ends to a lateral back edge of the double uprights of upper section  12 . Straps  42  and  44  all deploy a quick release snap mechanism  60 , which permit straps  42  and  44  to be easily removed and reattached without any special technical skill. Still further, straps  42  and  44  all employ hook and loop material which provides for easy adjustability. Finally, as to straps  44 , although not required, in the preferred embodiment, each are provided with removeably attachable comfort pad  62  made of a soft and pliable material that is pleasing to the touch of human skin. Comfort pads  60  also assist in preventing brace migration when knee brace  10  is employed on a patient&#39;s leg. 
     With continuing reference to  FIG. 2 , a posteriorly positioned lower calf strap  46  attaches at opposed ends to back edges of lower section  14  where the double uprights meet the rear of the shin cuff  26 . A posteriorly positioned middle calf strap  48  also attaches at opposed ends to back edges of lower section  14  near the upper end  34 . Posteriorly positioned lower and middle calf straps,  46  and  48  respectively, in conjunction with anteriorly positioned shin cuff  26 , provide a complete circular attachment around the entire circumference of a patient&#39;s calf and shin when knee brace  10  is employed on the leg of the patient. Straps  46  and  48  both deploy the quick release snap mechanism  60 , which permit straps  46  and  48  to be easily removed and reattached without any special technical skill. Still further, straps  46  and  48  both employ hook and loop material which provides for easy adjustability. 
     Referring now to  FIG. 1 , a pair of anteriorly positioned thigh straps  56  attached at opposed ends thereof to front edges of the double uprights of upper section  12 , below thigh cuff  24 . Straps  56  also deploy quick release snap mechanism  60  at their opposed ends, which permit straps  56  to be easily removed and reattached. An anteriorly positioned middle shin strap  58  attaches, at opposed ends, to a front edge of upper end  34 , of lower section  14 . Again, quick release snap mechanisms  60  are deployed at both ends of strap  58 . Also, a comfort pad  62  is removeably attached to an inner surface of strap  58  and provides the same functions as those comfort pads deployed on straps  44 . 
     Referring to both  FIGS. 1 and 2 , a pair of air bladders  50  is removeably attached to inner surfaces  52  of hinges  16 . In the preferred embodiment, hook and loop material is used to attach air bladders  50  to inner surfaces  52  of hinges  16 , although other materials can be employed in alternate embodiments. A pair of inflation/deflation apertures  54  is formed in the lower end  32  of the double uprights of upper section  12  and which is in direct communication with a tube of each air bladder  50 . Air bladders  50  are positioned on knee brace  10  such that they can be inflated and deflated to apply the necessary pressure to the outer surfaces of each knee of the patient using knee brace  10 . They accordingly stabilize the knee when the knee brace  10  is being used and also assist in preventing brace migration while the patient ambulates. 
     Referring to  FIG. 1 , an upper bladder plate  70  removeably attaches to inner surfaces of the pair of anteriorly positioned thigh straps  56 . An elongated anteriorly positioned upper air bladder  64  then removeably attaches to an inner surface of upper bladder plate  70 . In the preferred embodiment, hook and loop material is again used, although other known materials have like properties can be employed that allow for upper bladder plate  70  and upper air bladder  64  to be easily removed and repositioned. 
     Referring to  FIG. 2 , a lower bladder plate  72  removeably attaches to inner surfaces of posteriorly positioned lower and middle calf straps,  46  and  48  respectively. An elongated posteriorly positioned lower air bladder  66  then removeably attaches to an inner surface of lower bladder plate  72 . In the preferred embodiment, hook and loop material is again used, although other known materials have like properties can be employed that allow for lower bladder plate  72  and lower air bladder  66  to be easily removed and repositioned. 
     Referring to both  FIGS. 1 and 2 , up and outwardly extending inflation/deflation nozzles  68  are provided on both upper and lower air bladders  64  and  66 , extending, in a preferred embodiment, through apertures formed in both upper and lower bladder plates,  70  and  72 , at a  45  degree angle. The apertures formed in upper and lower plate plates,  70  and  72 , are positioned near top middle edges thereof, respectively. 
     As shown in  FIGS. 1 and 2 , both upper and lower bladder plates,  70  and  72 , have a slight convex shape which assists knee brace  10 , along with the pressure being applied by upper and lower air bladders,  64  and  66 , to apply the proper posterior-anterior mobilization to the patient while he or she ambulates. Further, the hinge  16  and elastic bands  36  provide the necessary gait swing assistance mechanism to the patient as he or she flexes and then contracts the leg during ambulation. Proper fitting of the knee brace  10  for each patient is realized through adjustment of all the straps,  42 ,  44 ,  46 ,  48 ,  56  and  58 , proper inflation of air bladders  50  located on the inner surfaces of the hinges  16  and the upper and lower air bladders  64  and  66 . 
     Referring to  FIGS. 3 and 4 , both figures show knee brace  10  in its flexed and tensioned position, whereby  FIGS. 1 and 2  show knee brace  10  in its contracted and relaxed position. However, regardless of whether knee brace  10  is in its flexed or contracted position, upper and lower air bladders,  64  and  66 , are always applying posterior-anterior mobilization to the patient wearing knee brace  10 . 
     Referring to  FIG. 5 , lover section  14  is shown and illustrates how straps  46  and  48  can unsnap quickly and easily through the use of quick release snap mechanisms  60 . Although all not shown in  FIG. 5 , all of the straps  42 ,  44 ,  46 ,  48 ,  56  and  58  are manipulated this way. 
     Equivalent elements described hereinabove can be substituted for the ones set forth herein to achieve the same results in the same manner and in the same way.